Patricia M. Crittenden

Physical and Psychological Maltreatment: Relations Among Types of Maltreatment

Maltreatment has serious consequences for the development of children. The reason for the negative outcomes is not, however, fully understood. This study investigated the hypotheses that psychological maltreatment would be present in almost all cases of physical maltreatment and that it would be more related to detrimental outcomes for children than would severity of injury. A sample of 175 maltreated children, 39 children in mental health treatment, and 176 normative children was assessed for type and severity of maltreatment. Both hypotheses were supported. In addition, evidence is provided that psychological maltreatment can occur alone, that assessments of parental psychologically maltreating behavior and negative child outcomes are highly correlated, and that child age and gender are unrelated to psychological maltreatment in young children whereas family income is related. Implications for investigation and treatment are considered.

Internal representational models of attachment relationships

Bowlbys notion of internal representational models is explored with the purpose of clarifying the nature of such models. Distinctions are made among the concepts of (a) focus, (b) memory systems, (c) content, (d) cognitive function, (e) meta-structure, (f) quality of attachment, (g) behavioral strategies, and (h) attitude toward attachment. New terms are offered for familiar concepts, such as defended insecure quality of attachment. New meanings are given for familiar terms, such as working model and balanced attitude toward attachment. In addition, new concepts are introduced including procedural models and meta-models. Areas for further research are discussed in terms of other aspects of relationships and nonattachment relationships. Throughout, the emphasis is on specification of meaning and integration of aspects and levels of models. Finally, issues about assessing attachment and intervening clinically are discussed.

Children's strategies for coping with adverse home environments: An interpretation using attachment theory☆

The coping strategies of four groups of maltreated children were compared with those of adequately reared children. The children were videotaped in a brief play session with their mothers, then in the Strange Situation, and finally during free play while the parent(s) were being interviewed. The coded videotapes of mother-child interaction yielded four scores for the children: cooperation, compulsive compliance, difficultness, and passivity. The coded videotapes of the Strange Situation yielded ten patterns of child attachment to the mother. The coded observations of play during the interview were analyzed in terms of seven child behaviors. The results indicated that abused, and abused-and-neglected children were difficult or compliant in interaction with their mothers, avoidant under stress, and aggressive with siblings; neglected children were cooperative in play with the mother, anxious under stress, and aggressive with siblings; adequately reared children were cooperative with both their mothers and siblings and secure under stress. Older children who had experienced abuse were less difficult and more compulsively compliant. Both marginally maltreated and adequately reared 1-year-olds were more difficult than either older or younger children from those groups but at all ages cooperation was the dominant pattern. The coherencies in the childrens coping strategies were interpreted in terms of underlying internal representational models of relationships.

Compulsive compliance: The development of an inhibitory coping strategy in infancy

This study explored the development of young childrens behavioral strategies for coping with child abuse. It was hypothesized that infants exposed to the controllingness and harshness of interaction with an abusive mother would first learn to inhibit behavior disagreeable to the mother and later learn to comply with maternal demands. It was expected that this developmental change in abused childrens behavior would be adaptive in the short term because it would reduce the probability of continued abuse. In the long term, however, compulsive compliance was expected to be maladaptive because it distorted the childs perception of, and response to, reality. In addition, it was hypothesized that the compliant behavior pattern would be used only with controlling interactants during the first 3 years of life. In other words, the descriptions of defensive patterns of behavior applied indiscriminantly by older abused children were not expected to apply to infants and toddlers. Both hypotheses were supported using data drawn from videotapes of mother- child and other adult- child interaction.

Developmental Trends in the Nature of Child Homicide

Child homicide is a frequent cause of death in children under 6 years of age. However, compared to other, less prevalent causes of death, it is poorly understood. There is a need to identify a coherent pattern or set of patterns among cases of child homicide. Child age may be a useful explanatory variable. This study differentiated among neonatal, early, and middle childhood deaths. Neonatal deaths were not related to child behavior, child physiological abnormality, or maternal parity or marital status; they were related to maternal isolation during the birth. Homicidal deaths of infants, toddlers, and preschoolers (early childhood) were usually the result of parental attempts to control child behavior. These deaths appeared to be unintended and related to the physical vulnerability of the child who is smaller than the attacking adult. Deaths of school-age children (middle childhood) resulted most often from gunshot wounds. Few children of any age were unsupervised or killed by strangers. The data suggest that it is difficult, or even impossible, to identify preventively specific cases of incipient homicide. An epidemiological approach to prevention is suggested; means of reducing risk are suggested for each of three age groups.

