Understanding Child Abuse and Neglect (1993) / Chapter Skim
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4 ETIOLOGY OF CHILD MALTREATMENT
4 ETIOLOGY OF CHILD MALTREATMENT
Pages 106-160
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From page 106... ...
The panel recognizes that some factors are more closely linked with certain forms of child abuse and neglect (such as the relationship between poverty and child neglect)
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From page 107... ...
Gil (1970) , for example, was one of the first to document the role of poverty and family disadvantage on the rates of child abuse.
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From page 108... ...
The emerging social interactional models emphasize the importance of viewing child maltreatment in the context of the family, community, and society rather than emphasizing only individual parental psychopathology or individual stressors (Belsky, 1980, 1992; Cicchetti and Carlson, 1989; Garbarino, 1977; Parke and Collmer, 1975; Wolfe, 1991~. The phenomenon of child abuse and neglect has thus been moved away from the conception of an individual disorder or psychological disturbance, toward the conception of a symptom of an extreme disturbance of childrearing, often part of a context of other serious family problems, such as poverty, alcoholism, or antisocial behavior (Burgess, 1979; Pelton, 1989; Starr, 1979; Wolfe, 19911.
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From page 109... ...
It is the combination of risk potentiating and protective factors in all levels of the system that determine the likelihood of maltreatment, rather than a single factor serving as a causal influence in isolation from the others (Cicchetti and Carlson, 1989~. In reviewing potentiating and contributing factors, researchers often focus on risk factors that appear to be malleable, that is, that can be changed as a result of a treatment or preventive interventions.
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From page 110... ...
ecologically integrative model of child abuse. SOURCE: Hamilton, Stiles, Melowsky, and Beat (1987~.
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From page 111... ...
Physical Abuse Early psychiatric studies stimulated a search for parental characteristics and a personality profile of abusing parents (Milner and Chilamkurti, l991~.5 Recent prospective studies (e.g., Pianta et al., 1989) have identified a set of parental personality attributes associated with child maltreatment that have emerged with sufficient frequency to warrant attention.
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From page 112... ...
Although no specific syndrome or diagnostic category has been associated with child sexual abuse, personality characteristics frequently found in child molesters have contributed to various etiological theories of pedophilia (DSM-III-R, 1987~. Some child molesters are reported to be timid, unassertive and awkward; others
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From page 113... ...
, concerns about detection bias, general research inattention to women, and the significance of maternal-child relations suggest that the role of female sexual offenders has been underestimated in research on child sexual abuse. Clinical studies of child victims of sexual abuse as well as adult offenders (based on retrospective studies)
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From page 114... ...
Emotional Maltreatment The etiology of emotional abuse and neglect is less developed than that of the other three forms of maltreatment discussed above. However, emotional maltreatment appears to be more prevalent, and some investigators believe that its consequences are more destructive than other forms of child abuse and neglect (Garbarino and Vondra, 1987; Hart and Brassard, 1987; Hart et al., 1987~.
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From page 115... ...
. Abusive parents may have incomplete or distorted knowledge and understanding of normal child development or their own children's behaviors.
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From page 116... ...
Intergenerational Transmission of Abusive Parenting The notion that abused children become abusing parents has received significant attention and has been one of the most pervasive and popular themes in the literature over the past several decades (Cicchetti and Aber, 1980; Kaufman and Zigler, 1987; Kempe and Kempe, 1978; Steele and Pollack, 1968; Widom, 1989~. Two clinicians at the forefront of child maltreatment research in the 1970s observed that "the most constant fact (concerning child abusers)
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From page 117... ...
one-year prospective study of premature infants yielded an intergenerational transmission rate of 18 percent when examined from a prospective vantage point, in contrast to a transmission rate of 90 percent when the same data were examined from a retrospective position.9 Since some studies have shown that "antisocial behavior patterns are passed from one generation to the next at a rate well beyond chance," particularly when controls for confounding factors such as family size, area of residence, or rates of criminal behavior have been established, the relationship between antisocial behavior and child maltreatment deserves further exploration in intergenerational studies (Huesmannetal., 1984; Wahler and Dumas, 1986:50, quoted in Belsky, 1992~. Several investigators have tentatively identified protective factors that break the cycle of abuse (Egeland, 1988; Egeland et al., 1988; lIunter and Kilstrom, 1979~.
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From page 118... ...
concluded that the results were contradictory, with some studies finding a significant relationship and others not (Widom, 1992~. A second review published about the same time also found "no empirical data to support an association between alcoholism and child abuse" (Orme and Rimmer, 1981: 273~.
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From page 119... ...
One prospective study that compared matched groups of sons of alcoholic and nonalcoholic fathers found no significant differences in the extent of childhood physical abuse (Pollock et al., 1990; Widom, 19921. Although alcohol often is cited as a principal risk factor in the etiology of child maltreatment, its relationship to child abuse and neglect remains uncertain (Widom, 19921.
