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Abuse

Abuse. Non-accidental injury or pattern of injury to a child Not a DSM-IV clinical category Coded on Axis 4. Kaufman & Zigler (1987). 90% of abusers were abused 82% of those abused do NOT become abusers Difference between those who did and did not become abusers.

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Abuse

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  1. Abuse • Non-accidental injury or pattern of injury to a child • Not a DSM-IV clinical category • Coded on Axis 4

  2. Kaufman & Zigler (1987) • 90% of abusers were abused • 82% of those abused do NOT become abusers • Difference between those who did and did not become abusers

  3. What causes parents to abuse their children? • Socio-cultural factors • Parents’ personal characteristics • Characteristics of parent-child interaction

  4. Twentyman et al. (1984) Sequence of abusive events: • Parent has unrealistic expectations • Child fails to meet expectations • Parent makes intentional attribution for child behavior • Parent reacts/overreacts

  5. Impact of abuse • Increases risk for psychological problems • Abuse as a stressor • Acute symptoms mimic reactions to stress • Disrupted attachment in infants • Disordered peer relationships • Withdrawal • aggression • Distorted views of self • School problems • Sexual problems

  6. Adult Outcomes Many adults survive okay • Physical • Interpersonal problems • Aggression & violence • Sexual • Impaired self-esteem • Emotional self-regulation • Interpersonal difficulties • DSM disorders (anxiety, PTSD,

  7. Treatment • Frame problem in terms of daily discipline problems • Identify stressful situations • Emphasize painfulness of problem/ search for alternative strategies Goals: reduce aversive parent-child interactions • Increase positive exchanges • Increase skill with nonphysical discipline • Quick resolution of confrontations • Decrease stress and anger levels • Decrease physical discipline

  8. Controversy around children’s self-reports of abuse • Quiz • Name at least three issues that are raised by Saywitz in considering children’s eye witness testimony.

  9. Factors that inhibit reporting • Power imbalance • Desire to do what adults tell them • Threats to keep secret • Relationship involving trust or dependency • Implied or imagined negative consequences • Feelings of guilt, self-blame, shame

  10. Factors that may impact a child’s testimony • Memory • Suggestibility • Reality vs. fantasy • Stressors

  11. Saywitz perspective • Children don’t make things up • Children not more suggestible (4 & up) to main events • Sometimes more suggestible to peripheral events • No false reports • All bets off with 3 year olds

  12. Ceci’s perspective • Children conform to suggestion • Answer in affirmative

  13. Reconciliation • Questioning style • Repeated questioning

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