Soc Work Res. 2009 Mar 1; 33(1): 55-60
Taussig HN, Garrido EF, Crawford G

Prax Kinderpsychol Kinderpsychiatr. 2009; 58(10): 764-85
Kindler H

In Germany child protection law is governed by the term "child endangerment". Based on a definition of that term recent research on child maltreatment is reviewed. Regarding etiology the need to go beyond risk factors and to consider risk mechanisms is highlighted. The discussion on the impact of child maltreatment focuses on the often underestimated effects of early neglect. After a review of progresses regarding the evaluation of maltreated children and the assessment of risk based on a systematic literature review suggestions for design of effective family interventions after abuse or neglect are made.

Prax Kinderpsychol Kinderpsychiatr. 2009; 58(10): 761-3
Lenz A, Lehmkuhl U

Prax Kinderpsychol Kinderpsychiatr. 2009; 58(10): 814-37
Spangler G, Bovenschen I, Globisch J, Krippl M, Ast-Scheitenberger S

The Child Abuse Potential Inventory (CAPI) is an evidence-based procedure for the assessment of the risk for child abuse in parents. In this study, a German translation of the CAPI was applied to a normal sample of German parents (N = 944). Descriptive analysis of the CAPI scores in the German provides findings comparable to the original standardization sample. The subjects' child abuse risk score was associated with demographic characteristics like education, marital status, occupation and gender. Long-term stability of the child abuse risk score and associations with individual differences in emotional regulation and attachment were investigated in a sub-sample of mothers with high and low child abuse risk scores (N = 69). The findings proved long-term stability. Furthermore associations between the child abuse risk score and anger dispositions were found which, however, were moderated by attachment differences. The findings suggest attachment security as a protective factor against child abuse.

Prax Kinderpsychol Kinderpsychiatr. 2009; 58(10): 798-813
Katzenstein H, Schönecker L

The following essay outlines the legal foundations of child protection in Germany. It can be shown that constitutional law postulates a balance between parents responsibility on the one hand and public assignment to safeguard children on the other hand. The article focuses on the impact of legislative provisions on practitioners working together to safeguard children. Discussion of the demands of successful cooperation in the field of child protection shows that the political debate focuses somewhat to much on questions of control. It is argued that prospective development of child protection law should rather be based on a thorough debate of the demands in the respective professional domains.

Health Aff (Millwood). 2010 Mar-Apr; 29(3): 342
Dentzer S

Child Abuse Negl. 2010 Mar 4;
Wolfe DA, Jaffe PG, Leschied AW, Legate BL

Practitioners may be called upon to assess adults who have alleged child abuse as a minor and are seeking reparations. Such assessments may be used by the courts to determine harm and assess damages related to their claim or testimony. Our clinical/research team has conducted many such evaluations and reported the findings pertaining to the psychological harm stemming from historical abuse in published studies. We use the opportunity provided by this new section on Practical Strategies to describe the role of the assessor, and to provide details concerning our methods for preparing these assessments and reporting the findings for the purpose of civil or criminal actions. Specific recommendations for wording of written reports are provided.

Soc Work Res. 2009 Mar 1; 33(1): 19-28
Kim MJ, Tajima EA, Herrenkohl TI, Huang B

This article examines whether running away from home mediates the link between child maltreatment and later delinquency and victimization in adolescence. Specifically, the authors tested the hypothesis that childhood physical and psychological abuse increase the risk of a child's running away from home by the time of adolescence. Running away from home is, in turn, hypothesized to increase the risk of delinquency and victimization. Childhood sexual abuse, modeled independently of physical and psychological abuse, is hypothesized to have a similar effect on the intervening factor of running away, as well as the two adolescent outcomes: delinquency and victimization. The sample of 416 adolescents was drawn from the Lehigh Longitudinal Study conducted in a two-county area of Pennsylvania. Findings show that physical and psychological abuse predict a child's running away from home. Running away predicts later delinquency and victimization and partially mediates the effect of earlier abuse. Both child abuse and running away from home are adverse events that can be addressed through systematic prevention and intervention efforts tailored to those who have been victimized. Findings can support social workers in their efforts to advocate on behalf of child abuse victims in developing interventions and support services.

