Multi-type maltreatment : relationships between familial characteristics, maltreatment and adjustment of children and adults

This thesis examines the nature, extent and impact of multiple forms of maltreatment (multi-type maltreatment) from within a developmental victimological framework. The interrelationships between sexual abuse, physical abuse, psychological maltreatment, neglect, and witnessing family violence are assessed. The role of family variables in predicting maltreatment and the relative contribution of child maltreatment and family variables to adjustment are evaluated. Risk factors for multi-type maltreatment, and the relationship between multi-type maltreatment and adjustment are explored. The major theories of child development are reviewed. As well as exploring the relevance of developmental theories to understanding the impact of child maltreatment, factors influencing the emergence of child psychopathology are reviewed from a developmental psychopathology perspective. Ecological and developmental perspectives on how child maltreatment translates into the behavioural and emotional adjustment problems of children are integrated in the Child Maltreatment: Risk and Protection Model. After exploring some of the relevant conceptual issues, the literature on the prevalence and impact of each maltreatment type is reviewed, and the literature on multi-type maltreatment critiqued. Methodological and ethical concerns with the conduct of research in the field of child maltreatment using direct assessment of children led to the need for an instrument to assess parent perceptions of each of the types of abuse and neglect, as well as adult retrospective reports. Data are presented from two cross-sectional questionnaire-based studies using the Parent and Adult versions of the Family and Life Experiences Questionnaire which was designed to assess perceptions of children's experiences of sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence. Problems with the isolated focus of research on single forms of child maltreatment are addressed by the inclusion of each of these forms of child maltreatment within a single research design. Respondents for both studies were volunteers recruited from counselling agencies, medical, community health, child care and fitness centres and a first year psychology course. Parents (N=50) described their perceptions of primary school children's family characteristics, experiences of maltreatment and adjustment. Children's behavioural adjustment (internalising and externalising), sexual behaviours, emotions, self-esteem, gender identity, family adaptability and cohesion, parental traditionality, parental sexual punitiveness, interparental relationship satisfaction, and demographic characteristics are assessed in the study of Parents' perceptions. A large degree of overlap between the different types of abuse and neglect was found, with a high proportion of parents describing children's experiences of multiple forms of child maltreatment. Using both maltreatment and family characteristics to predict internalising behaviour problems, neglect and family cohesion were the only unique predictors. Family adaptability and cohesion were the only unique predictors of externalising behaviour problems. Physical and sexual abuse were not predicted from family characteristics; neglect was predicted, but no variables provided unique prediction. Unique predictors of psychological maltreatment were family cohesion, parental sexual punitiveness and divorce. Divorce was the only variable with significant unique prediction of the child witnessing family violence. Family background and family functioning were found to predict some forms of maltreatment, but to also be important factors mediating the adjustment of children, independent of maltreatment. The results are interpreted within an ecological framework, integrating risk factors for maltreatment with experiences of abuse and neglect and subsequent adjustment in childhood. Retrospective reports of adults' (N=175) own childhood family characteristics, experiences of maltreatment, and reports of their current adjustment are also studied. Included with the adult version of the FLEQ were the Trauma Symptom Checklist-40, Rosenberg's Self-esteem Scale, and the Family and Adaptability and Cohesion Evaluation Scale-II. Similar results were found in the in the Adult Study. As hypothesised, adult retrospective reports of the five different types of child maltreatment were found to be highly intercorrelated. Family characteristics predicted maltreatment and adjustment scores and discriminated between single and multi-type maltreatment. Maltreatment scores also predicted adult adjustment. As the number of maltreatment types increased, there was an increase in the number of adjustment problems reported. Alternate hypotheses regarding the possible operation of mediating and moderating processes in the relationships between family characteristics, maltreatment and the adjustment of adults were assessed. Finally, the results of these investigations are discussed and interpreted in the light of extant findings previously reviewed. Data from the two major empirical studies are used to demonstrate the overlap between different child maltreatment categories, and the extent and impact of multi-type maltreatment. The results show that children are vulnerable to more than one type of maltreatment. Individuals who experience a number of different forms of maltreatment had greater adjustment problems than those experiencing only one or two different types of abuse or neglect. Dysfunctional families place children at risk of child maltreatment. Negative family characteristics lead to adjustment problems in children and adults. The type of maltreatment having the most damaging effect on children was neglect, and in the long-term, sexual abuse. A multi-dimensional approach to prevention and intervention needs to be adopted, based on the co-morbidity of maltreatment types, and the likelihood of children experiencing further abuse or neglect of a different type. Dysfunctional family dynamics which place children at risk of multi-type maltreatment, and mediate the effects of maltreatment on adjustment, need to be specifically targeted with support and family intervention strategies. Risk-assessment measures used by Child Protection workers must include adequate knowledge of the inter-relationships between maltreatment types, and the particularly negative impact on adjustment of experiencing many forms of abuse or neglect. Suggestions for future clinical and research work in the area of child maltreatment are developed. The importance of assessing all forms of maltreatment when examining the relationships of maltreatment to adjustment is emphasised. It is recommended that prevention and intervention strategies acknowledge the interrelationships between maltreatment types.

