Responding to domestic violence in primary care : we know more about what works but questions remain

This commissioned editorial examines what we know about responding to domestic violence in primary care in the light of the recent publication of findings from the first randomised controlled trial in the United Kingdom on domestic violence.

What themes trigger investigative interviewers to ask specific questions when interviewing children?

Recent research has established that investigative interviewers have difficulty adhering to openended questions and instead ask specific questions when interviewing children about abuse. The current study aims to examine the themes in abuse-related interviews that trigger investigators to ask specific questions. Twenty police officers who were authorised to conduct investigative interviews with children completed a mock interview with an expert in child abuse interviewing who had been trained to play the role of an abused child. During the interview, the officers were stopped by a researcher and asked to reflect on why they had asked specific questions. Overall, the results revealed five areas where the officers deviated from open-ended questions. These related to: (1) the identity of the alleged offender; (2) the meaning of terms used by the child to describe genitals; (3) whether or not penetration occurred; (4) the offender's intent and motives; and (5) the timing of the abuse and where it occurred. Each of these themes is discussed, along with the implications for trainers and researchers in child abuse interviewing.

Problem gambling and family violence : family member reports of prevalence, family impacts and family coping

There exists only a small number of empirical studies investigating the patterns of family violence in problem gambling populations, although some evidence exists that intimate partner violence and child abuse are among the most severe interpersonal correlates of problem gambling. The current article reports on the Australian arm of a large-scale study of the patterns and prevalence of co-occurrence of family violence and problem gambling in Australia, New Zealand and Hong Kong. The current study screened 120 help-seeking family members of problem gamblers in a range of clinical services for both family violence and problem gambling. The main results showed that 52.5% reported some form of family violence in the past 12 months: 20.0% reported only victimisation, 10.8% reported only perpetration and 21.6% reported both victimisation and perpetration of family violence. Parents, current and ex-partners were most likely to be both perpetrators and victims of family violence. There were no gender differences in reciprocal violence but females were more likely to be only victims and less likely to report no violence in comparison to males. Most of the 32 participants interviewed in depth, reported that gambling generally preceded family violence. The findings suggest that perpetration of family violence was more likely to occur as a reaction to deeply-rooted and accumulated anger and mistrust whereas victimisation was an outcome of gambler’s anger brought on by immediate gambling losses and frustration. While multiple and intertwined negative family impacts were likely to occur in the presence of family violence, gambling-related coping strategies were not associated with the presence or absence of family violence. The implications of the findings for service providers are discussed.

Deficient cognitive control fuels children's exuberant false allegations.

In eyewitness studies as in actual investigations, a minority of children generate numerous false (and sometimes incredulous) allegations. To explore the characteristics of these children, we reinterviewed and administered a battery of tasks to 61 children (ages 4-9 years) who had previously participated in an eyewitness study where a man broke a "germ rule" twice when he tried to touch them. Performance on utilization, response conflict (Luria tapping), and theory of mind tasks predicted the number of false reports of touching (with age and time since the event controlled) and correctly classified 90.16% of the children as typical witnesses or exuberant (more than 3) false reporters. Results of a factor analysis pointed to a common process underlying performance on these tasks that accounted for 49% of the variability in false reports. Relations between task performance and testimony confirmed that the mechanisms underlying occasional intrusions are different from those that drive persistent confabulation and that deficient cognitive control fuels young children's exuberant false reports.

The effects of e-simulation interview training on teachers' use of open-ended questions.

Teachers in many parts of the world are mandated reporters of child abuse and maltreatment but very little is known concerning how they question children in suspicious circumstances. Teachers (n=36), who had previously participated in a mock interview scenario designed to characterize their baseline use of various question-types when attempting to elicit sensitive information from children, were given online training in choosing effective questions. They engaged in simulated interviews with a virtual avatar several times in one week and then participated in a mock interview scenario. The amount and proportion of open-ended questions they used increased dramatically after training. The overall number of questions, and amount and proportions of specific and leading questions decreased. In particular, large decreases were observed in more risky yes-no and other forced-choice questions. Given that most teachers may feel the need to ask a child about an ambiguous situation at some point during their careers it is worthwhile to incorporate practice asking effective questions into their training, and the present research suggests that an e-learning format is effective. Additionally, effective questions encourage the development of narrative competence, and we discuss how teachers might include open-ended questions during regular classroom learning.

The Maltreatment-Offending Association: a systematic review of the methodological features of prospective and longitudinal studies

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.

