Showing papers on "Neglect published in 2004"
TL;DR: The study provides strong evidence that ACEs are interrelated rather than occurring independently, and collecting information about exposure to other ACEs is advisable for studies that focus on the consequences of a specific ACE.
1,408 citations
TL;DR: The results demonstrate that the right superior temporal cortex, the insula and subcortically putamen and caudate nucleus are the neural structures damaged significantly more often in patients with spatial neglect.
Abstract: A major challenge for any anatomical study of spatial neglect in neurological patients is that human lesions vary tremendously in extent and location between individuals. Approaches to this problem used in previous studies were to focus on subgroups of patients that are more homogeneous either with respect to the branch territory affected by the stroke or with respect to existing additional neurological symptoms (e.g. additional visual field defects). It could be argued that such strategies might bias the conclusions on the critical substrate associated with spatial neglect. The present study thus addressed the high variability inherent in naturally occurring lesions by using an unselected, but very large sample size and by comparing a neglect group with a non-neglect group using voxelwise statistical testing. We investigated an unselected 7 year sample of 140 consecutively admitted patients with right hemisphere strokes. Seventy-eight had spatial neglect, 62 did not show the disorder. The incidence of visual field defects was comparable in both groups. For assessing lesion location, in a first step, we used conventional lesion density plots together with subtraction analysis. Moreover, due to the large size of the sample voxelwise statistical testing was possible to objectively estimate which brain regions are more frequently compromised in neglect patients relative to patients without neglect. The results demonstrate that the right superior temporal cortex, the insula and subcortically putamen and caudate nucleus are the neural structures damaged significantly more often in patients with spatial neglect.
577 citations
TL;DR: The neglect syndrome per se, rather than overall stroke severity, predicts poor outcome in right hemisphere stroke.
Abstract: Objective: To assess the relative frequency of occurrence of motor, perceptual, peripersonal, and personal neglect subtypes, the association of neglect and other related deficits (e.g., deficient nonlateralized attention, anosognosia), and the neuroanatomic substrates of neglect in patients with right hemisphere stroke in rehabilitation settings. Methods: The authors assessed 166 rehabilitation inpatients and outpatients with right hemisphere stroke with measures of neglect and neglect subtypes, attention, motor and sensory function, functional disability, and family burden. Detailed lesion analyses were also performed. Results: Neglect was present in 48% of right hemisphere stroke patients. Patients with neglect had more motor impairment, sensory dysfunction, visual extinction, basic (nonlateralized) attention deficit, and anosognosia than did patients without neglect. Personal neglect occurred in 1% and peripersonal neglect in 27%, motor neglect in 17%, and perceptual neglect in 21%. Neglect severity predicted scores on the Functional Independence Measure and Family Burden Questionnaire more accurately than did number of lesioned regions. Conclusions: The neglect syndrome per se, rather than overall stroke severity, predicts poor outcome in right hemisphere stroke. Dissociations between tasks assessing neglect subtypes support the existence of these subtypes. Finally, neglect results from lesions at various loci within a distributed system mediating several aspects of attention and spatiomotor performance.
520 citations
TL;DR: These data are consistent with animal research that demonstrated reduced CC size in nursery-reared compared with semi-naturally reared primates and early experience might also affect the development of the human CC.
459 citations
TL;DR: As expected, borderline PD was more consistently associated with childhood abuse and neglect than other PD diagnoses, but even when controlling for the effect of borderline PD, otherPD diagnoses were associated with specific types of maltreatment.
Abstract: Adverse childhood experiences such as abuse and neglect are frequently implicated in the development of personality disorders (PDs); however, research on the childhood histories of most PD groups remains limited. In this multisite investigation, we assessed self-reported history of abuse and neglect experiences among 600 patients diagnosed with either a PD (borderline, schizotypal, avoidant, or obsessive-compulsive) or major depressive disorder without PD. Results indicate that rates of childhood maltreatment among individuals with PDs are generally high (73% reporting abuse; 82% reporting neglect). As expected, borderline PD was more consistently associated with childhood abuse and neglect than other PD diagnoses. However, even when controlling for the effect of borderline PD, other PD diagnoses were associated with specific types of maltreatment.
