Theories of Child Physical Abuse


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Advanced Topics: Child Maltreatment Theory
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Southern Arkansas University
Kimberly Keith, MEd, LPC

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Theories of Child Physical Abuse

  2. 2. <ul><li>Biological Factors </li></ul><ul><li>Age </li></ul><ul><li>Emotional & Behavioral Disorders </li></ul><ul><li>Child Characteristics </li></ul>Individual Factors in Physical Child Abuse
  3. 3. Individual Risk Factors <ul><li>Biological Factors </li></ul><ul><ul><li>Reports of physical health problems and disabilities </li></ul></ul><ul><ul><li>Intellectual impairment </li></ul></ul><ul><ul><li>Physiological overreactivity </li></ul></ul><ul><ul><li>Neuropsychological deficits </li></ul></ul><ul><li>Age </li></ul><ul><ul><li>Younger parents; many teens when child born </li></ul></ul><ul><ul><li>Slightly more mothers than fathers </li></ul></ul>
  4. 4. Individual Risk Factors <ul><li>Emotional & Behavioral Difficulties </li></ul><ul><ul><li>Depression </li></ul></ul><ul><ul><li>Low frustration tolerance </li></ul></ul><ul><ul><li>Low self-esteem </li></ul></ul><ul><ul><li>Rigidity </li></ul></ul><ul><ul><li>Anger control problems </li></ul></ul><ul><ul><li>Deficits in empathy </li></ul></ul><ul><ul><li>Anxiety </li></ul></ul><ul><ul><li>Perceived life stress and personal distress </li></ul></ul><ul><ul><li>Substance abuse/dependence </li></ul></ul><ul><ul><li>Deficits in problem-solving skills </li></ul></ul>
  5. 5. Individual Risk Factors <ul><li>Child Characteristics </li></ul><ul><ul><li>Low birth weight, premature </li></ul></ul><ul><ul><li>Physical, mental, and developmental disabilities </li></ul></ul><ul><ul><ul><li>Emotional disturbance </li></ul></ul></ul><ul><ul><ul><li>ADHD </li></ul></ul></ul><ul><ul><ul><li>Learning disabilities </li></ul></ul></ul><ul><ul><ul><li>Speech or language delay </li></ul></ul></ul><ul><ul><ul><li>Intellectual impairment </li></ul></ul></ul>
  6. 6. Individual Protective Factors <ul><li>Temperament </li></ul><ul><li>Overall good physical, emotional, and intellectual health </li></ul>
  7. 7. <ul><li>Attachment </li></ul><ul><li>Parenting Style </li></ul><ul><li>History of Abuse </li></ul><ul><li>Family Development Stage </li></ul>Microsystem (Family) Factors in Physical Child Abuse
  8. 8. Attachment Patterns <ul><li>  Secure – The securely attached child uses the caregiver as a secure base. The child explores freely in the caregivers presence but ‘checks’ on the caregiver periodically either through eye or physical contact. When the caregiver leaves, the child’s reaction to the separation ranges from little to extreme distress. However, upon reunion, the child actively positively greets the caregiver, seeks, physical contact, and then continues playing. </li></ul><ul><li>  Insecure-Avoidant – The insecurely avoidant child ‘avoids’ the caregiver in his/her presence. The child appears not interested in the caregiver and explores his/her environment without interest in the caregiver’s presence. When the caregiver leaves, the child is minimally distressed. Upon reunion, the child continues to ignore the caregiver. </li></ul><ul><li>  Insecure-Resistant/Ambivalent – The insecure resistant/ambivalent child is preoccupied with the caregiver when the caregiver is in the room; the child has great difficulty separating from the caregiver. These children have great difficulty leaving the caregiver to play or explore. Upon separation, ambivalently attached children tend to be extremely distressed. At reunion, they again become preoccupied with the caregiver and seek physical contact. </li></ul><ul><li>  Insecure-Disorganized/Disoriented – Children with insecure – disorganized/disoriented attachment patterns utilize a disorganized coping strategy for dealing with separation from their primary caregiver. Children with disorganized/disoriented attachments also have difficulty managing arousal patterns, and either fail to or seem confused about approaching the caregiver when distressed. Characteristics of this type of attachment pattern include odd behaviors in which the child appears confused or scared of the caregiver and her/his presence. These children are the most distressed upon separation from the caregiver. </li></ul><ul><li>Bowlby (1982) and Ainsworth (1978, 1989); (Main and Solomon, 1986, 1990) </li></ul>