Curr Opin Pediatr. 2010 Feb 15;
Newton AW, Vandeven AM

PURPOSE OF REVIEW: As knowledge about child abuse and neglect increases worldwide, so does the literature on abuse and neglect. The authors explore many studies published this year, with attention to the advances in understanding which are guiding prevention efforts as well as diagnosis and treatment of abuse and neglect. RECENT FINDINGS: The evidence base for many forms of child abuse continues to grow. Controversy around the diagnosis of child abuse still continues, with current debate focused on the diagnosis of abusive head injury and whether children with vitamin D deficiency are misdiagnosed with abusive fractures. As clinicians begin to understand the factors which may increase child vulnerability to abuse, more sophisticated and focused prevention efforts are being implemented, and researchers are evaluating these efforts with an eye to whether or not they really contribute to prevention. SUMMARY: The short-term and long-term impact of child maltreatment is significant not only for individuals but for families and communities in which abuse is taking place. General pediatricians have an important role to play with families and in the community as advocates for the protection of children. However, it is clear that specialists in child abuse should also play a role in order for diagnosis and management of abuse to adhere to a high standard of care. This has been validated this year by the creation of Child Abuse Pediatrics as a board certified specialty in the United States. As knowledge about abuse and neglect grows, clinicians are focusing on prevention as well as diagnosis and treatment.

J Pediatr Health Care. 2010 March - April; 24(2): 103-107
Knox M

Research has clearly demonstrated associations between corporal punishment of children and maladaptive behavior patterns such as aggression and delinquency. Hitting children is an act of violence and a clear violation of children's human rights. In this article, the position of the United States on corporal punishment of children is discussed. Professional and international progress on ending corporal punishment is explained, and the relationship between corporal punishment and child abuse is discussed. An appeal is made for prevention efforts such as parent education and removal of social sanctions for hitting children that may hold significant promise for preventing child maltreatment.

State Legis. 2010 Jan; 35(11): 33
Crane K

Child Abuse Negl. 2010 Feb; 34(2): 105-113
Hien D, Cohen LR, Caldeira NA, Flom P, Wasserman G

OBJECTIVE: This study examines how emotion regulation deficits in the area of anger arousal and reactivity are associated with child abuse potential in mothers with substance use and depressive disorders in order to identify targeted areas for prevention and treatment. METHODS: A sample of 152 urban mothers was interviewed on measures of substance use, diagnosis of depression, anger arousal and reactivity, and child abuse potential. RESULTS: Linear hierarchical regressions revealed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. Additionally, anger arousal and reactivity was found to be a partial mediator of the relationship between diagnostic category and child abuse potential. CONCLUSIONS: Findings are discussed in relation to a multifaceted model of child abuse potential which broadens the existing literature to include an examination of depression and emotion regulation in order to more fully understand how substance use and child abuse potential are linked. PRACTICE IMPLICATIONS: Models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful, and may be most readily applied in such populations.

Int J Epidemiol. 2010 Feb 22;
O'Donnell M, Nassar N, Leonard H, Jacoby P, Mathews R, Patterson Y, Stanley F

OBJECTIVES: To investigate specific child and parental factors associated with increased vulnerability to substantiated child maltreatment. METHODS: A retrospective cohort study of all children born in Western Australia during 1990-2005 using de-identified record linked child protection, disability services and health data. Cox regression was used for univariate and multivariate analysis to determine the risk of substantiated child maltreatment for a number of child and parental factors, including child disability, parental age, socio-economic status, parental mental health, substance use and assault-related hospital admissions. Separate analyses were conducted for Aboriginal and non-Aboriginal children. RESULTS: This study found a number of child and parental factors that increase the risk of substantiated child maltreatment. The strongest factors were child intellectual disability, parental socio-economic status, parental age and parental hospital admissions related to mental health, substance use and assault. CONCLUSIONS: Awareness of the factors that make children and families vulnerable may aid the targeting of child maltreatment prevention programmes. To prevent child abuse and neglect it is essential that we have a platform of universal services, which assist parents in their role, as well as targeted services for at-risk families.