402 citations
TL;DR: Findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.
355 citations
TL;DR: Indicators of poverty, such as perceived material hardship and infrequent employment, and parenting characteristics,such as low parental warmth, use of physical discipline, and allowing a child to engage in frequent television viewing, are predictive of child neglect.
Abstract: A strong association between poverty and child neglect has been established, but the mechanisms that explain this relationship have not been clearly articulated. This research takes advantage of survey and child maltreatment administrative data about families with young children and assesses the influence of poverty and parenting characteristics on subsequent child neglect. The authors find that indicators of poverty, such as perceived material hardship and infrequent employment, and parenting characteristics, such as low parental warmth, use of physical discipline, and allowing a child to engage in frequent television viewing, are predictive of child neglect. Parenting characteristics do not appear to mediate the link between perceived hardship and neglect, although they suppress the link between employment and neglect. Results from this study provide information that is highly relevant to the approach and design of child maltreatment prevention and intervention strategies.
343 citations
TL;DR: It is confirmed that hemispatial neglect may occur with damage to several supratentorial structures but is most common and persistent with lesions of the right temporoparietal cortex.
Abstract: Objective To delineate the frequency, course, risk factors, and neuroanatomy of hemispatial neglect in a large stroke cohort. Methods One thousand two hundred eighty-one patients with acute stroke were enrolled in a multicenter trial of an anticoagulant. Presence and severity of neglect were assessed with the NIH Stroke Scale (NIHSS) neglect item, assessing tactile extinction and visuospatial neglect at entry, daily for 1 week, and at 3 months. Head CT scans were obtained on day 7, and infarct location and size were characterized. Results Neglect was common at presentation, occurring in 43% of right brain-lesioned (RBL) patients and 20% of left brain-lesioned (LBL) patients (p Conclusions This series confirms that hemispatial neglect may occur with damage to several supratentorial structures but is most common and persistent with lesions of the right temporoparietal cortex. Increasing age is associated with neglect, particularly after right brain lesions. Gender and handedness do not exert a marked effect on the likelihood of the occurrence of neglect.
327 citations
TL;DR: It is suggested that self-reported childhood trauma is associated with increased risk of a range of physical illnesses during adulthood.
Abstract: BACKGROUND: The goal of this investigation was to determine the association between self-reported childhood trauma and physical disorders among adults in the United States. METHOD: Data were drawn from the National Comorbidity Survey (N=5877). Multiple logistic regression analyses were used to determine the associations between childhood physical abuse, sexual abuse, and childhood neglect and the likelihood of specific physical disorders among adults. RESULTS: Childhood physical abuse, sexual abuse and neglect were associated with a statistically significantly increased risk of a wide range of physical illnesses during adulthood. After adjusting for demographic characteristics, lifetime anxiety and depressive disorders, alcohol and substance dependence, and all types of trauma: results showed that childhood physical abuse was associated with increased risk of lung disease (OR= 1.5 (1.1, 2.2)), peptic ulcer (OR= 1.5 (1.03, 2.2)) and arthritic disorders (OR= 1.5 (1.1, 2.2)); childhood sexual abuse was associated with increased risk of cardiac disease (OR = 3.7 (1.5, 9.4)); and childhood neglect was associated with increased risk of diabetes (OR=2 2 (1.1, 4.4)) and autoimmune disorders (OR =4.4 (1.7, 11.6)). CONCLUSIONS: Consistent with previous work, these results suggest that self-reported childhood trauma is associated with increased risk of a range of physical illnesses during adulthood. Future research that includes replication of these findings using prospectively assessed physical and mental disorders with objectively measured biological data using a longitudinal design, including other known risk factors for these diseases and more detailed information on specific forms of abuse, is needed to understand the potential mechanisms of these links. Language: en
319 citations
TL;DR: The most common forms of trauma for both men and women were physical abuse, physical neglect, and emotional abuse, all of which were highly likely to co-occur, and differential relationships with particular maltreatment types were observed.
