Kathryn B. Sherrod

Prospective study of antecedents for nonorganic failure to thrive

The cause of nonorganic failure to thrive (NFT) was studied prospectively in 274 low-income pregnant mothers by interviewing them for characteristics that retrospective studies indicated were associated with child maltreatment. After delivery, medical charts of mothers and infants were reviewed for complications of pregnancy, delivery, and postdelivery hospitalization, and the infants were observed for growth failure. The characteristics of 15 families with infants who developed NFT were compared with those of 86 selected randomly from the remaining families. Interview results suggest that NFT correlates significantly with aberrant nurture during the mothers childhood and with conflicts between the parents of the infants. Perinatal events correlating significantly with NFT include complications of pregnancy, short gestation, and residual minor medical problems at discharge from the nursery. We speculate that these events predispose to NFT by disturbing the development of the mother-infant relationship.

Prediction of child maltreatment during pregnancy.

Abstract Fourteen hundred expectant mothers volunteered to be interviewed about their attitudes, experiences, and knowledge of child rearing. The purpose of the interview was to identify parental predictors of child maltreatment. Based upon answers, 273 were expected to be at high risk for parenting disorders. After delivery, their infants and 225 selected randomly from all remaining mothers were followed in a double-blind fashion for evidence of child abuse, neglect, and nonorganic failure to thrive. All three parenting disorders were found significantly more often in the high-risk families.

A prospective study of secondary prevention of child maltreatment

This study sought (1) to retest an approach to the prediction of risk of child maltreatment and (2) to test the effect of a comprehensive prenatal and pediatric health services program on the rate of maltreatment. Of 2585 women screened at their first prenatal visit, 1154 qualified for the study. Risk assignment was determined by a structured interview. High-risk women (n = 314) were assigned to receive standard (high-risk control group; n = 154) or intervention (high-risk intervention group; n = 160) services throughout the prenatal period and during the first 2 years of their infants life. A third group (low-risk control group; n = 295) was selected among low-risk women and received standard care without intervention services. State records were searched for substantive reports of child maltreatment up to 36 months after birth. Physical abuse was found for 5.1% of the study population; neglect was substantiated for 5.9%. Prediction efforts were effective in identifying risk of physical abuse but not of neglect. Comprehensive health services did not alter the reported abuse rate for high-risk parents and was associated with an increased number of neglect reports. Intervention reduced subject attrition and appeared to serve as a bias for detection of maltreatment. Thus this long-term, prospective approach was ineffective for child abuse prevention, perhaps because of detection biases and societal changes.

The prospective assessment of self-concept in neglectful and physically abusive low income mothers

Maternal self-esteem has long been associated with the quality of maternal-child interactions and many assume that low self-esteem contributes to the cause of maltreatment. Assessments of the self-concepts of maltreating parents, however, have been done only after maltreatment has occurred. Prospective measurement of self-concept would help to clarify its role in the etiology of maltreatment. In this study, 471 pregnant women completed the Tennessee Self-Concept Scale (TSCS). State protective services records were reviewed 3 years after these children were born. When records of the 459 women with a known live-born child were reviewed, 29 were found to have maltreated their children (neglect n = 22; physical abuse n = 11; four women found to have both neglected and abused their children). Neglectful mothers had lower scores on scales measuring overall self-esteem, moral self-worth, personal and social adequacy, and perception of self-worth in family relationships than matched nonreported mothers. They described their identity and behavior more negatively and had greater general maladjustment and neurotic symptoms. Physically abusive mothers had lower scores on self-worth in family relationships. When measured prospectively, low self-esteem appears to be a risk factor for child neglect, but is not a strong predictor for physical abuse. Implications for prevention programs are discussed.

Evidence for Specific Effects of Childhood Sexual Abuse on Mental Well-Being and Physical Self-Esteem.

Women who are sexually abused are at increased risk for having mental health problems long after the abuse. Other nonexploitive experiences can also be psychologically detrimental, may coexist with sexual abuse, and may explain some portion of subsequent mental health problems. This study addresses the association between childhood sexual abuse and a womans psychological functioning, independent of the quality of parental nurturance received during childhood and other variables which may influence mental health. Of 609 women completing mental health and self-concept measures, 98 reported sexual abuse; 110 of the remaining women were selected as comparisons. Women sexually abused as children scored lower on measures of mental health status. Both sexual abuse and fewer years of education were related to lower scores on a psychological well-being scale after variance accounted for by family and demographic variables was removed. Sexual abuse was not a predictor of general self-concept scores after the removal of family and demographic variables, but sexual abuse was independently associated with the subscale measuring the physical aspect of self-concept. These findings lend support to theorized causal links between child sexual abuse and some aspects of later psychological difficulties.