  9. 9. Attachment Connection to Physical Child Abuse <ul><li>Two-thirds of children who are maltreated have insecure attachments, and most exhibit the disorganized-disoriented (D) attachment pattern. ( Crittenden, 1988, Carlson, et al, 1989 ) </li></ul><ul><li>  Mothers of children with disorganized attachment style (D) felt helpless and out of control with children, viewed children as out of control, described harsh punishment. George, 1996 </li></ul><ul><li>  Mothers and children with insecure attachment style (B-D) were at significantly higher risk for child abuse than secure attachment style. Moncher, 1996 </li></ul>
  10. 10. Attachment and the Lifespan <ul><li>Bowlby’s hypothesis is that “children form an internal working model that is based on their attachment to their primary caregiver, which includes affect, cognition, and expectations about future interactions and which serves as a template for other interpersonal relationships. </li></ul><ul><li>  This places parents who were maltreated with a possible predisposition to maltreat, depending upon other” factors in the ecology/process. </li></ul><ul><li>  Thus, attachment’s impact on child maltreatment is seen in the micro- or family system, yet it impacts the ontogenic or individual through the child’s (then parent’s) internal working model of parent-child relationship, as well as other intimate relationships. </li></ul><ul><li>  Attachment patterns are highly influenced by culture, both at the exo- and macro system levels. For example, child care experts and/or extended family, neighborhood, or friends may influence an inexperienced parent to ‘let a baby cry or risk spoiling him/her.’ The parent may do just that, even to the point of harming the child’s secure attachment. </li></ul><ul><li>  A possible protective factor may be identified if the internal working model formed in the first three years is malleable, which it seems likely to be. In other words, can other factors in the ontogenic process change the internal working model of the parent-child relationship? </li></ul>
  11. 11. Parenting Styles Demandingness – amount of control parent attempts to exert over child Responsiveness – frequency of parenting interactions (both positive and negative) that are child centered versus parent centered (i.e. the degree to which the parent responds to the needs and behaviors shown by the child) Responsiveness Demandingness Responsive Child-Centered Unresponsive Parent-Centered Demanding Controlling Authoritative Authoritarian Undemanding Low in Control Attempts Indulgent Neglecting
  12. 12. Parenting Style Comparison <ul><li>Authoritative parents are demanding of the child but in a manner commensurate with the child’s capabilities. Demands are age-appropriate and focused on teaching mature behavior, socialization, independence, and communication skills. Discipline tends to be consistent. </li></ul><ul><li>Authoritarian parents are demanding of the child and unresponsive to the child’s needs and behaviors. Authoritarian parents may respond to the child’s behavior, but the focus is on parental control rather than the child’s developmental level and needs. Authoritarian parents see their authority and will as being of primary importance, and challenges to this authority by the child are duly suppressed, often through fairly severe forms of punishment. </li></ul>
  13. 13. Effects of Authoritarian Parenting Style <ul><li>  Children less socially competent; tendency to withdraw; lack of spontaneity, affection, curiosity, and originality (Baumrind & Black, 1967) </li></ul><ul><li>Children show less evidence of moral conscience; external, rather than internal, orientation in situations involving moral conflict (placing blame outside of themselves, less likely to admit guilt or self-blame.) (Hoffman, 1970) </li></ul><ul><li>Boys show lower self-esteem and diminished intellectual performance. (Coopersmith, 1967) </li></ul><ul><li>Inconsistent and intense levels of power assertion by parents is related to childhood aggression. (Park & Slaby, 1983) </li></ul><ul><li>Abusive parents rely heavily on power-assertive techniques and are often unresponsive to the child’s needs. (Wolfe, p. 22) </li></ul>
