Mark D. Everson

Longscan: A consortium for longitudinal studies of maltreatment and the life course of children

The National Research Council (1993) has issued an urgent call for theory-based, longitudinal research to examine the antecedents and consequences of child maltreatment. Many of the concerns raised by the National Research Council are addressed by LONGSCAN (LONGitudinal Studies of Child Abuse and Neglect), a consortium including a coordinating center and five independent prospective longitudinal investigations sharing common protocols for data collection, entry, and management. The children in the five investigations vary by their level of risk, ranging from a community sample with no identified risk beyond low income status, to children placed in foster care. The longitudinal study has been designed with six age-specific data collection points extending from 4 through 20 years of age. The conceptual model, organization, and analytic strategy for LONGSCAN are described.

A Longitudinal Study of Modifying Influences in the Relationship between Domestic Violence and Child Maltreatment

The increased risk of child maltreatment in the presence of domestic violence is well documented, but much remains unknown about factors that modify this relationship. This study investigates the roles of risk and protective factors in the relationship between domestic violence and being reported to the Department of Social Services for child maltreatment. Consistent with the literature, we find a significant overlap between domestic violence and maltreatment. Young maternal age, low education, low income, and lack of involvement in a religious community add to the risk for maltreatment associated with domestic violence. Separation between the maternal caregiver and her partner significantly reduces the risk for maltreatment when domestic violence is reported. A significant reduction in the risk for maltreatment is also found with higher levels of support from the maternal caregiver reported by the child in the context of domestic violence.

Impact of legal intervention on sexually abused children

OBJECTIVE Examining the psychologic risks of court and related interventions on child sexual abuse victims. DESIGN A prospective cohort study with follow-up at 5 months. SETTING Eleven county social service departments in central North Carolina. SUBJECTS 100 sexually abused children, ages 6 to 17 years, were recruited from consecutive referrals by social service departments; 75 completed the study. MEASUREMENTS AND RESULTS Using a structured psychiatric inventory, the Child Assessment Schedule, we found a high degree of distress at referral. The level of distress fell by 26% over the next 5 months (p less than 0.001). The 33 children not involved in criminal proceedings improved 30%, in comparison with a 17% improvement in the 22 children waiting for the proceedings (p = 0.042). The 12 children who had testified in juvenile court improved 42% on the Anxiety subscale, in comparison with a 17% improvement in all other subjects (p less than 0.01). With mathematical modeling that controlled for the factors of vaginal or anal penetration, the relationship to the perpetrator, an estimate of verbal IQ, duration of abuse, and whether counseling was received, it was estimated that children waiting for court proceedings at the follow-up examination were only one twelfth as likely to have improved by one standard deviation on the Depression subscale (p less than 0.05). A second model revealed that children who testified in juvenile court were 20.11 times more likely to improve by one standard deviation on the CAS Anxiety subscale (p less than 0.05). CONCLUSIONS Testimony in juvenile court may be beneficial for the child, whereas protracted criminal proceedings may have an adverse effect on the mental health of the victim.

False allegations of sexual abuse by children and adolescents

The frequency of false allegations of sexual abuse by children and adolescents is of significant legal and clinical importance. The rate of false allegations of sexual abuse is examined in a large sample of Child Protective Services (CPS) cases. The criteria used by CPS workers in judging the validity of allegations are considered, and the relationship between substantiation rates and attitudes about the trustworthiness of child reports of abuse is explored. Many professionals in the field of child sexual abuse are more skeptical of child and adolescent claims of sexual abuse than available research suggests is warranted.

Investigative interviews of alleged sexual abuse victims with and without anatomical dolls

Verbal and nonverbal responses by alleged victims of child sexual abuse were coded for length, amount of information, and the manner in which they were elicited by the interviewer. In 16 of the interviews, anatomical dolls were employed for the purposes of demonstration, whereas they were not used in another eight cases matched with respect to other characteristics of the children and the alleged events. Children interviewed with dolls provided an equivalent number of details and spoke as many words in the substantive portion of the interview as did children interviewed without dolls, and interviewers in the two groups used similar probes to elicit information. However, the average responses by the children were significantly longer and more detailed when dolls were not used. Children gave longer and more detailed responses to open-ended invitations when dolls were not used. Caution is necessary when interpreting these findings.

Concordance Between Adolescent Reports of Childhood Abuse and Child Protective Service Determinations in an At-Risk Sample of Young Adolescents

This study examines the concordance between adolescent reports of abuse and abuse determinations from Child Protective Service (CPS) agencies. It also compares the utility of adolescent reports of abuse, relative to CPS determinations in predicting adolescent psychological adjustment. The sample included 350 early adolescents, ages 12 to 13 years, who were initially identified prior to age 2 years as being at elevated risk of maltreatment. An Audio-Computer Assisted Self Interview (A-CASI) was used to assess lifetime experiences of physical, sexual, and psychological abuse. The A-CASI interview elicited prevalence rates of abuse 4 to 6 times higher than those found in CPS records. However, 20 of 45 adolescents with CPS determinations of abuse failed to report abuse during the study interview. Adolescent psychological adjustment was more strongly associated with self-reports than with CPS determinations. The implications of these findings are discussed for validity of adolescent self-reports of childhood abuse and for the ongoing debate about disclosure patterns among victims of child sexual abuse.