316 citations
TL;DR: The HSP program did not prevent child abuse or promote use of nonviolent discipline; it had a modest impact in preventing neglect.
Journal Article•
TL;DR: This overview of the literature shows that individuals who suffer abuse, neglect, or serious family dysfunction as children are more likely to be depressed, to experience other types of psychiatric illness, to have more physical symptoms, and to engage in more health-risk behaviors than their nonabused counterparts.
Abstract: Childhood maltreatment strongly predicts poor psychiatric and physical health outcomes in adulthood. This overview of the literature shows that individuals who suffer abuse, neglect, or serious family dysfunction as children are more likely to be depressed, to experience other types of psychiatric illness, to have more physical symptoms (both medically explained and unexplained), and to engage in more health-risk behaviors than their nonabused counterparts. The more severe the abuse, the stronger the association with poor outcomes in adulthood. Childhood sexual abuse in particular has been repeatedly associated, in adulthood, with physical complaints such as chronic pain that are likewise associated with depression. Individuals with a history of childhood abuse, particularly sexual abuse, are more likely than individuals with no history of abuse to become high utilizers of medical care and emergency services. Childhood maltreatment is highly prevalent among both men and women, especially in specialty settings such as emergency psychiatric care.
TL;DR: The CTQ appears to be a valid measure of abuse and neglect in student samples, although experiences are somewhat differentially identified as different types of Abuse and neglect depending on age and patient versus nonpatient status.
TL;DR: Early research related to children's peer relationships was explored, followed by a discussion of the relative "neglect" of social withdrawal prior to the 1980s as discussed by the authors, and increased research attention since that time has provided a greater understanding of the causes, correlates, and consequences associated with "solitude".
Abstract: This commentary outlines the origins, history, and current status of research related to children's social withdrawal and social isolation. Early research related to children's peer relationships is first explored, followed by a discussion of the relative "neglect" of social withdrawal prior to the 1980s. Increased research attention since that time is briefly reviewed; this latter research has provided a greater understanding of the causes, correlates, and consequences associated with "solitude." In the latter half of this essay, the roles of biological factors and parenting are described. The essay closes with a discussion of future directions, including the exploration of risk and protective factors for socially withdrawn children, as well as the need for more research related to prevention and intervention.
TL;DR: Gender is important in evaluating potential psychiatric and physical correlates of childhood maltreatment, which is a potent risk factor for cardiovascular disease in women and for depression in both women and men.
Abstract: BACKGROUND: Traumatic experiences in childhood are linked to adult depression and cardiovascular disease. Depression is twice as common in women than men, and depression after cardiovascular events is more common in women than men. However, sex differences in these relationships have not been comprehensively investigated using a nationally representative sample in which demographic factors related to these illnesses can be controlled. METHOD: Data come from the Part 2 sample of the U.S. National Comorbidity Survey, a nationally representative sample containing over 5000 adults. Relationships between childhood maltreatment (sexual abuse, physical abuse, neglect), adult depression (DSM-III-R), and cardiovascular disease were examined using multiple logistic regression models with a specific emphasis on the evaluation of sex differences. RESULTS: Childhood maltreatment was associated with a significant increase in cardiovascular disease for women only and with a significant increase in lifetime depression for both genders. A history of childhood maltreatment removed the natural protection against cardiovascular disease for women and depression for men. Although depression and cardiovascular disease were correlated, depression did not contribute to the prediction of cardiovascular disease in women when controlling for history of childhood maltreatment. CONCLUSIONS: Gender is important in evaluating potential psychiatric and physical correlates of childhood maltreatment. Maltreatment is a potent risk factor for cardiovascular disease in women and for depression in both women and men. Effective clinical assessment should recognize the role of childhood abuse or neglect in adult health and disease. Research on the consequences of childhood maltreatment should focus on both psychiatric and physical outcomes. Language: en
TL;DR: A significant overall positive effect was found, pointing to the potential usefulness of early prevention programs for families with young children at risk for physical child abuse and neglect with mostly nonrandomized designs.