  14. 14. Parental History of Maltreatment in Childhood <ul><li>Abusive backgrounds significantly increase the likelihood that an individual will become subsequently involved in coercive relationships with...their own children. ( Gaines, et al, 1978; Straus, Gelles & Steinmetz, 1980, Widom, 1989b) </li></ul><ul><li>Maltreatment experiences (including milder forms of corporal punishment) are the single most significant risk factor for subsequent relationship violence in adulthood. ( Straus & Kantor, 1994) </li></ul><ul><li>  30% of child abuse victims carry the pattern into adolescence and adulthood. Most child victims of maltreatment do not grow up to be perpetrators of violence. ( Kaufman & Zigler, 1989) </li></ul><ul><li>  Individuals learn to be violent from growing up in violent homes, where they observe violent models, see violence being reinforced, and learn justification for violence. ( Gelles & Cornell, 1990) </li></ul><ul><li>In women, witnessing parental violence in childhood positively associated with higher rates of child abuse. ( Mihalic & Elliott, 1997) </li></ul>
  15. 15. Family Development Stage <ul><li>Developmental Life Cycle Crisis Points </li></ul><ul><ul><li>Major transitions during a family’s development can lead to increased stress, and thus, be a time when symptoms are most likely to appear in a family. </li></ul></ul><ul><li>Six Stages of the Family Life Cycle </li></ul><ul><ul><li>Launching of the single young adult </li></ul></ul><ul><ul><li>Joining of families through marriage </li></ul></ul><ul><ul><li>Families with young children </li></ul></ul><ul><ul><li>Families with adolescents </li></ul></ul><ul><ul><li>Launching children and moving on </li></ul></ul><ul><ul><li>Families in later life </li></ul></ul>
  16. 16. Family Boundaries <ul><li>Parent – Parent holon </li></ul><ul><li>Parent – Child system </li></ul><ul><li>Sibling system </li></ul><ul><li>Family – Exo-Meso system </li></ul>
  17. 17. Healthy Boundaries in the Family Life Cycle <ul><li>Marriage or Coupling – Strong boundary around the marital subsystem </li></ul><ul><li>Addition of Children – Marital subsystem expands and adapts to include the child; strong boundary around the family system when children are young </li></ul><ul><li>Children Enter School – Family boundary expands as the children move into the school environment </li></ul><ul><li>Children Become Teens – Family boundary expands further as peer interaction and individual interests become more prominent </li></ul><ul><li>Children Leave the Home – Marital boundary becomes prominent again; family system boundary begins to incorporate grandchildren and in-laws </li></ul>
  18. 18. Family Protective Factors <ul><li>Protective Factors in Parent-Child Relationship (Cicchetti & Lynch, 1995, and Wekerle & Wolfe, 1993 in Wolfe, p. 25) </li></ul><ul><ul><li>Adequate knowledge of child development and expectations, including knowledge of children’s normal sexual development and experimentation </li></ul></ul><ul><ul><li>Adequate skill in coping with stress related to caring for small children and ways to enhance child development through proper stimulation and attention </li></ul></ul><ul><ul><li>Opportunities to develop normal parent-child attachment and early patterns of communication </li></ul></ul><ul><ul><li>Adequate parental knowledge of home management, including basic financial management, proper shelter, and meal planning </li></ul></ul><ul><ul><li>Opportunities and willingness to share child care duties between both parents, when applicable </li></ul></ul><ul><ul><li>Provision of necessary social and health services </li></ul></ul><ul><li>Parent-Child Transaction (Wolfe, p. 26) </li></ul><ul><ul><li>The parent-child relationship is interdependent because it emerges from active participation and mutual influence of both parent and child. It is transactional because both parent and child contribute to desired and undesired behavior patterns, and one cannot readily be separated from the other. </li></ul></ul><ul><ul><ul><li>“ A style of cooperation tends to develop reciprocally among parents and children in healthy, adaptive relationships.” (Wolfe, p. 27) </li></ul></ul></ul><ul><li>Parental History of Child Maltreatment </li></ul><ul><ul><li>&quot;Supportive adults within and outside the family, siblings, and successful school achievement may over time moderate the effect of abuse or other stressors in childhood.&quot; (1, p. 83) Rutter, 1979 </li></ul></ul>
  19. 19. <ul><li>Life/Environmental Stress </li></ul><ul><li>Child-Rearing Norms </li></ul><ul><li>Support </li></ul><ul><li>Neighborhood/Community </li></ul>Exo-Meso System Factors in Physical Child Abuse