Guidelines for teachers to elicit detailed and accurate narrative accounts from children

This paper provides interview strategies for teachers who talk to children about serious events, including bullying, truancy, and suspected maltreatment. With regard to the latter, teachers are among the largest group of professionals reporting child abuse, but also tend to evince low substantiation rates. We review research on best practice interviewing, with a focus on its application in school settings. Interview phases are described chronologically, with interview excerpts included for illustrative purposes. Gaps in knowledge about the appropriateness of techniques are highlighted, and recommendations for future research specifically within the school setting are made. It is proposed that teachers receive basic training in best practice interviewing so that, when required, they can confidently ask about difficulties in children's lives while minimizing the potential for contamination of children's responses.

An abominable crime: filicide in the context of parental separation and divorce

The victims of filicide in the context of parental separation and divorce have recently been identified as the largest group among all filicide victims in Australia. Nevertheless, research into this group of victims has been sparse, fragmentary and contradictory, with the consequence that confusion has prevailed. This article critically reflects on the existing research on filicide and argues that it has been insufficiently comprehensive and reliable and, therefore, is not suitable for use as a knowledge base for professional individuals, programmatic and policy interventions, and prevention. The article suggests ways of developing more reliable research for knowledge building and details the data developed so far that underpins their recommendations for a national programme of research.

What reading and writing trauma fiction illuminates about post-traumatic growth.

Angelina Mirabito's PhD in Creative Writing investigated the therapeutic value of reading and writing trauma fiction. Her findings show that it is possible for adult survivors of complex trauma to experience post-traumatic growth from writing an adult survivor of childhood trauma coming of age story.

Examining interview techniques to assist children’s recall of repeated events.

This thesis tested interview techniques expected to assist children reporting on repeated events, such as ongoing abuse. The quality and quantity of information children provided was improved by several techniques that rehearsed children in key cognitive tasks. Developmental trends were found whereby techniques often assisted older children more than younger children.

The assessment of motivation for behaviour change among sex offenders against children: an investigation of the utility of the Stages of Change Questionnaire

A better understanding of motivation for behaviour change among sex offenders against children would improve treatment programmes designed to modify sexual offending behaviour. However, investigation of this issue is limited by lack of theoretically and empirically sound measures of motivation for behaviour change among sex offenders. This paper reports on two studies that were conducted to investigate the psychometric properties (validity, reliability, and social desirability) of the Stages of Change Questionnaire, adapted to measure motivation for behaviour change among sex offenders against children. In Study 1, the psychometric properties of the questionnaire were assessed for sex offenders against children (n=36) who were on a treatment waiting list. In Study 2, the psychometric properties of the questionnaire were assessed for sex offenders against children (n=47) at pre-treatment, mid-treatment, and post-treatment. Both studies supported the validity and reliability of the adapted Stages of Change Questionnaire, and the influence of social desirability upon responding was less than expected. The results of this investigation supported the potential utility of the Stages of Change Questionnaire as a measure of motivation for behaviour change for sex offenders against children.

The relationship between child sexual abuse and academic achievement in a sample of adolescent psychiatric inpatients

Objectives:
To examine the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. Individual factors expected to influence this relationship were measured to explore the way they each interacted with sexual abuse and its relationship to academic achievement.

Method:
Eighty-one adolescent psychiatric inpatients participated in the study (aged 12–18 years: M = 16.0). Participants were administered tests of academic achievement (dependent variable) and intelligence, and completed a number of self-report measures of their experience of different types of maltreatment, their perception of the parenting they received, socio-economic status, substance abuse, and psychopathology.

Results:
Hierarchical regression analysis revealed that intelligence was the main predictor of academic achievement (uniquely explaining 26% of the variance). A number of interaction effects were also significant indicating that intelligence, substance abuse, internalizing behavior problems, externalizing behavior problems all influenced the relationship between sexual abuse and academic achievement.

Female-perpetrated child sex abuse: definitional and categorisational analysis

A recent series of court cases in Australia in which teachers have been convicted of sexual crimes against children and adolescents has brought to attention the fact that females are capable of, and do commit, such crimes. However, the nature of the crimes does not reflect the range of sexually abusive behaviours females may perpetrate, nor the kinds of women who may engage in such behaviour. We consider definitional problems in identifying female-perpetrated sexual abuse, and note that apart from one attempt to describe the range of sexual abuse perpetrated by mothers, there is little to guide researchers or clinicians in relation to female perpetrated offences more generally. We then consider approaches to categorising female sex offenders, and conclude that, although there a several such approaches that overlap in some ways, a multidimensional approach that combines aspects of each taxonomy may be more useful.

Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health

Issue addressed: Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems.
Methods: Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance
abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES.
Results: Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use.
Conclusion: Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.