Abstract: In this article, a meta-analysis is presented on 40 evaluation studies of early prevention programs for families with young children at risk for physical child abuse and neglect with mostly nonrandomized designs. The main aim of all programs was to prevent physical child abuse and neglect by providing early family support. For the meta-analysis, a multilevel approach was used. A significant overall positive effect was found, pointing to the potential usefulness of these programs. The study demonstrated a significant decrease in the manifestation of abusive and neglectful acts and a significant risk reduction in factors such as child functioning, parent-child interaction, parent functioning, family functioning, and context characteristics.
TL;DR: The association of neurobehavior disinhibition in childhood and SUD by young adulthood suggests that a prefrontal cortex dysfunction contributes to SUD liability.
TL;DR: The current state of the foster care system is examined and it is found that it is really not a cohesive system but a combination of many overlapping and interacting agencies, all charged with providing services, financial support, or other assistance to children and their families.
Abstract: All children do best when they live in safe, stable, and nurturing families, yet far too many children lack this fundamental foundation. Every year, millions of children are abused or neglected--close to 300,000 so egregiously that they are removed from their homes by the state and placed in foster care. For too many of these children, foster care is no safe haven. Instead, the children drift from foster home to foster home, lingering in care while awaiting a permanent, "forever family." In 1998, The Future of Children examined the problem of child maltreatment and offered recommendations for preventing abuse and neglect. This journal issue focuses on the challenges of helping children after abuse and neglect has occurred by strengthening the web of supports for children and families in foster care. Public opinion polls reveal that the public is largely uninformed about foster care, yet highly critical of the system. In a 2003 poll of voters by the Pew Commission on Children in Foster Care, most respondents were generally unfamiliar with the child welfare system that administers foster care, but more than 50% believed it needed major changes, if not a complete overhaul. (1) These impressions are no doubt fueled by media accounts of tragic incidents, such as the death of 2-year-old Brianna Blackmond in Washington, D.C., two weeks after a judge returned her to her mother's custody without reviewing the child welfare agency's report recommending that she not be reunified; (2) or the inability of child welfare workers in Florida to find 5-year-old foster child Rilya Wilson and 500 others like her over the past decade; (3) or reports of Brian Jackson, a 19-year-old adopted foster youth in New Jersey who weighed only 45 pounds and was found rummaging through a garbage can for food because he and his brothers were apparently being starved by their adoptive parents. (4) Media reports of system failures are tragic, heartbreaking, and at times, chilling. In their wake, public calls to "do something" about foster care are made, and changes in organizational leadership, policy, and practice often follow. Yet policymaking in the aftermath of tragedy is often over reactive and piecemeal. Effecting enduring change requires a thoughtful understanding of the inherent challenges the child welfare system faces on a daily basis. As Judge Ernestine Gray states in her commentary in this journal issue, truly understanding the child welfare system and pursuing meaningful and lasting reform require a close examination of how the system works "when the cameras are off and the reporters are gone." This journal issue examines the current state of the foster care system and finds that it is really not a cohesive system but a combination of many overlapping and interacting agencies, all charged with providing services, financial support, or other assistance to children and their families. Lack of coordination among agencies, chronic underfunding, and low morale have led to a system that exacts a toll on everyone it touches. Children may suffer, as the incidents described above suggest. But so do foster parents and the relatives who step in to care for children who cannot remain with their birth parents; so do harried caseworkers; and so do birth parents who would like to reunite with their children but find the path difficult. Too few of the players in the system have adequate training for their responsibilities and, as a result, children and families frequently do not receive the services and supports they need. Instead, the child welfare system labors in an atmosphere of distrust, impending failure, and reflexive, uniform solutions that rarely succeed for anyone. Recent reforms have shifted some of the priorities within the system, but much more needs to be done. This article discusses the major challenges faced by the child welfare system and offers policy and practice recommendations that can improve how children and families experience foster care. …
TL;DR: Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior.