  20. 20. Life/Environment Stress <ul><li>Stress- filled environments common in child abuse. (Egeland, Breitenbucher, Rosenberg, 1980) </li></ul><ul><li>  Stress (changes/disruptions requiring adjustment and exceeding one's adaptive resources) associated with instrumental (e.g. spanking children to stop crying…) and expressive family violence (lashing out in anger). (Farrington, 1986) </li></ul><ul><li>  Abusive mothers reported more stress due to frequent life events, more negative perceptions of these events, and higher rates of both depression and state anxiety. (Whipple et al. 1991) </li></ul><ul><li>  Physically abusive parents reported significantly lower incomes. (Whipple et al. 1991) </li></ul><ul><ul><li>Poverty – lack of adequate child care, poor nutrition, unsafe neighborhoods, inadequate housing, financial strain, lack of privacy </li></ul></ul><ul><ul><li>Poverty is double stressful because the stressors encountered can’t be counterbalanced with adequate resources to buffer the stress. </li></ul></ul>
  21. 21. The Role of Stress in Child Maltreatment <ul><li>Stress occurs when an event, or accumulation of events, disturbs the functioning of family member(s) and initiates a chain of adaptive or maladaptive responses. </li></ul><ul><li>Stress creates an acute or chronic imbalance for the individual or family system. This imbalance is typically met by counterpressure from the individual’s coping efforts to return himself or herself to a more comfortable state of equilibrium. </li></ul><ul><li>  The positive or negative impact of stressful event(s) depends on: </li></ul><ul><ul><li>Degree of interruption and disarray set into motion by the event. </li></ul></ul><ul><ul><li>Presence of psychological and physical buffers that regulate the harshness of the stressor. </li></ul></ul><ul><li>Rutter, 1983 </li></ul>
  22. 22. Child-Rearing Norms <ul><li>  Physical abuse of children is related to child-rearing patterns that sanction the use of violence and power-assertive techniques. (Cichetti & Lynch, 1995; Parke & Collmer, 1975 </li></ul><ul><li>  Families that lack a connection to their community have fewer opportunities for exposure to child-rearing practices that could improve their own parenting skills. Without this social filter and opportunities for parental learning, parents lack a connection to emotional and material support during times of stress. (Trickett & Sussman, 1988) </li></ul>
  23. 23. Support <ul><li>  Physically abusing parents report fewer contacts with and support from peer networks, immediate family and other relatives, and professionals. Coohey, 2000, Corse, et al, 1990) </li></ul><ul><li>  In neighborhoods with equal socioeconomic disadvantage rates, neighborhoods with more social resources, whether formal or informal, experienced less child maltreatment than neighborhoods with fewer social resources. (Garbarino & Sherman, 1980) </li></ul><ul><ul><li>  Areas at high risk for child maltreatment characterized as socially impoverished - fewer neighbors exchanging child care, lower involvement in community exchanges, fewer people can be counted on. (Garbarino & Sherman, 1980 </li></ul></ul>
  24. 24. Neighborhood <ul><li>Children from high-violence neighborhoods were significantly more likely to have been physically abused than children from low-violence neighborhoods. (Lynch & Cicchetti, 1998) </li></ul><ul><li>  Causes of child abuse identified by parents [in interviews with parents from neighborhoods with differential risk for child maltreatment report rates] included poverty and family disruption; substance abuse and stress; lack of moral and family values; and individual pathology - all of which were related to neighborhood conditions and individual perception of neighborhood characteristics. (Korbin et al. 2000) </li></ul>
  25. 25. Exo-Meso Protective Factors <ul><li>Social Bonding Theory - Travis Hirschi Looked at what social forces PREVENT child abuse. </li></ul><ul><ul><li>Stake in conformity – live where people know one another, where people are invested in the community, active in the community </li></ul></ul><ul><ul><li>Attachment – to family, friends, community </li></ul></ul><ul><ul><li>Belief – that hitting children is wrong </li></ul></ul>
  26. 26. Macrosystem Factors in Physical Abuse
  27. 27. Macrosystem Factors <ul><li>Media - violence on TV, video games, music </li></ul><ul><li>Macroeconomic conditions – unemployment, funding for community support services </li></ul><ul><li>Laws – Federal laws affect state laws affect local policies and conditions </li></ul><ul><li>Religious institutions – values and belief systems </li></ul><ul><li>Others? </li></ul>