Assessing attachment in school-age children.

The School-age Assessment of Attachment (SAA) is a newly developed clinical tool to identify pattern of attachment using the Dynamic-Maturational Model of attachment and adaptation (DMM). Seven picture cards were used to elicit fantasy stories and recalled episodes. The transcribed discourse was analyzed to yield one of 13 DMM attachment classifications, together with possible unresolved traumas and losses, and modifiers (depression and intrusions). In this article, we outline the steps necessary to validate an assessment tool, describe the development of the SAA, and report data from a preliminary clinical study testing the SAA’s reliability, validity, and utility. Concurrent construct, familial, and discriminant validity were evaluated in terms of mental health status and exposure to danger on a sample of 5—12-year-old children, drawn from clinical ( n = 51) and normative (n = 40) populations. The SAA (a) differentiated children referred for psychiatric diagnosis from those in the normative population; (b) accounted for 31% of the variance (46% when family variables were added); (c) identified risk children in the normative sample; and (d) suggested risk factors associated with children’s psychiatric disorder.

Non-organic failure-to-thrive: Deprivation or distortion?

Infants diagnosed non-organic failure-to-thrive (NOFT) show arrested physical development. The cause of the growth delay and of the accompanying behavioral anomalies is not known, but generally is attributed to maternal deprivation. This study investigated the hypothesis that family hostility was also a contributing factor. NOFT families were compared with maltreating and adequate families and found to be larger and more intact, but characterized by extremely distressed interpersonal relationships and family violence. This result was interpreted as suggesting that NOFT resulted from the stress of both insufficient and inappropriate treatment of the infant. The source of the stress was observed to include the entire family, the members of which were displaying other psychosomatic manifestations of stress.

Comparing Two Attachment Classification Methods Applied to Preschool Strange Situations

This study compared two methods for classifying preschool-age children’s behavior in the Strange Situation procedure, the MacArthur (MAC) and the Preschool Assessment of Attachment (PAA), to determine whether they operationalized converging or diverging approaches to attachment theory. Strange Situations of 306 randomly selected 3-year-old children and their mothers in the NICHD Study of Early Child Care and Youth Development were classified with the MAC and PAA. The methods showed 50% agreement. A block of seven demographic, child and family predictors was unrelated to MAC classifications, but accounted for 19% of the variance in PAA classifications. The MAC and PAA each had associations with some child outcomes in grades 1—5 (ages 6—10) totaling 5% and 12% of the variance respectively, but some of the MAC associations were counter to the hypothesis. The MAC and PAA were sufficiently different to reflect both different classificatory methods and different theoretical understandings of attachment. Results are discussed in terms of limitations of the sample and measures available to compare the two methods, and clinical implications.

Dimensions of maltreated children's home behavior : a factor analytic approach

Abstract This study identified dimensions of home behavior of maltreating parents and their children through exploratory factor analysis. Five child factors were identified: self-directed behavior, affiliative behavior, negativity, positive social interaction, and questioning. Five parent factors were identified: positive social interaction, caretaking, discipline, refusal, and hostility. Multivariate analyses indicated that neglected children and abused children had less positive social interaction than adequately reared children. Children showed more questioning and less negativity at older ages. Abusing parents were most hostile, whereas neglecting parents showed the least positive social interaction. Abusing parents directed less hostility toward older children than the other child-rearing groups. Parents exhibited less caretaking behavior toward older children and directed more positive social interaction toward children with higher developmental quotients. The results suggest that factor analysis is a viable means of identifying dimensions of child and parent behavior which could facilitate comparison of effects across studies.

Teaching Maltreated Children in the Preschool

This article applies the findings of previous research by the author and others to the management of preschool-aged maltreated children in the classroom. Such children are common in both regular and special education classrooms. Depending upon the type of maltreating home environment that they have experienced, they may be expected to display one of several patterns of atypical development and to need specialized intervention. The several types of home environments are described, as are the associated patterns of child development. Recommendations are offered regarding the social and academic needs of the children and the management of their problems in the classroom.