Jody Todd Manly

The impact of subtype, frequency, chronicity, and severity of child maltreatment on social competence and behavior problems

This investigation examined the impact of dimensions within maltreatment such as the severity, frequency, chronicity, and subtypes of maltreatment and their relationship with child outcome. Children between the ages of 5 and 11 who participated in a summer camp program were assessed on their social competence, behavior problems, and peers ratings of cooperation, disruption, and initiation of aggression. The 235 participants were all from low-socioeconomic status families; 145 children were from families with documented histories of child maltreatment, whereas 90 of the children had no record of maltreatment. The study found that severity of the maltreatment, the frequency of Child Protective Services reports, and the interaction between severity and frequency were significant predictors of childrens functioning. Additionally, the chronicity of the maltreatment in the family significantly predicted peer ratings of aggression. Subtype differences emerged as well, with children in the sexual abuse group being more socially competent than other maltreated children, and children in the physical abuse group having more behavior problems than nonmaltreated children. Regression analyses with cooccurrence of multiple subtypes of maltreatment indicated that physical neglect, physical abuse, and sexual abuse made significant unique contributions in predicting child outcomes. The advantages of exploring multiple dimensions within maltreatment, the necessity of developing better operational definitions of these dimensions, and social policy implications of the findings are discussed.

The relative efficacy of two interventions in altering maltreated preschool children's representational models: Implications for attachment theory

A narrative story-stem task was used to evaluate the efficacy of two competing, developmentally informed preventive interventions for maltreated preschoolers and their mothers designed to modify childrens internal representations of self and of self in relation to other. One hundred and twenty-two mothers and their preschoolers (87 maltreated and 35 nonmaltreated) served as participants. Maltreating families were randomly assigned to either the preschooler-parent psychotherapy (PPP, n = 23), psychoeducational home visitation (PHV, n = 34), or community standard (CS, n = 30) intervention group at baseline. Thirty-five nonmaltreating (NC) families served as comparisons. Narratives were administered to children at baseline and at the postintervention evaluation. Children in the PPP intervention evidenced more of a decline in maladaptive maternal representations over time than PHV and CS children and displayed a greater decrease in negative self-representations than CS, PHV, and NC children. Also, the mother-child relationship expectations of PPP children became more positive over the course of the intervention, as compared to NC and PHV participants. These results suggest that an attachment-theory informed model of intervention (PPP) is more effective at improving representations of self and of caregivers than is a didactic model of intervention directed at parenting skills. Findings are discussed with respect to their implications for developmental theory, with a specific focus on attachment theory and internal working models of relationships.

Child maltreatment and vulnerability to depression

This investigation explored differences in depressive symptomatology among low-socioeconomic status children aged 7–12 years from abusive ( N = 46), neglectful ( N = 35), and nonmaltreating ( N = 72) homes. Measures of aggression and self-esteem also were included. Children from abusive homes evidenced significantly more depressive symptomatology than children from either neglectful or nonmaltreating families. Additionally, children from physically abusive homes exhibited lower self-esteem than did nonmaltreated children. While significant differences among groups on aggression did not emerge, all groups evidenced higher levels of acting out behaviors than would be expected in a nonclinic group of children. Results were discussed in terms of the effects of physical abuse on depression and the importance of intervening to prevent the deleterious effects of abuse. Additionally, the impact of neglect and poverty status on the presence of aggression was discussed.

The Efficacy of Toddler-Parent Psychotherapy to Reorganize Attachment in the Young Offspring of Mothers with Major Depressive Disorder: A Randomized Preventive Trial.

The development of insecure attachment relationships in the offspring of mothers with major depressive disorder (MDD) may initiate a negative trajectory leading to future psychopathology. Therefore, the provision of theoretically guided interventions designed to promote secure attachment is of paramount importance. Mothers who had experienced MDD since their childs birth were recruited (n = 130) and randomized to toddler-parent psychotherapy (DI) or to a control group (DC). Nondepressed mothers with no current or history of major mental disorder and their toddlers also were recruited for a nondepressed comparison group (NC; n = 68). Children averaged 20.34 months of age at the initial assessment. Higher rates of insecure attachment were present in both the DI and the DC groups at baseline, relative to the NC group. At postintervention, at age 36 months, insecure attachment continued to predominate in the DC group. In contrast, the rate of secure attachment had increased substantially in the DI group and was higher than that for the DC and the NC groups. These results demonstrate the efficacy of toddler-parent psychotherapy in fostering secure attachment relationships in young children of depressed mothers.