Outcome of abuse during childhood among pregnant low income women

The outcome of experiencing abuse as a child was studied by comparing pregnant women who did recall versus those who did not recall this type of maltreatment. Fourteen hundred low income women were interviewed in prenatal clinic; those who said they were both punished by abuse and beaten by caretakers as children were considered abused. Abuse was recalled by more white than black women but families were followed after delivery and protective service reports of abuse for their offspring were equal. Because of low numbers, black subjects were dropped and the 95 white women who recalled abuse during childhood were compared to the remaining 832 white subjects. The groups did not differ in attitude about current pregnancy, age or marital status, and no differences were found for their children at birth. Abused mothers were more likely to have felt unwanted and unloved as children and to have lower self-images and more isolation than controls. Abused mothers had greater stress, and many of their stresses reflected disturbances in interpersonal relationships. Thus, women abused as children had some characteristics similar to those of known child abusers. Although abused women had more aggressive tendencies, their children were reported to protective services for abuse at the same frequency as control children. Intergenerational transmission of abuse was therefore not demonstrated prospectively. Classic theories of child abuse suggest a special child, special parent and stress act as independent agents to cause abuse. The above data suggest, alternatively, that abuse during childhood may lead to other risk characteristics and to greater stress. These may act together to increase risk for abuse. The special child may have an independent influence on abuse.

Social-psychological characteristics of adolescent mothers and behavioral characteristics of their first-born infants

This study examined the child-rearing attitudes perceptions of infant temperament and mother-infant interactional behaviour of primiparous adolescent mothers in comparison to mothers having their first infant post-adolescence as well as the newborn behaviour of the infants born to these women. The total number of mother-infant pairs in the study was 317. Measures were taken of maternal attitudes maternal perceptions of infant temperament and behavioural characteristics of the infant. An observational system was also used. The lack of differences between adolescent and post-adolescent mothers was attributed to the prescence of a comprehensive prenatal care program. (authors)

Toward a Semispecific, Multidimensional, Threshold Model of Maltreatment

Nonorganic failure to thrive (NOFT) is not well understood. Among the few points that are accepted are the idea of the severity of the problem, defined in terms of number of children affected (Altemeier, O’Connor, Sherrod & Vietze, in press) and sequelae (Hufton & Oates, 1977; White et al., 1980). One of the definitional aspects that is fairly generally accepted is that NOFT that occurs in very young infants is different from NOFT (often called psychosocial dwarfism) that occurs in toddlers or young children (Green, Campbell & David, 1984; Money, Annecillo & Kelley, 1983). Beyond that, NOFT appears to be a form of maltreatment, sometimes viewed as related to abuse or as a precursor to abuse (Koel, 1979; Oates, 1982), but more aptly viewed as a form of neglect, probably because it arises more through acts of omission than commision. However, the manner in which NOFT relates to other forms of maltreatment has not adequately been clarified or addressed thoroughly. Books giving a general overview of maltreatment invariably mention NOFT, although, unfortunately, few devote much space to it (e.g., Giovannoni & Becerra, 1979; Oates, 1982; Pelton, 1981). There are no books entirely focused on the psychological aspects of NOFT, although there are medically oriented ones (e.g. Accardo, 1982; Patton & Gardner, 1963).

Effects of irradiation and/or handling on shuttle box performance of C57B1/6 mice

Abstract Twenty C57B1/6 primigravida females were irradiated at 0.1R/hr for 15 days of gestation (36R total) and 20 were sham irradiated. The offspring were cross-fostered to sham irradiated or irradiated dams, resulting in 4 groups of 10 litters each, 0.1R/0.1R,S/0.1R,0.1R/S, and S/S. Half of the infants in each group were handled on postpartum Days 3–12. On Days 30 and 60 the offspring were given 30 trials in a 2-way shuttle box avoidance apparatus. Although irradiation was predicted to enhance learning, irradiation of the infant tended to depress learning on Day 30 and particularly on Day 60. This effect could have been due to the early age at which the first trials were given or to the low irradiation level used. Effects of irradiation are hypothesized to be nonmonotonic from 0 to 200–300+ R. The importance of finding any effects following chornic administration of such low levels of irradiation was noted. Handling had no effect on shuttle box behavior.