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Desmond K. Runyan, MD, DrPH Jonathan Kotch, Terri Lewis, Jamie Smith

Listening to Children: What do 12 year olds tell us about their psychological maltreatment ?. Desmond K. Runyan, MD, DrPH Jonathan Kotch, Terri Lewis, Jamie Smith University of North Carolina at Chapel Hill Richard Thompson Juvenile Protective Association. Acknowledgements.

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Desmond K. Runyan, MD, DrPH Jonathan Kotch, Terri Lewis, Jamie Smith

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  1. Listening to Children: What do 12 year olds tell us about their psychological maltreatment? Desmond K. Runyan, MD, DrPH Jonathan Kotch, Terri Lewis, Jamie Smith University of North Carolina at Chapel Hill Richard Thompson Juvenile Protective Association

  2. Acknowledgements • U.S. Department of Health and Human Services Administration for Children, Youth, and Families Children's Bureau Office on Child Abuse and Neglect • U.S. Department of Health and Human Services National Institutes of Health National Institute of Child Health and Human Development  

  3. Background • LONGSCAN (Longitudinal Studies on Child Abuse and Neglect) a consortium of 5 longitudinal studies of maltreatment • Data on maltreatment from multiple sources • Parent report on discipline at age 8 • CPS record reviews at two year intervals • At Age 12, children asked about their abuse histories.

  4. Research Questions • What is the impact of psychological maltreatment on child mental health status? • Outcomes as reported by children • Outcomes as reported by caregivers?

  5. Sample • LONGSCAN subjects from all 5 sites • Child completing an Age 12 Interview • Complete data on the Self-Report of Abuse Measure • Sample N = 851

  6. Sample Demographics • Mean Age: • 12.4 years (SD = 0.44) • Gender: • 49.7% Boys; 50.3% Girls • Race: • 27.1% White; 54.3% Black; 18.6% Other • Site: • 12% Midwestern • 22% Eastern • 19% Southern • 26% Southwestern • 21% Northwestern

  7. Independent Variables • Exposure to emotional maltreatment was determined by: • Reviews of child protective service (CPS) reports. • Using a project developed instrument that addressed terrorizing, threaten abandonment, humiliation, shame, and other hurtful events.

  8. Child Protective Services Reports • Abstraction of CPS narratives using a Modified Maltreatment Coding System: • Adaptation of system developed by Barnett, Manly & Cicchetti. • # of Psychological Maltreatment Allegations through Age 12 (M = 0.79, SD = 1.53). • 34% (n = 293) children had at least one psychological maltreatment allegation.

  9. Child Self-Report of Abuse • Adolescent participants are asked about their maltreatment experiences at the age 12 interview. • The LONGSCAN self-report of abuse measure • 3 modules assessing lifetime experience of abuse • A-CASI (audio-computer assisted self interview). • 18 Psychological Maltreatment items (n = 18) - items listed on next slide. • Items were summed to create a Psychological Maltreatment Score (M = 1.2, SD = 2.2). • 40% (n = 343) of participants endorsed one or more psychological maltreatment items.

  10. Self-Report of Psychological Maltreatment Items (example items) • Has any parent… • ever made you feel that you couldn’t do anything right, no matter how hard you tried? • ever punished you in an unusual way-like tying you up, or locking you in a closet? • ever threatened to hurt you badly? • ever threatened to kill you? • ever threatened to kick you out of your home, or to have you taken away?

  11. Dependent Variables • Child Behavior Checklist • internalizing, externalizing, and total problems T scores. • Youth Self-Report • internalizing, externalizing, & total T scores. • Trauma Symptom Checklist for Children • anxiety, anger, & depression T scores.

  12. Child Behavior Checklist (CBCL) • Parent report of child competencies & behavior • 113 item checklist, problem behavior items • Answer set from 0 (not true) to 2 (very true or often true) indicates behavior • Higher scores = increased behavior problems • LONGSCAN Age 12 Interview

  13. Distribution of CBCL T Scores M = 51.3 SD = 11.0 23% (n = 191) Borderline/ Clinical Range (>=60) M = 55.2 SD = 11.1 35% (n = 290) Borderline/ Clinical Range (>=60) M = 53.9 SD = 11.7 32% (n = 269) Borderline/ Clinical Range (>=60)

  14. Youth Self Report (YSR) • Child report of child competencies & behavior • 113 item checklist, problem behavior items • Answer set from 0 (not true) to 2 (very true or often true) indicates behavior • Higher scores = increased behavior problems • LONGSCAN Age 12 Interview

  15. Distribution of YSR T Scores M = 48.6 SD = 9.9 13% (n = 110) Borderline/ Clinical Range (>=60) M = 48.0 SD = 10.7 13% (n = 111) Borderline/ Clinical Range (>=60) M = 49.5 SD = 10.6 18% (n = 153) Borderline/ Clinical Range (>=60)

  16. Trauma Symptom Checklist (TSC) • 44 item symptom checklist, five subscales: anxiety, depression, post-traumatic stress, dissociation, & anger. • Answer set of 0 (never) to 3 (almost all the time) indicates frequency of each symptom • Higher scores indicate increased symptoms. • Child report, LONGSCAN Age 12 Interview T scores used in the analysis: • Anxiety • Anger • Depression

  17. Distribution of TSC T Scores M = 41.2 SD = 9.5 2% (n = 19) Borderline/ Clinical Range (>=65) M = 40.5 SD = 8.0 2% (n = 18) Borderline/ Clinical Range (>=65) M = 39.8 SD = 8.7 2% (n = 17) Borderline/ Clinical Range (>=65)

  18. Analysis Plan • Correlations between Independent and Dependent Variables. • Regression analyses predicting Child Functioning (CBCL, YSR, TSC T scores).

  19. Correlations * p < .05 ** p < .01 *** p < .001

  20. Regression Analysis Predicting CBCL T Scores * p < .05 ** p < .01 *** p < .001

  21. Regression Analysis Predicting YSR T Scores * p < .05 ** p < .01 *** p < .001

  22. Regression Analysis Predicting TSC T Scores * p < .05 ** p < .01 *** p < .001

  23. Discussion • The correlations between parent reported outcomes and either CPS or self-reported psychological maltreatment were low but significant. • The correlations between the child report of outcomes & child report of psychological maltreatment were large & significant.

  24. Discussion (cont.) • In analyses controlled for site and gender, self-reported psychological maltreatment predicted most of the variation in child outcome. • In analyses controlled for study site and gender, CPS allegations containing reports of psychological maltreatment explain almost none of the variance in child outcome.

  25. Conclusions • Our MMCS coding system captures allegations of psychological abuse. • Official reports of psychological abuse pale in comparison to the psychological maltreatment reported by children. • Psychological maltreatment has profound effects on children that would be missed if we relied upon official reports. • We need to ask the children • For more information, visit our website at http://www.iprc.unc.edu/longscan/

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