  28. 28. <ul><li>Stage 1: Reduced Tolerance for Stress & Disinhibition of Aggression </li></ul><ul><li>Stage 2: Poor Management of Acute Crises and Provocation </li></ul><ul><li>Stage 3: Chronic Patterns of Anger and Abuse </li></ul><ul><li>Wolfe, David A. Child Abuse (2 nd Edition): Implications for Child Development and Psychopathology. 1999. Thousand Oaks: Sage </li></ul>Process Model of Physical Abuse
  29. 29. Stage 1: Reduced Tolerance for Stress & Disinhibition of Aggression <ul><li>  Learning experiences in childhood and young adulthood increase the likelihood of creating a predisposition toward aggressive behavior. </li></ul><ul><li>History of abuse or family violence, social learning of aggression (individual) </li></ul><ul><li>Neighborhood violence (exosystem) </li></ul><ul><li>Local or family culture of physical punishment (exosystem) </li></ul><ul><li>Societal violence and acceptance of physical punishment of children (macrosystem) </li></ul><ul><li>Effects of the level of stress and the level of internal tolerance/coping combine to disinhibit anger and aggression. </li></ul>
  30. 30. Stage 2: Poor Management of Acute Crises and Provocation <ul><li>  As the abusive process moves into Stage 2, the parent’s previous attempts or methods of managing life stress and child behavior begin to fail significantly in their effectiveness. </li></ul><ul><li>  Stress coping strategies become increasingly negative (excessive alcohol or drug usage, frequent moves, harsh punishment of children) and the parent begins to feel that he or she is losing control over the child, other family members, and related aspects of his or her life. </li></ul><ul><li>  At this point the risk of an abusive incident rises sharply. Factors that increase the likelihood of abuse now are: </li></ul><ul><ul><li>  Mood – a parent’s previous mood of distress and anger toward the child is recalled by the child’s current behavior, leading to an overgeneralized (more angry and aggressive) response. </li></ul></ul><ul><ul><li>  Transfer of Arousal – an abusive parent may become angered and aroused by a previous encounter with someone else (in the exosystem possibly or the microsystem of the family), which lowers his or her threshold for anger and aggression with family members. Negative arousal interferes with rational problem solving and reduces one’s ability to control aggressive or excessive reactions (Vasta, 1982) </li></ul></ul><ul><ul><li>  Protective factors at this point include cognitive-behavioral processes of accurate attribution for the arousal and awareness of alternative, nonabusive responses. </li></ul></ul><ul><li>  During Stage 2 of the development of abusive behavior, the parent begins to view familiar, difficult interactions with the child as being ‘out of control’ and as a deliberate attempt to defy the parent’s authority. Even when the child is relatively compliant and well-mannered, the parent may feel arousal and perceive the child’s crying or fussing to seek attention or assistance, as a deliberate provocation. </li></ul>
  31. 31. Stage 3: Chronic Patterns of Anger and Abuse <ul><li>  In Stage 3, a chronic and escalating pattern of anger and abusive behavior become established. A habitual pattern of stress, arousal, and overgeneralized responses to the child and other significant persons becomes entrenched. Feelings of hopelessness and helplessness surface from repeated failure and frustration. The parent believes that everything will rapidly disintegrate if the loosen the grip that keeps them in tenuous control of the stress in their lives. </li></ul><ul><li>Also by this time, some children habituate to punishment. The cycle continues negatively as the parent feels the need to increase the intensity of the punishment to maintain strict control; the child avoids the parent and is susceptible to emotional and physical harm; and the child fails to learn the behavior the parent desires. </li></ul>
  32. 32. The Way to Resilience <ul><li>To know good is to do good.~Socrates </li></ul>
  33. 33. Sources <ul><li>Wolfe, David A. Child Abuse (2 nd Edition): Implications for Child Development and Psychopathology. 1999. Thousand Oaks: Sage </li></ul><ul><li>Miller-Perrin, Cindy L. & Perrin, Robin. Child Maltreatment: An introduction. 2007. Thousand Oaks: Sage </li></ul><ul><li>Scannapieco, Maria & Connell-Carrick, Kelli. Understanding Child Maltreatment: An ecological and developmental perspective. 2005. New York: Oxford University Press </li></ul>