Jan L. Faust

Family variables associated with the onset and impact of intrafamilial childhood sexual abuse

Abstract Researchers and clinicians have examined variables mediating the onset and consequences of childhood incest. Overall research has illuminated two primary clusters of variables that appear to significantly impact a childs response and adjustment to incest. The purpose of this article was to help elucidate one of these clusters of variables: those family variables which both contribute to the onset of and childs response to incest. Overall, it was evident that little empirically sound research exists in this area. Preliminary results of the few existing well-designed studies suggested that increased risk for onset of and poor adjustment to incest is associated with status of perpetrator, perpetrator substance abuse, nonoffending mothers absence, lack of maternal support toward incested daughter, and other specific family environment characteristics. Articles were critically evaluated for methodological flaws and suggestions for improving future research were made.

Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression.

OBJECTIVE The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression. METHOD PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD. RESULTS Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks. CONCLUSIONS For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.

Same-Day Surgery Preparation: Reduction of Pediatric Patient Arousal and Distress through Participant Modeling.

Twenty-six children (mean age = 5.5 years) were exposed to one of three surgery preparatory conditions: participant modeling alone (n = 9), participant modeling with mother (n = 8), and standard procedure control (n = 9). Children exposed to the modeling slide-tape without their mothers had significant reductions in physiological arousal after the slide-tape presentation, unlike children viewing the tape with their mothers and children exposed to the control condition. Both participant modeling groups exhibited significantly fewer distressful behaviors during recovery (postsurgery) than did control group children. Results are discussed with respect to previous medical preparation research. Implications of these findings concerning clinical application and future research are addressed.

Predicting Posttraumatic Stress Following Pediatric Injury: A Systematic Review

OBJECTIVE To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research. METHODS A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles. RESULTS Pre-injury psychological problems, the childs subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury. CONCLUSIONS Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.

Mother-Child Agreement on Self-Report of Anxiety in Abused Children

This study investigates the lack of agreement in maternal and child report of child anxiety with a sample of abused and nonabused clinic-referred children. Based on the literature, it was predicted that nonabused clinic-referred children would report more symptoms of anxiety than their mothers would report for them. It was also predicted that mothers of abused children would report greater anxiety symptoms for their children than the childrens self-report. Finally, it was predicted that maternal psychopathology, specifically anxiety, would increase the probability that mothers would overreport their childrens anxiety. Mother-child agreement based on anxiety symptoms assessed by the Quay Behavior Problem Checklist and the Revised-Childrens Manifest Anxiety Scale was obtained on 54 male and female outpatients, 5 to 16 years of age. Overall, mothers reported significantly more anxiety for their children, than the childrens own self-report, irrespective of abuse history. The implications of the findings are discussed with respect to the validity of maternal and child report. Directions for future research are also offered.

Impact of Child Abuse Timing and Family Environment on Psychosis

SUMMARY The theoretical basis for the development of differential psychopathology in children in response to a traumatic event suggests the timing of trauma and the family environment likely influence the development of psychological disturbances. We predicted that abused children who had psychotic symptoms would have experienced the trauma earlier in life than those children diagnosed with post traumatic stress disorder (PTSD). We also predicted that children with psychotic symptoms would hail from homes higher in cohesion and family conflict than those children with PTSD. Participants were 40 children, ages 6 to 17, and their mothers. All children were receiving treatment at a community mental health center, and were diagnosed with either posttraumatic stress disorder (PTSD; n = 20) or a psychotic based disorder (n = 20). Results indicated that children with psychotic disorders experienced trauma earlier than children with PTSD (p < .02). Children with psychotic disorders reported more familial conflict (p < .04) than those children with PTSD. When compared to mothers of children with PTSD, mothers of psychotic children rated their family as less cohesive (p < .03). Implications of this research were discussed.

Trauma Practice in the Wake of September 11, 2001

Abstract The attacks of September 11th, 2001 were unprecedented in several respects. They were the first attacks on U.S. soil by a foreign power in several generations, were witnessed live on television throughout the U.S. and the world, and shattered widely held assumptions about security in the U.S. and, by implication, elsewhere. Some questions and challenges evoked by the events of September 11th of particular relevance to trauma practitioners are discussed. The contents of Trauma Practice in the Wake of September 11, 2001, are summarized and framed as representing a preliminary attempt to respond to some of these questions. Finally, some of the opportunities created by the September 11th attacks-increasing public awareness of trauma and its impact, fostering compassion for victims of various types of trauma, and strengthening international collaboration among traumatologists and advocates of world peace-are considered.

Integration of Family and Cognitive Behavioral Therapy for Treating Sexually Abused Children

This paper demonstrates the application and integration of family systems therapy and cognitive behavioral therapy for the treatment of symptomatic children with histories of sexual abuse. This is achieved via the case of Ryan, a 12-year-old boy who had been sexually abused by two family members and who was experiencing affective/anxiety symptoms and acting-out behavior problems. While this paper provides a theoretical rationale and comprehensive treatment plan, additional details of specific treatment interventions, from both treatment modalities, are delineated. From the family systems perspective, an emphasis is placed upon the discussion of realignment of family structure and changing familial communication patterns (including messages about safety, protection, and validation of childrens experiences). From the cognitive behavioral paradigm, exposure therapy and cognitive restructuring are accentuated. Finally, the importance of the integration of both modalities without violating the theoretical assumptions of either is highlighted.

Differences in family functioning of sexually abused vs. nonabused enuretics

The present study examined self-reported maternal depression, childrens somatic complaints, and perception of family functioning in sexually abused and nonabused enuretics. Forty children with primary nocturnal enuresis served as subjects. Half had documented histories of sexual abuse while the other half did not report a history of victimization. Results indicated that those children with a history of sexual abuse perceived and rated their families as significantly more conflictual and rigid than their nonabused counterparts. Variables such as type of abuse (intrafamilial vs. extrafamilial) and perpetrator did not affect the outcome. However, there were no significant differences in child somatic complaints or maternal depression between the two groups. These results suggest that primary nocturnal enuresis may manifest itself differently in families of sexually abused children than nonabused children. Implications of these findings with respect to intervention are discussed.

Parent–child gender matching and child psychological adjustment after divorce

ABSTRACT The present study aimed to determine whether a parent–child gender match would influence child psychological adjustment after divorce. Participants included 69 parents (36 mothers) in active family law litigation to resolve issues related to postdissolution of marriage or time-sharing matters. Participants provided demographic information and completed the Child Behavior Checklist (CBCL; Achenbach, 1991) to assess their perceptions of their child’s internalizing and externalizing behavior problems. Results demonstrated that internalizing and externalizing behaviors were not affected by whether children spent more time with the same gender parent, opposite gender parent, or split their time equally between both. Comparisons and contradictions between the results in this study and existing research are discussed, as well as practical implications.