The impact of propensity evidence on juror decisions

The thesis's study evaluated the effect that the admission of an accused's prior criminal behaviour had on mock jurors' verdict decisions. The findings indicated that exposing participants to evidence about any previous offence biases the decision. Further, the greater the similarity of the previous offence with the present charge, the more likely the accused was found guilty. The clinical portfolio seeks to demonstrate through the presentation of four case studies, the various pathways (or offence trajectories) contained within the Pathways Model that may lead an adult male to sexually offend against a child.

Pathways to sex offending

The research of the thesis aimed to contribute to the theoretical understanding of the various pathways that offenders follow in committing sexual offences. Using grounded theory a theoretical model was generated which described four major pathways to sexual offending. Quantitative analyses revealed that offenders who take different pathways differ significantly in respect of their risk of recidivism, demographic variables, rape myth acceptance and aggression. The portfolio considered the limitations of sex offender treatment programs for treating sex offenders with histories of childhood sexual abuse and presented four case studies.

Colour of walls : incorporating the exegesis "Unfit for publication"

The thesis is presented in two parts: a novel and a theoretical essay. It is a broadly autobiographical work, concerning issues and events surrounding father-daughter rape. It is written from the mother's perspective, and deals with the impact of child sexual assault on the lives of two generations of working-class women.

Theory of planned behaviour and implementation intentions in dental attendance

The thesis used a model of health behaviour to examine the predictors of dental attendance. Older respondents who had strong intentions, low perceived vulnerability, stable plans to attend, and were influenced by significant others were more likely to have attended the dentist for preventive care in the last 12 months. The portfolio concludes that attachment theory is a useful conceptual framework for enhancing our understanding of the antecedents and consequences of childhood sexual abuse.

Shared parenting

The thesis addresses shared parenting, an arrangement which emphasises the equal responsibility of both parents for children after separation, which is often assumed to ameliorate the supposed negative effects of parental separation. This study found that from children's perspective, the most important consideration was not the type of family they lived in but rather the quality of their relationship with each parent that impacted on their emotional adjustment. The portfolio focuses on the challenge of dealing with allegations of child sexual abuse in the context of the Family Court. The comples issues involved in these types of cases are illustrated by four case studies.

Examination of the consistency of interviewer performance across three distinct interview contexts

The current study examined the consistency of investigative interviewers' performance (n=31) across three distinct interview paradigms: (a) a mock interview where an adult actor played the role of a child recalling abuse, (b) a mock interview where a school child recalled an innocuous event that was staged at the child's school, and (c) a field interview where the interviewer elicited a statement of abuse from a child. Performance was measured by calculating the proportion of open-ended and leading questions, and by eliciting expert ratings of the presence of a range of problem behaviours commonly exhibited by interviewers. Overall, the performance of individual interviewers was relatively stable across the tasks. Heterogeneity in stability, however, differed according to the type of question and the nature of the event being examined. In particular, the mock interview paradigm where the adult acted the role of an alleged child abuse victim produced a measure of performance that was more similar to the field interview than the interview where a school child recalled an innocuous event. The implications of the findings for trainers, and directions for future research, are discussed.