TL;DR: It is demonstrated that an impairment in SWM capacity can contribute to the neglect syndrome in patients with stroke involving regions within the right parietal lobe and insula.
Abstract: It has been proposed recently that a deficit in keeping track of spatial locations may contribute to the severity of unilateral neglect in some right hemisphere stroke patients. However, performance on traditional spatial working memory (SWM) tasks (e.g. Corsi blocks) might be confounded by failure to encode leftward locations, rather than a true deficit of maintaining locations in SWM. Here we introduced new procedures for circumventing this to measure SWM capacity in neglect. In a first experiment, 20 right hemisphere stroke patients (10 with and 10 without neglect) were tested on a computerized vertical variant of the Corsi task. Sequences of spatial locations in a vertical column were displayed and participants had to tap out the remembered sequence on a touchscreen. Patients with left neglect were impaired on this vertical SWM task compared with all control groups. However, poor performance on this task (as for Corsi blocks) might involve impaired memory for stimulus sequence, or poor visuomotor control of manual responding, rather than reduced SWM capacity per se. A second experiment therefore employed a purer measure of vertical SWM. After the displayed sequence, a single location was now probed visually, with observers judging verbally (yes/no) if it had been in the preceding sequence. Hence order no longer mattered, and no spatial motor response was required. Again, the neglect group was impaired relative to all others, now with very little overlap between the performances of individual neglect patients versus individuals in control groups. Poor performance on the second task, which provides a purer measure of SWM capacity, correlated with severity of left neglect on cancellation tasks (but not on line bisection), consistent with recent proposals that SWM deficits can exacerbate left neglect on visual search tasks when present conjointly. Lesion anatomy indicated that neglect patients with a SWM deficit were most likely to have damage to parietal white matter, plus, in the second experiment, to the insula also. These findings demonstrate that an impairment in SWM capacity can contribute to the neglect syndrome in patients with stroke involving regions within the right parietal lobe and insula.
TL;DR: A large proportion of CRPS patients have disturbances of the self‐perception of the hand, indicating an alteration of higher central nervous system processing, and physical therapy of such patients should take this observation into consideration.
Abstract: To investigate neglect, extinction, and body-perception in patients suffering from complex regional pain syndrome (CRPS). So-called 'neglect-like' symptoms have been reported in CRPS, however no studies have yet analyzed this phenomenon which might substantiate the theory of the central nervous system involvement in the pathophysiology of CRPS. A total of 114 patients with CRPS of the upper limb underwent bedside neurological examination. 'Neglect-like' symptoms were determined by asking all patients what kind of feeling they had toward the affected hand (feeling of foreignness). Hemispatial neglect was tested with the line bisection task in 29 patients and sensory extinction to simultaneous stimulation in 40 patients. The ability to identify fingers after tactile stimulation was tested in 73 patients. Independently of the affected side and disease duration, 54.4% of the patients reported that their hand felt 'foreign' or 'strange'. The ability to identify fingers was impaired in 48% on the affected hand and in 6.5% on the unaffected hand ( X(2) = 33.52, df = 1, p < 0.0001). These findings were related to pain intensity, illness duration and the extent of sensory deficits. No typical abnormalities indicating neglect were found in the line bisection test. Sensory extinction was normal in all patients. A large proportion of CRPS patients have disturbances of the self-perception of the hand, indicating an alteration of higher central nervous system processing. There are no indicators that classic neglect or extinction contribute to these findings. Physical therapy of such patients should take this observation into consideration.
TL;DR: Findings show that spatial attention deficits partially improve during the acute phase of the disease in less than half the patients investigated, emphasising that neglect is a negative prognostic factor in motor functional recovery.
Abstract: Objectives: The evolutionary pattern of spontaneous recovery from acute neglect was studied by assessing cognitive deficits and motor impairments. Detailed lesion reconstruction was also performed to correlate the presence of and recovery from neglect to neural substrates.