Putting the anatomical doll controversy in perspective: An examination of the major uses and criticisms of the dolls in child sexual abuse evaluations

Through an extensive review of guidelines and protocols on the use of anatomical dolls in sexual abuse evaluations, seven functional uses of the dolls were identified: Comforter, Icebreaker, Anatomical Model, Demonstration Aid, Memory Stimulus, Diagnostic Screen, and Diagnostic Test. These functional uses are discussed in light of several criticisms that have been raised about the use of anatomical dolls in sexual abuse evaluations. The relevancy of these criticisms is shown to vary greatly by doll use. As a result, the authors argue that any critique of anatomical dolls must consider the specific function the dolls serve in the evaluation. Although there seem to be widespread perceptions in both lay and professional circles that young childrens behavior with the dolls is commonly used to make definitive diagnoses of sexual abuse (Diagnostic Test Use), such a use of the dolls was not endorsed by any of the guidelines reviewed and is open to significant criticism. The most common criticisms of the dolls, that they are overly suggestive to young, sexually naive children, is not supported by available research. Finally, the continued, informed use of anatomical dolls in sexual abuse evaluations of young children is strongly supported.

Sexualized Doll Play among Young Children: Implications for the Use of Anatomical Dolls in Sexual Abuse Evaluations

The use of anatomical dolls in sexual abuse evaluations remains controversial because of concerns that the dolls induce normal, nonabused children to act out in sexual ways that are likely to be misinterpreted as evidence of sexual abuse. This study examines the incidence of explicit sexual doll play in a large, demographically diverse sample of 2- to 5-year-olds. The 6% incidence of demonstrations of apparent sexual intercourse found in this sample compared favorably with the rate of less than 2% across prior studies of anatomical doll play among presumably nonabused children. However, higher rates of explicit sexual play were associated with being older, poor, black, and somewhat with being male, with over 20% of some subgroups of children displaying such behavior. These results are interpreted as evidence that anatomical dolls are not overly suggestive to young, sexually naive children, but are useful in assessing sexual knowledge and exposure to sexual intercourse.

Suicidal Ideation Among 8-Year-Olds Who Are Maltreated and At Risk: Findings From the LONGSCAN Studies

Suicidal ideation was examined among 1,051 8-year-old children identified as maltreated or at risk for maltreatment. Of these children, 9.9% reported suicidal ideation. Many variables, including maltreatment, had bivariate associations with suicidal ideation. Severity of physical abuse, chronicity of maltreatment, and the presence of multiple types of maltreatment strongly predicted suicidal ideation. In multivariate analyses of the domains of proximity, only ethnic background remained significant among demographic variables, only witnessed violence and maltreatment remained significant among family or contextual variables, and only child psychological distress, substance use, and poor social problem solving remained significant among child variables. The effects of ethnicity, maltreatment, and witnessed violence on suicidal ideation were mediated by child functioning. There were few interactions between maltreatment and other factors to predict suicidal ideation. Children who are maltreated and those exposed to community and domestic violence are at increased risk of suicidal ideation, even by age 8.

Youth self-report of physical and sexual abuse: A latent class analysis

OBJECTIVE To determine if meaningful groups of at-risk pre-adolescent youth could be identified based on their self-report of physical and sexual abuse histories. METHODS Youth participating in a consortium of ongoing longitudinal studies were interviewed using an audio-computer assisted self-interview (A-CASI) when they were approximately 12 years of age to obtain information about their perceived experiences of physical (18 items) and sexual (12 items) abuse. In addition, Child Protective Service records were reviewed and the taxonomy developed for defining maltreatment characteristics (Barnett, Manly, & Cicchetti, 1993) was applied. A total of 795 youth completed the age 12 interview and had their records reviewed during the period from birth to the time of their age 12 interview. A latent variable modeling approach, specifically latent class analysis (LCA), was used to generate profiles of youth based on their endorsements of the physical and sexual abuse items. These profiles were then compared to CPS reports of physical or sexual abuse to determine their validity. RESULTS The LCA identified 4 interpretable classes or groups of pre-adolescent youth. Based on the pattern of responses to specific items the classes were identified as follows: (1) no physical or sexual abuse; (2) high physical abuse/low sexual abuse; (3) no physical abuse/moderate sexual abuse; and (4) high physical and sexual abuse. Follow-up analyses indicated that the odds of a CPS report for Classes 2, 3, and 4 compared to Class 1 were significantly greater (2.21, 2.55, and 5.10, respectively). CONCLUSION The latent variable modeling approach allowed for the identification of meaningful groups of youth that accounted for both the occurrence of multiple types of abuse as well as differing severities associated with each type. It is suggested that this methodological approach may be most useful in future efforts to identify the antecedents and consequences of maltreatment. PRACTICE IMPLICATIONS The results of the present study not only have implications for future research efforts, but also suggest that in practice, youth at-risk for maltreatment may be reliable and valid reporters of their physical and sexual abuse experiences.