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From page 120... ...
Primate studies by Suomi and colleagues suggest that, although some species of monkeys and apes have a capacity to neglect or abuse their young, a valid and useful primate model of human child abuse has not been identified (Suomi, 1978; Suomi and Ripp, 1983~. The most extensive data on infant maltreatment by nonhuman primates comes from laboratory settings (Suomi, 19781.
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From page 121... ...
Different parts of the brain continuously interact with each other, and violent or abusive behaviors represent a combination of stimulation and suppression of particular brain areas, past experience and learning, and immediate environmental stimuli or stressors. Results of studies regarding the relationship between testosterone levels and aggression in humans are equivocal (Ehrenkraz et al., 1974; Kreuz and Rose, 1972; Meyer-Bahlberg, 1974; Monti et al., 1977; Rada et al., 19764.
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From page 122... ...
Reports of specific demographic factors associated with child maltreatment are derived primarily from clinical research, which is subject to reporting and labelling bias. Such reports are inconsistent.
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From page 123... ...
Research on child risk factors associated with maltreatment have included prematurity, temperament, age, and gender. Retrospective research has suggested that factors such as prematurity, low birthweight, and illness or handicapping conditions in the infant or child interfere with attachment and bonding, making the child more vulnerable to maltreatment (Lynch and Roberts, 1977; Oates et al., 1979~.
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From page 124... ...
Children under age 3, perhaps because of their physical vulnerability, are the most likely to suffer from fatal child abuse (Belsky, 1992~. Straus and colleagues (1986)
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From page 125... ...
Child characteristics also may be important in reabuse or revictimization. Sexually abused children may develop or learn sexualized behaviors that put them at risk of continued abuse by the original and/or other perpetrators (Frederich, 1988~.
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From page 126... ...
Anger and conflict are pervasive features of maltreating families, although conflict may be more characteristic of abusive families and social isolation may be more associated with neglectful families (Crittenden, 19851. Husbands and wives in maltreating families are less warm and supportive, less satisfied in their conjugal relationships, and more aggressive and violent than those in nonabusive families (Fagan and Browne, 1990; Rosenbaum and O'Leary, 1981; Rosenberg, 1987; Straus, 19801.~3 Furthermore, sibling relationships are more conflicted and less supportive in families characterized by high marital conflict or coercive punitive parenting, and tolerance of sibling violence sets the stage for later family violence (Hetherington, 1991; Hetherington and Clingempeel, 1992; Patterson et al., 1992; Straus, 1980~.
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From page 127... ...
The effect on children of repeated fluctuations in the makeup of their household, in addition to child neglect, has not been examined in the research literature, although such changes are suspected to contribute to unrelatedness and detachment (Polansky et al., 19921. Family relationships that affect the quality of parent-child interactions have also been considered in developing the context for understanding child sexual abuse (Finkelhor, 1984; Hartman and Burgess, 1989~.
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From page 128... ...
an authoritarian style involving punitiveness, coercion, restrictiveness, and low warmth and support. The first appears to be related to child neglect and the second to child abuse (Maccoby and Martin, 1983~.
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From page 129... ...
Abusive and nonabusive parents usually, but not consistently, exhibit differences in control and disciplinary practices. Abusive parents are more likely to use punishment, threats, coercion, and power and they are less likely to use reasoning and affection in controlling their children (Lorber et al., 1984; Trickett and Sussman, 1988~.
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From page 130... ...
International and cross-cultural comparisons also do not support an inevitable tie between physical discipline and physical abuse. Sweden, which has laws prohibiting physical punishment, was significantly lower than the United States on self-reports of physical punishment on the Conflict Tactics Scales (Gelles and Edfeldt,1986~.
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From page 131... ...
Stressful Life Events and Child Maltreatment Several investigators have examined the relationship between stressful life events and parenting outcomes, including quality of mother-infant attachment (Crockenberg, 1981) and child maltreatment (Egeland et al., 1980; Straus, 1980~.~6 Most research has compared maltreating and nonmaltreating families on a scale that typically consists of a checklist of stressful life events, such as loss or reduction in family income, sickness in family, moves, and death or loss of family member.
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From page 132... ...
The relationship between physical discipline and child maltreatment is also largely unknown, particularly in terms of cultural differences and practices. Finally, stressful life events are thought to play an important role on individuals, abilities to parent, but relations between stressors and parenting outcomes are complex and poorly understood at this time.
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From page 133... ...
. Discussion of the relationship of poverty to child maltreatment has persisted since publication of the early professional papers on child abuse (e.g., Gil, 1970; Gelles, 1983, 1992; Kadushin, 1976; Kempe et al., 1962; Pelton, 1978; Steele and Pollock, 1968~.
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From page 134... ...
