Ann Hazzard

Psychiatric and Family Functioning in Children with Leukemia and Their Parents

The present study reports data from a cross-sectional investigation of the psychiatric and psychosocial functioning of 55 children diagnosed with acute lymphocytic leukemia and their families at three points in time: diagnosis (newly diagnosed), 1 year postdiagnosis, and 1 year after the completion of chemotherapy (off-therapy). Results reveal minimal psychopathology in these children and their parents based on self- and informant-reports and structured diagnostic interviews. These families appear to be functioning adequately and report more family cohesiveness and marital satisfaction after chemotherapy was completed. Coping strategies commonly used by children and their parents include problem-solving, a positive outlook, and good communication. Implications for psychiatric consultation are presented.

Predicting symptomatology and self-blame among child sex abuse victims

Fifty-six sexually-abused girls and their nonoffending female caretakers from primarily low-income. African American families were comprehensively assessed in order to determine factors related to child symptomatology and self-blame. Girls whose overall relationships with their caretakers were somewhat negative exhibited more behavioral difficulties. Girls with disruptions in their relationship with a primary caretaker and who felt powerless as a result of the abuse were rated as functioning less well overall by clinicians. Child age, general attributional style, and caretaker blame of the child were related to child self-blame. Clinical implications of these findings include identification of clients at high risk for negative sequelae and development of interventions targeted at specific clinical issues.

Factors affecting group therapy outcome for adult sexual abuse survivors

Adult female sexual abuse survivors (N = 148) participated in year-long therapy groups. Demographic, abuse history, initial symptomatology, and group process variables were examined in relationship to group completion and improvement over time. Survivors who had previously been psychiatrically hospitalized were less likely to complete group treatment. Among group completers, significant pretreatment-posttreatment changes were found on measures of locus of control, sexual problems, self-esteem, trauma-related symptomatology (TSC-33), and general psychological distress (SCL-90-R). Greater changes on the SCL-90-R were found among Caucasian women, women with more initial trauma-related symptomatology, women whose abuse included intercourse, members of groups with similar abuse histories, and women with previous psychotherapy experience.

Training teachers to identify and intervene with abused children

Teachers are a potentially helpful resource for abused children, but generally lack training in child abuse identification and intervention. Elementary and junior high school teachers (n = 104) were surveyed concerning their abuse‐related experience, knowledge and attitudes. Sixty‐eight percent of the teachers reported 3 or fewer hours of education about child abuse and 62% reported no prior experience with abuse cases. Half of the teachers (n = 51) then participated in a one‐day training workshop on child abuse. Repeated measures analyses revealed that treatment teachers, compared to control teachers, increased in knowledge about child abuse and developed more sympathetic attitudes toward the abusive parent. A six‐month follow‐up using self‐report data revealed no significant differences between groups in the number of cases of child abuse identified or reported. However, treatment teachers were significantly (1) more likely to report talking with individual students to determine if abuse was occurring, ...

A note on the knowledge and attitudes of professional groups toward child abuse

This study compares the child abuse-related knowledge and attitudes of pediatricians (n = 47), mental health professionals (n = 53), teachers (n = 104), and college students (n = 68). Mental health professionals were better informed than pediatricians; teachers and college students were the least knowledgeable. Knowledge was related significantly to amount of professional education and experience with abuse cases and was associated with less negative emotional reaction to abusive parents. On the basis of study results, additional abuse-related education is recommended for pediatricians and particularly for teachers.

Attribution Retraining With Sexually Abused Children: Review of Techniques

Clinicians increasingly use empirically based cognitive-behavioral techniques in their treatment of child victims of sexual abuse. Attribution retraining is often a primary component of this work, and it involves various techniques aimed at decreasing abuse-related self-blame and encouraging the child to attribute responsibility for the abuse to the perpetrator. This article reviews literature that highlights the complexity of self and other blame for sexually abused children in terms of developmental status, the multifaceted nature and interrelationships of abuse-specific attributions, and the psychological effects of self-blame and perpetrator blame. A review of written attribution retraining techniques developed by diverse authors for use with sexually abused children and their nonoffending parents is provided, including written and verbal techniques and techniques using games and the arts. The relative utility of different approaches with children of various stages of development is discussed, along with the need for empirical research regarding the effectiveness of these techniques.

Child Sexual Abuse Prevention: Evaluation of a Teacher Training Model.

Teachers are potentially helpful resource persons for large numbers of sexually abused children who may have difficulty disclosing abuse, particularly to family members. In the present study, the effectiveness of a 6-hour teacher training workshop on child sexual abuse prevention was evaluated. Responses of 26 female elementary teachers who participated in the workshop were compared to responses of 19 control teachers on several pre-, post-, and follow-up measures. Relative to controls, trained teachers demonstrated significant increases from pre- to post-testing in knowledge about child sexual abuse and pro-prevention opinions. On a post-only vignettes measure, trained teachers were better able than control teachers to identify behavioral indicators of abuse and suggest appropriate interventions for hypothetical sexually abused children. Over a 6-week follow-up period, trained teachers read more about child abuse than control teachers but did not differ on other behavioral dimensions such as reporting suspected abuse cases. Further research will examine the effects of additional teacher training over an extended follow-up period.

Effects of STARBRIGHT World on knowledge, social support, and coping in hospitalized children with sickle cell disease and asthma.

STARBRIGHT World is an innovative computer network for hospitalized children that provides interactive health education as well as opportunities to meet online with children in other hospitals. Fifty hospitalized children with sickle cell disease (SCD) or asthma participated in at least 1 day of a 3-day curriculum involving STARBRIGHT World activities and were compared to 60 control participants who participated in traditional hospital educational and recreational activities. Disease knowledge, perceived social support from peers, and coping skills were assessed at pre- and posttest. Participation in STARBRIGHT World resulted in a trend toward greater increases in knowledge for teens with asthma, more perceived peer support for children with SCD, and decreased negative coping among teens with SCD. The lack of more global treatment effects may be related to sample size and measurement variability issues, as well as limitations and variability in treatment intensity. Discussion focuses on ways to enhance STARBRIGHT World efficacy via outpatient and home-based program development and the need for further research using larger samples and more standardized intervention.

Knowledge, Attitudes, and Behavior in Children with Asthma

Psychosocial aspects of asthma were studied by administering questionnaires to 80 children with asthma and their parents. Overall, children demonstrated high levels of knowledge about asthma, an internal health locus of control, and positive self-concepts. Increased knowledge was associated with more internal health locus of control scores, whereas more positive self-concept scores were associated with more adaptive asthma-related behavior. Children who attended a week-long camp did not differ significantly from comparison children on these measures.

Teacher versus Expert Presentations of Sexual Abuse Prevention Programs

Previous studies of sexual abuse prevention programs conducted in schools have not compared the effectiveness of teachers versus outside consultants in implementing these programs. The current study contrasted three treatment conditions: (1) 15 regular teachers with their own classes (237 children); (2) eight lead teachers with unfamiliar classes (114 children); and (3) expert consultants with unfamiliar classes (201 children). All trainers used an adaptation of the Feeling Yes, Feeling No prevention curriculum, and both lead teachers and classroom teachers went through extensive training before implementing the program. No significant differences were found in the relative efficacy of using teachers versus expert consultants to present the program, with children demonstrating equivalent knowledge gains and equivalent skill scores on a videotape vignettes measure. Children in each condition made equivalent numbers of disclosures and had similar positive reactions to the programs.