Methods: A consecutive series of right brain-damaged (RBD) patients with and without neglect underwent weekly tests in the acute phase of the illness. The battery assessed neglect deficits, neglect-related deficits, and motor impairment. Age-matched normal subjects were also investigated to ascertain the presence of non lateralised attentional deficits. Some neglect patients were also available for later investigation during the chronic phase of their illness.
Results: Partial recovery of neglect deficits was observed at the end of the acute period and during the chronic phase. Spatial attention was impaired in acute neglect patients, while non spatial attentional deficits were present in RBD patients with and without acute neglect. A strong association was found between acute neglect and fronto-parietal lesions. Similar lesions were associated with neglect persistence. In the chronic stage, neglect recovery was paralleled by improved motor control of the contralesional upper limb, thus emphasising that neglect is a negative prognostic factor in motor functional recovery.
Conclusions: These findings show that spatial attention deficits partially improve during the acute phase of the disease in less than half the patients investigated. There was an improvement in left visuospatial neglect at a later, chronic stage of the disease, but this recovery was not complete.
TL;DR: It is demonstrated that unilateral spatial neglect may produce specific representational deficits in number processing that implicate different spatial representations according to the task demands.
TL;DR: In this paper, the authors examined the role of neighborhood social disorganization and alcohol access on child abuse and neglect and found that neighborhoods with higher percentages of poverty, female-headed households, Hispanic residents, population loss, and greater densities of bars have higher rates of child maltreatment.
TL;DR: This comparative analysis of Aboriginal and non-Aboriginal families uses a 1998 Canadian study of child maltreatment cases to identify important differences: Aboriginal families face worse socioeconomic conditions, are more often investigated because of neglect, less often reported for physical or sexual abuse, and report higher rates of substance abuse.
Abstract: This comparative analysis of Aboriginal and non-Aboriginal families uses a 1998 Canadian study of child maltreatment cases to identify important differences: Aboriginal families face worse socioeconomic conditions, are more often investigated because of neglect, less often reported for physical or sexual abuse, and report higher rates of substance abuse. At every decision point in the cases, Aboriginal children are over represented: investigations are more likely to be substantiated, cases are more likely to be kept open for ongoing services, and children are more likely to be placed in out-of-home care. Findings suggest the development of neglect intervention programs that include poverty reduction and substance misuse components.
TL;DR: The frequency of occurrence of right neglect was, as expected, much lower than that reported in a study using the same assessment battery in right brain damage stroke patients, and neglect was found in a substantial proportion of patients at a subacute stage, suggesting that it should be considered in the rehabilitation planning of left brainDamage stroke patients.
Abstract: Objectives: Comparatively little research has been conducted on right neglect after left brain damage. The authors sought to assess contralateral neglect in subacute left hemisphere stroke patients using a comprehensive test battery validated in a large control group after right hemisphere stroke. Methods: Seventy-eight left hemisphere stroke patients were assessed. The test battery included a preliminary assessment of anosognosia and visual extinction, a clinical assessment of gaze orientation and personal neglect, and paper-and-pencil tests of spatial neglect in the peripersonal space. Only nonverbal tests were used. Results: Drawing and cancellation tasks revealed neglect in 10 to 13% of patients. The combined battery was more sensitive than any single test alone. A total of 43.5% of patients showed some degree of neglect on at least one measure. Anatomic analyses showed that neglect was more common and severe when the posterior association cortex was damaged. Conclusions: The frequency of occurrence of right neglect was, as expected, much lower than that reported in a study using the same assessment battery in right brain damage stroke patients. Nevertheless, neglect was found in a substantial proportion of patients at a subacute stage, suggesting that it should be considered in the rehabilitation planning of left brain damage stroke patients.
TL;DR: C careful long-term neurocognitive follow-up is needed in order to inform parents and teachers about the behavioral and cognitive sequelae and to contribute to timely social and educational intervention.