Neighborhood Impact Poor neighborhoods differ in their social and physical conditions and in their ability to influence the specific risks posed to children by poverty, unemployment, drugs, and community violence (Coulton et al., 1990a,b; Coulton and Pandey, 1992; Duncan and Aber, in press) .~7 Garbarino and colleagues found that, although socioeconomic conditions have predictive value for explaining child maltreatment rates, some neighborhoods have higher child abuse rates than would be expected (high-risk neighborhoods)
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From page 135... ...
While arguments for neighborhood impact on child abuse and child neglect are compelling, Polansky (1981) notes that neglectful families often are socially isolated and their perceptions of themselves, their children, and others do not reflect attitudes prevalent in their neighborhoods.
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From page 136... ...
Little is known about the relationship of religion to either neglect or emotional abuse. Although religious beliefs favoring harsh discipline of children have been suggested to contribute to physical abuse, religious affiliation and participation have been identified as countering the social isolation associated with maltreatment (Garbarino, 1977)
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From page 137... ...
Societal fascination with violence, including violence toward children, also has been suggested as a risk factor for physical abuse (Gil, 1970; Gelles and Straus, 1988~. The lack of coherent family leave and family support policies, such as those in place in many European countries, increases the difficulties faced by many parents (National Research Council, 1990; Ferber and O'Farrell, 1991~.
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From page 138... ...
The causal relationship of cultural factors and child sexual abuse requires further research within and across populations. For example, the practice of parent and child sleeping together may be viewed as a potentiating factor in some populations, according to the preconditions model set for by Finkelhor (1984)
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From page 139... ...
In 1986, however, the attorney general's Commission on Pornography identified several areas of "pronounced harm" due to pornography, including a link between pornography, sexual violence, and child abuse (Mason, 1989) , but did not support these findings with empirical evidence.
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From page 140... ...
Research designs and analytic strategies should focus on the multidimensional character of child maltreatment using a framework that accommodates risk and protective factors in an interactive model, examining possible etiological factors in child maltreatment in combination with other contributing agents. Continued reliance on univariate models or isolated risk factors in future research will not be productive.
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From page 141... ...
Relationships between acute intoxication, chronic alcoholism, and various forms of child maltreatment, including physical and sexual abuse, neglect, and emotional maltreatment, require systematic examination and analysis. · The operation of social relationships and social networks is a critical feature in the etiology of child maltreatment.
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From page 142... ...
For example, being a victim of physical abuse or emotional maltreatment may be a significant risk factor for child sexual abuse (or vice versa) , but the relationships among multiple forms of maltreatment remain unexamined.
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From page 143... ...
Research on child maltreatment has often been grouped collectively because of the child status of the victim. Many research sponsors and investigators assume that child physical and sexual abuse, emotional maltreatment, and neglect have more similarities than differences.
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From page 144... ...
12. Although many aspects of the punitiveness measured in these studies, such as criticism, threats, physical punishment, coerciveness, and guilt-inducing behaviors, fall within definitions of maltreatment used by many investigators, the studies of older children dealt with punitiveness and not specifically abuse.
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From page 145... ...
Becker, J.V. 1988 The effects of child sexual abuse on adolescent sexual offenders.
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From page 146... ...
White, and D.A. Comely 1985 Maternal perinatal risk factors and child abuse.
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From page 147... ...
1984 147 Mothers' age and risk for physical abuse. Child Abuse and Neglect 16:703-712.
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From page 148... ...
Caulfield 1977 Measuring the components of parents potential for child abuse and neglect. Child Abuse and Neglect 1:279-296.
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From page 149... ...
Joseph 1985 The maltreated adolescent: Patterns of physical abuse. Child Abuse and Neglect 9(2)
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From page 150... ...
Gil, D.G. 1970 Violence Against Children: Physical Child Abuse in the United States.
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Divasto 1981 Prior incest in mothers of abused children. Child Abuse and Neglect 5:87-96.
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From page 152... ...
Loda 1978 Antecedents of child abuse and neglect in premature infants: A prospective study in a newborn intensive care unit. Pediatrics 61:629-635.
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From page 153... ...
Leventhal, J.M. 1981 Risk factors for child abuse: Methodologic standards in case-control studies.
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From page 154... ...
Lynch, M.A., and J Roberts 1977 Predicting child abuse: Signs of bonding failure in the maternity hospital.
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From page 155... ...
Ryan, and L.F. Stewart 1979 Risk factors associated with child abuse.
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From page 156... ...
American Journal of Orthopsychiatry 48:608-617. 1981 The Social Context of Child Abuse and Neglect.
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:872-878. 1982 Child Abuse Prediction: Policy Implications.
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From page 158... ...
Dooley 1981 Economic antecedents of child abuse and neglect. Child Development 52:975-985.
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From page 159... ...
1985 The sexual abuse of Afro-American and white American women in childhood. Child Abuse and Neglect 9:507-519.
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From page 160... ...
Zigler, E., and N.W. Hall 1989 Physical child abuse in America: Past, present, and future.
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