Ann Fam Med. 2010 March-April; 8(2): 134-140
van Tilburg MA, Runyan DK, Zolotor AJ, Graham JC, Dubowitz H, Litrownik AJ, Flaherty E, Chitkara DK, Whitehead WE

PURPOSE: Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediated by psychological distress. METHODS: Data were obtained from the Longitudinal Studies of Child Abuse and Neglect, a consortium of 5 prospective studies of child maltreatment. The 845 children who were observed from the age of 4 through 12 years were the subjects of this study. Every 2 years information on gastrointestinal symptoms was obtained from parents, and maltreatment allegations were obtained from Child Protective Services (CPS). At the age of 12 years children reported gastrointestinal symptoms, life-time maltreatment, and psychological distress. Data were analyzed by logistic regression. RESULTS: Lifetime CPS allegations of sexual abuse were associated with abdominal pain at age 12 years (odds ratio [OR] = 1.75; 95% confidence interval [CI] = 1.1-2.47). Sexual abuse preceded or coincided with abdominal pain in 91% of cases. Youth recall of ever having been psychologically, physically, or sexually abused was significantly associated with both abdominal pain and nausea/vomiting (range, OR = 1.5 [95% CI, 1.1-2.0] to 2.1 [95% CI, 1.5-2.9]). When adjusting for psychological distress, most effects became insignificant except for the relation between physical abuse and nausea/vomiting (OR = 1.5; 95% CI, 1.1-2.2). CONCLUSION: Youth who have been maltreated are at increased risk for unexplained gastrointestinal symptoms, and this relation is partially mediated by psychological distress. These findings are relevant to the clinical care for children who complain of unexplained gastrointestinal symptoms.

Prax Kinderpsychol Kinderpsychiatr. 2009; 58(10): 786-97
Stötzel M

Child protection has become a political and social hot topic. Due to dramatic cases of child neglect and maltreatment federal and state governments as well as municipalities with their respective responsibilities are in public focus. The knowledge, that families and children, who must live under difficult conditions, need special attention, contact and support is the common aim of many activities. Under the impression of publicly discussed horrific violence against children and their death, the main federal and state decision-makers--the chancellor and the prime ministers of the states--have dealt with the protection of children. To be effective against neglect and maltreatment, in their conferences on 19th December 2007 and 12th June 2008, they have decided a package of concrete measures for an active child protection. This paper gives an overview of these agreed measures and reports on the status of implementation.

Forensic Sci Med Pathol. 2010 Feb 27;
Erfurt C, Hahn G, Roesner D, Schmidt U

Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child's welfare.

J Res Adolesc. 2010; 20(1): 210-236
Wilson HW, Widom CS

Behaviors beginning in childhood or adolescence may mediate the relationship between childhood maltreatment and involvement in prostitution. This paper examines five potential mediators: early sexual initiation, running away, juvenile crime, school problems, and early drug use. Using a prospective cohort design, abused and neglected children (ages 0-11) with cases processed during 1967-1971 were matched with non-abused, non-neglected children and followed into young adulthood. Data are from in-person interviews at approximate age 29 and arrest records through 1994. Structural Equation Modeling tested path models. Results indicated that victims of child abuse and neglect were at increased risk for all problem behaviors, except drug use. In the full model, only early sexual initiation remained significant as a mediator in the pathway from child abuse and neglect to prostitution. Findings were generally consistent for physical and sexual abuse and neglect. These findings suggest that interventions to reduce problem behaviors among maltreated children may also reduce their risk for prostitution later in life.