Implicit theories and personality patterns in child-victim sex offenders

Research has suggested that child sex offenders hold thematically distinct cognitive distortions, which Ward and Keenan (1999) call Implicit Theories. The aim of this preliminary study was to investigate the relationship between offenders’ Implicit Theories and their personality related cognitions. The variables were measured using the Implicit Theory Questionnaire and Millon’s (1990) MCMI-III personality scales. Subjects were 28 male sex offenders against children serving a custodial sentence in New Zealand, who elected to participate in a treatment program. A majority of participants had personality scale scores that reached the clinical threshold. Results found that dependant, depressive and schizoidal personality patterns significantly correlated with Implicit Theories. Clinical and theoretical implications are discussed.

Identification of five fundamental implicit theories underlying cognitive distortions in child abusers : a preliminary study

Qualitative analysis of interviews with 22 child abusers found strong evidence for Ward and Keenan's (1999) proposal that there are five implicit theories in child abusers that account for the majority of their cognitive distortions/thinking errors. These implicit theories are: Child as a sexual being where children are perceived as being able to and wanting to engage in sexual activity with adults and also are not be harmed by such sexual contact; Nature of harm where the offender perceives that sexual activity does not cause harm (and may in fact be beneficial) to the child; Entitlement where the child abuser perceives that he is superior and more important than others: and hence is able to have sex with whoever, and whenever, he wants; Dangerous world where the offender perceives that that others are abusive and rejecting and he must fight to regain control; and Uncontrollable where the offender perceives the world as uncontrollable and hence he believes that circumstances are outside of his control. There was no evidence for any other type of implicit theory. Results of the study also indicated that there was a significant difference in terms of the endorsement of the Dangerous world implicit theory between participants reporting a history of child sexual abuse and those who did not. Offenders against male victims were significantly more likely to endorse the Child as a sexual being and Dangerous world implicit theories compared to men who had offended against female children.

Back to basics : empirical support for the importance of release planning in reducing sex offender recidivism

This article reports findings from a series of empirical studies investigating whether poor release planning might contribute to sex offender recidivism. A coding protocol was developed to measure the comprehensiveness of release planning which included items relating to accommodation, employment, pro-social support, community based treatment, and the Good Lives Model (T. Ward & C.A. Stewart, 2003) secondary goods. The protocol was retrospectively applied to groups of recidivist and non recidivist child molesters, matched on static risk level and time since release. As predicted, overall release planning was significantly poorer for recidivists compared to non recidivists. The accommodation, employment, and social support items combined to best predict recidivism, with predictive accuracy comparable to that obtained using static risk models. Results highlighted the importance of release planning in efforts to reduce sex offender recidivism. Implications for policy makers and community members are briefly discussed.

COMT Val158Met and 5HTTLPR functional loci interact to predict anxiety across adolescence : results from the Victorian Adolescent Health Cohort Study (1992-2006)

We investigated whether a composite genetic factor, based on the combined actions of catechol-O-methyltransferase (COMT) (Val158Met) and serotonin transporter (5HTTLPR) (Long-Short) functional loci, has a greater capacity to predict persistence of anxiety across adolescence than either locus in isolation. Analyses were performed on DNA collected from 962 young Australians participating in an eight-wave longitudinal study of mental health and well-being (Victorian Adolescent Health Cohort Study). When the effects of each locus were examined separately, small dose–response reductions in the odds of reporting persisting generalized (free-floating) anxiety across adolescence were observed for the COMT Met158 [odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.76–0.95, P = 0.004] and 5HTTLPR Short alleles (OR = 0.88, CI = 0.79–0.99, P = 0.033). There was no evidence for a dose–response interaction effect between loci. However, there was a double-recessive interaction effect in which the odds of reporting persisting generalized anxiety were more than twofold reduced (OR = 0.45, CI = 0.29–0.70, P < 0.001) among carriers homozygous for both the COMT Met158 and the 5HTTLPR Short alleles (Met158Met + Short-Short) compared with the remaining cohort. The double-recessive effect remained after multivariate adjustment for a range of psychosocial predictors of anxiety. Exploratory stratified analyses suggested that genetic protection may be more pronounced under conditions of high stress (insecure attachments and sexual abuse), although strata differences did not reach statistical significance. By describing the interaction between genetic loci, it may be possible to describe composite genetic factors that have a more substantial impact on psychosocial development than individual loci alone, and in doing so, enhance understanding of the contribution of constitutional processes in mental health outcomes.