Abstract: Objective: To study long-term effects on neurologic, neuropsychological, and behavioral functioning in children treated for cerebellar pilocytic astrocytoma (CPA) without additional radio- and chemotherapy. Methods: The authors assessed speech, language, nonverbal intelligence, attention, memory, executive skills, and visual (-spatial) functions in a consecutive series of 23 children. Neurologic and neuropsychological follow-up ranged from 1 year to 8 years and 10 months after resection. Results: Long-term sequelae in the investigated domains were found in all children. Apraxia, motor neglect, and dysarthric features, as well as language, sustained attention, visual-spatial, executive, memory, and behavioral problems, were observed in various combinations and to different degrees. No clear pattern of neurocognitive disturbances could be discerned in this group. In addition, significant relationships were revealed between severity of preoperative hydrocephalus and visual-spatial skills. The high percentage of children who needed special education reflects the severity of the impairments. Conclusion: Despite the current opinion of a good quality of life after CPA treatment, careful long-term neurocognitive follow-up is needed in order to inform parents and teachers about the behavioral and cognitive sequelae and to contribute to timely social and educational intervention.
TL;DR: Some form of adversity is a common experience, although the severest abuses are less common in this population, but happiness is affected most by domestic warmth and harmony, and normalcy by abuse and neglect.
Abstract: The impact of adversity in childhood is well established in clinical populations, but there is little information about adversity in wider populations. The aim of this paper is to report and to explore the distribution of childhood family adversity in an Australian population. A total of 7485 randomly selected subjects in 20–24, 40–44 and 60–64 year age bands were interviewed at the outset of a longitudinal community study of psychological health in the Canberra region of Australia. In the initial cross-sectional interview, subjects answered 17 questions about experience of adversity in the home to age 16 years. In the population, 59.5% had experienced some form of childhood adversity and 37% had experienced more than one adversity. Domestic conflict and parental psychopathology and substance use are the common adversities. Parental sexual abuse was reported by 1.1%. Adversity was highest in the 40–44 year age group and reported more in women in all age groups. The majority of subjects saw their childhood as happy or normal despite adversity, but happiness is affected most by domestic warmth and harmony, and normalcy by abuse and neglect. Severe adversities, physical and sexual abuse and neglect, were uncommon, but were related to multiple and other severe adversities. Some form of adversity is a common experience, although the severest abuses are less common in this population. Multiple adversities are common and only a minority experience single adversities. Physical abuse, sexual abuse and neglect rarely occur alone, but indicate a context of abuse.
TL;DR: This article will attempt to describe principles of a psychological treatment for maltreated children and young people who have been placed in foster care and adoptive homes that provide dyadic interventions that aim to be transforming and integrative.
Abstract: Repetitive, intrafamilial abuse and neglect leads to a complex array of deficiencies and symptoms that reflect both the traumatic effects of maltreatment on children as well as the effects of their failing to develop a coherent pattern of attachment behaviours toward their caregivers. This article will attempt to describe principles of a psychological treatment for maltreated children and young people who have been placed in foster care and adoptive homes. This treatment, based on attachment theory, provides dyadic interventions that aim to be transforming and integrative. The co-regulation of affect and the co-construction of meaning are central to the treatment process, just as they are central features in attachment security.
TL;DR: It is suggested that alcohol access is differentially related to type of child maltreatment, with higher densities of bars being related to higher rates of child neglect, andHigher rates of off-premise outlets related tohigher rates ofChild physical abuse.
Abstract: Objective: The purpose of this study is to examine whether or not alcohol access in neighborhood areas is differentially related to substantiated reports of child physical abuse and neglect. Method: This cross-sectional ecological study uses spatial regression procedures to examine the relationship between the number of bars, restaurants and off-premise outlets per population and rates of child physical abuse and neglect in 940 census tracts in California, while controlling for levels of social disorganization, population density and county of residence. Results: The number of off-premise outlets per population was positively associated with rates of child physical abuse (b = 3.34, SE = 1.14), and the number of bars per population was positively related to rates of child neglect (b = 1.89, SE = 0.59). Conclusions: These results suggest that alcohol access is differentially related to type of child maltreatment, with higher densities of bars being related to higher rates of child neglect, and higher rates ...