Front Behav Neurosci. 2009; 3: 41
Heim C, Bradley B, Mletzko TC, Deveau TC, Musselman DL, Nemeroff CB, Ressler KJ, Binder EB

Variations of the corticotropin-releasing hormone receptor 1 (CRHR1) gene appear to moderate the development of depression after childhood trauma. Depression more frequently affects women than men. We examined sex differences in the effects of the CRHR1 gene on the relationship between childhood trauma and adult depression. We recruited 1,063 subjects from the waiting rooms of a public urban hospital. Childhood trauma exposure and symptoms of depression were assessed using dimensional rating scales. Subjects were genotyped for rs110402 within the CRHR1 gene. An independent sample of 78 subjects underwent clinical assessment, genotyping, and a dexamethasone/CRH test. The age range at recruitment was 18-77 years and 18-45, for the two studies respectively. In the hospital sample, the protective effect of the rs110402 A-allele against developing depression after childhood trauma was observed in men (N = 424), but not in women (N = 635). In the second sample, the rs110402 A-allele was associated with decreased cortisol response in the dexamethasone/CRH test only in men. In A-allele carriers with childhood trauma exposure women exhibited increased cortisol response compared men; there were no sex differences in A-allele carriers without trauma exposure. This effect may, however, not be related to gender differences per se, but to differences in the type of experienced abuse between men and women. CRHR x environment interactions in the hospital sample were observed with exposure to physical, but not sexual or emotional abuse. Physical abuse was the most common type of abuse in men in this cohort, while sexual abuse was most commonly suffered by women. Our results suggest that the CRHR1 gene may only moderate the effects of specific types of childhood trauma on depression. Gender differences in environmental exposures could thus be reflected in sex-specific CRHR1 x child abuse interactions.

Child Abuse Negl. 2010 Feb; 34(2): 84-94
Rodriguez CM, Henderson RC

OBJECTIVE: Relatively little research has investigated the connection between religiosity and physical child abuse risk. Certain aspects, such as specific religious orientation or beliefs, and cognitive schema, such as socially conformist beliefs, may account for the connection that some have claimed increase religious parents' abuse potential. The current study examined whether greater Extrinsic religiosity, but not Intrinsic religiosity, was associated with elevated physical abuse potential. Those who hold a literal interpretation of the Bible and attend church more frequently were also expected to evidence increased abuse risk. Additionally, the role of social conformity in mediating or moderating the association between religiosity and abuse potential was investigated. METHODS: Two hundred and seven regularly attending Christians of various denominations completed self-report measures of religiosity, social conformity, and child abuse potential. RESULTS: Findings indicate that Extrinsic religiosity was associated with increased physical abuse potential, with greater social conformity further moderating this association. Intrinsic religious orientation was not associated with abuse risk. Further, those who consider the Bible to be literally true were more socially conformist and evidenced greater abuse risk. CONCLUSIONS: For those working with religious parents, the particular nature of religiosity needs to be considered when interpreting a connection between religiosity and abuse risk, as well as the potential attitudes the parent holds regarding the need for conformity. Given the complexity of religiosity, future research should explore other potential mediating and moderating factors that could further clarify its connection to physical abuse risk. PRACTICE IMPLICATIONS: Clarifying how religiosity relates to child abuse risk has implications for professionals working with the vast numbers of parents for whom religion is a visible force in their daily lives. Findings from the present study suggest that professionals should consider the underlying motivation for an individual's religion as well as the importance the individual places on conformity. Religiosity per se may not be as critical to predicting physical abuse risk as selected approaches to religion or particular attitudes the religious individual assumes in their daily life.

Maturitas. 2010 Mar 4;
Greenfield EA

Despite prevention efforts worldwide, many children today continue to experience abuse within close relationships, and many adults carry with them histories of abuse. This narrative review focuses on the growing body of research regarding the long-term health consequences of child abuse. First, the review presents a brief introduction to the phenomenon of child abuse, as well as a discussion of theoretical approaches to describing processes through which child abuse can jeopardize later adult health. The review then provides an integrative summary of studies based on community samples that examine associations between physical, psychological, and sexual abuse in childhood and adult mental and physical health. The article concludes with a discussion of conceptualizing child abuse as a life-course social determinant of adult health for both clinical and public health purposes and calls for translational research that can inform efforts to promote the health of diverse individuals and populations with histories of child abuse.