Brief report : maltreatment in childhood and body concerns in adulthood

Objective: We examined the relationship between maltreatment in childhood and body concerns in adulthood.

Method: A community sample of 156 women and 143 men completed measures of maltreatment – frequency of sexual abuse, physical abuse, physical neglect, emotional abuse and emotional neglect – in childhood. They also reported current dissatisfaction with body weight and shape and drive for thinness and drive for muscle.

Results and conclusions: Childhood maltreatment was associated with drive for muscle in women and body dissatisfaction and drive for thinness in men. The results provide some evidence that adverse conditions in childhood can be associated with gender-atypical body concerns in adulthood.

Oral language competence, young speakers and the Law

Purpose: This paper highlights the forensic implications of language impairment in 2 key (and overlapping) groups of young people: identified victims of maltreatment (abuse and/or neglect) and young offenders.

Method: Two lines of research pertaining to oral language competence and young people's interface with the law are considered: 1 regarding investigative interviewing with children as victims or witnesses in the context of serious allegations of sexual abuse, and the other pertaining to adolescent offenders as suspects, witnesses, or victims. The linguistic demands that forensic interviewing places on these young people are also considered. Literature concerning the impact of early maltreatment on early language acquisition is briefly reviewed, as is the role of theory of mind in relation to the requirements of investigative interviewing of children and adolescents.

Implications: High-risk young people (i.e., those who are subject to child protection orders because of suspected or confirmed maltreatment, and those who are engaged with the youth justice system) face an elevated risk for suboptimal language development but may need to draw on their language skills in high-stakes forensic interviews. Implications for early intervention policy and practice are identified, and the need for greater speech-language pathology advocacy and engagement in forensic interviewing research is emphasized.

A new child protection strategy for Aboriginal communities in Western Australia

Despite numerous government inquiries and reforms, child sexual abuse in remote Aboriginal communities is a well-documented, ongoing problem. Established in Western Australia in 2009, Operation RESET is a multi-agency proactive community engagement initiative designed to improve the ability of communities and supporting agencies to detect, respond to and prevent child sexual abuse through the implementation of community engagement, capacity building and educational strategies. This comment describes the three core principles of Operation RESET: tackling child sexual abuse requires a collaborative, proactive approach between government and communities; the underlying causes and context of child sexual abuse must be recognised; and children's overall safety and wellbeing must be enhanced through integrated services that strengthen and empower families and communities. It also enumerates the seven phases of the operation's implementation, from identifying target communities to deploying an exit strategy. The comment ends by addressing the importance of empirical evaluation.

Effect of type and severity of intimate partner violence on women's health and service use : findings from a primary care trial of women afraid of their partners

Intimate partner violence (IPV) has major affects on women’s wellbeing. There has been limited investigation of the association between type and severity of IPV and health outcomes. This article describes socio-demographic characteristics, experiences of abuse, health, safety, and use of services in women enrolled in the Women’s Evaluation of Abuse and Violence Care (WEAVE) project. We explored associations between type and severity of abuse and women’s health, quality of life, and help seeking. Women (aged 16–50 years) attending 52 Australian general practices, reporting fear of partners in last 12 months were mailed a survey between June 2008 and May 2010. Response rate was 70.5% (272/386). In the last 12 months, one third (33.0%) experienced Severe Combined Abuse, 26.2% Physical and Emotional Abuse, 26.6% Emotional Abuse and/or Harassment only, 2.7% Physical Abuse only and 12.4% scored negative on the Composite Abuse Scale. A total of 31.6% of participants reported poor or fair health and 67.9% poor social support. In the last year, one third had seen a psychologist (36.6%) or had 5 or more general practitioner visits (34.3%); 14.7% contacted IPV services; and 24.4% had made a safety plan. Compared to other abuse groups, women with Severe Combined Abuse had poor quality of life and mental health, despite using more medications, counseling, and IPV services and were more likely to have days out of role because of emotional issues. In summary, women who were fearful of partners in the last year, have poor mental health and quality of life, attend health care services frequently, and domestic violence services infrequently. Those women experiencing severe combined physical, emotional, and sexual abuse have poorer quality of life and mental health than women experiencing other abuse types. Health practitioners should take a history of type and severity of abuse for women with mental health issues to assist access to appropriate specialist support.