Child maltreatment and trajectories of personality and behavioral functioning: Implications for the development of personality disorder

This study investigated the longitudinal impact of maltreatment parameters on personality processes and maladjustment and prospective relationships between personality trajectory classes and subsequent maladjustment outcomes. The sample involved maltreated (n = 249) and nonmaltreated (n = 200) children followed longitudinally between ages 6 and 10. Growth mixture modeling indicated multifinality in personality development depending on the risk status (i.e., maltreated vs. nonmaltreated). Two trajectory classes of ego resiliency were identified for maltreated children: those who showed a declining trajectory exhibited greater maladjustment. In contrast, three trajectory classes of ego control were identified for nonmaltreated children; the subgroups showing increases in ego undercontrol or dramatic changes from high ego undercontrol to high ego overcontrol exhibited poor adjustment. Experiencing multiple maltreatment subtypes and physical/sexual abuse were related to higher levels of ego undercontrol and externalizing symptomatology, whereas early onset of maltreatment was associated with the low and decreasing trajectory of ego resiliency and higher levels of internalizing symptomatology. The findings suggest that ego resiliency and ego control, personality processes related to self-regulation, may be important factors in identifying distinct pathways to later personality disorders as well as pathways to resilient functioning.

Child Maltreatment, Attachment Security, and Internal Representations of Mother and Mother–Child Relationships

Attachment security and internal representations of mothers, and of the mother—child relationship, were examined in an ethnically diverse and economically disadvantaged sample of maltreated (N = 92) and nonmaltreated (N = 31) preschool-aged children. Maltreated preschoolers had lower rates of secure attachment and higher rates of disorganized attachment than did nonmaltreated preschoolers. Maltreatment also was associated with less positive global representations of the mother—child relationship relative to the nonmaltreated comparison group. Analyses were conducted to determine whether maltreatment characteristics such as subtype, chronicity, severity, and frequency were associated with attachment organization and with internal representations. Implications of these results for developmental theory and intervention with maltreated children are discussed.

Continuing toward an operational definition of psychological maltreatment

More than any other subtype of abuse and neglect, psychological maltreatment offers a number of unique challenges to theoreticians and researchers. Although progress has been made, contention still remains over the definition of psychological maltreatment and its relation to other forms of child abuse and neglect (Brassard, Germain, & Hart, 1987; Garbarino, Guttmann, & Seeley, 1986). Thus, the definition and operationalization of psychological maltreatment continue to be important issues that require further research and explanation. In fact, the development of standardized definitions and assessment techniques for all forms of maltreatment is crucial to increase communication across laboratories, and across disciplines.

Social Perspective-Taking Skills in Maltreated Children and Adolescents

The primary goal of this study was to assess the ability of maltreated school-age children and adolescents to understand the thoughts, feelings, and points of view of others. Level of egocentrism and social perspective-taking coordination were assessed in a group of 49 maltreated and 49 demographically matched nonmaltreated children. Twenty-six elementary and 23 high school students in each group were individually interviewed and their responses to hypothetical interpersonal situations coded for egocentricity and level of perspective-taking ability. The findings revealed that maltreated children and adolescents were more egocentric and delayed in their social perspective-taking development than their nonmaltreated peers and that they reported lower levels of global self-worth. However, differences within the group of maltreated children and adolescents emerged with regard to negotiating novel relationships, as those with fewer internalizing or externalizing symptoms exhibited better skills in this area than their peers who displayed more symptoms.

Child Neglect and the Development of Externalizing Behavior Problems: Associations with Maternal Drug Dependence and Neighborhood Crime

Given the high prevalence of child neglect among maltreatment subtypes, and its association with exposure to additional environmental adversity, understanding the processes that potentiate child neglect and link neglect to subsequent child externalizing psychopathology may shed light on key targets for preventive intervention. Among 170 urban low-income children (ages 4–9) and their mothers, this 5-year prospective study examined the effects of early neglect severity and maternal substance abuse, as well as neighborhood crime, on children’s later externalizing behavior problems. Severity of child neglect (up to age 6 years) mediated the relation between maternal drug dependence diagnosis (MDDD), determined at children’s age of 4 years, and children’s externalizing behavior problems at age 9. Rates of neighborhood crime mediated the link between presence of child neglect and children’s externalizing behavior problems. The roles of MDDD, child neglect, and community violence in the development of child psychopathology are discussed in terms of their implications for intervention.

Bridging research and practice: Challenges and successes in implementing evidence-based preventive intervention strategies for child maltreatment

Child maltreatment has been associated with a wide range of negative developmental outcomes for children and families as well as significant economic consequences. While efficacious intervention strategies have been demonstrated to reduce symptoms of trauma and to improve behavioral and emotional functioning, these models have not been widely adopted by clinicians. The challenges associated with exporting evidence-based interventions into community settings are discussed, along with an example of a preventive intervention program for young mothers, successfully implemented through a partnership of community agencies and funders.