Browsing by Subject "child abuse"

Now showing 1 - 7 of 7
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    Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men
    (Archives of Sexual Behavior, 2018-02-01) Peterson, Zoё D.; Janssen, Erick; Goodrich, David; Fortenberry, J. Dennis; Hensel, Devon J.; Heiman, Julia R.
    Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ2[1300] = 2121.79, p < .001; CFI = 0.905; RMSEA [90% CI] = .044 [.041–.047]). Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.
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    Classic metaphyseal lesion acquired during physical therapy
    (Elsevier, 2018) Della Grotta, Lynn M.; Marine, Megan B.; Harris, Tara L.; Karmazyn, Boaz; Radiology and Imaging Sciences, School of Medicine
    A classic metaphyseal lesion (CML) is highly specific for nonaccidental trauma. Missing CMLs can be devastating to the child as the child can continue to be exposed to inflicted trauma. Yet, there are rare case reports on CMLs that occur due to birth trauma, IV line placement, and treatment for clubfoot. We present a case of a CML in the tibia that occurred in the hospital secondary to physical therapy, that also caused a femoral shaft fracture, in a term child with hypertonic lower extremities secondary to myelomeningocele. Radiologists, as well as child abuse pediatricians, should be aware of the rare exception when CML is secondary to non-abusive injury.
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    Compliance With Skeletal Surveys for Child Abuse in General Hospitals: A Statewide Quality Improvement Process
    (ARRS, 2019-05) Wanner, Matthew R.; Marine, Megan B.; Hibbard, Roberta A.; Ouyang, Fangqian; Jennings, S. Gregory; Shea, Lindsey; Karmazyn, Boaz; Radiology and Imaging Sciences, School of Medicine
    OBJECTIVE. The purpose of this study is to perform a statewide quality improvement process to improve compliance with the American College of Radiology (ACR) guidelines in performing skeletal surveys for suspected child abuse. SUBJECTS AND METHODS. We prospectively identified all outside hospital skeletal surveys for suspected child abuse in children younger than 3 years referred to our tertiary children's hospital in 2016–2017. We included a 3-month baseline and 21-month intervention period. The quality improvement process was based on sending educational material to all ACR member radiologists in the state and making telephone calls to radiology technologist team leaders whenever the surveys were not compliant, followed by e-mails with guidance on performing skeletal surveys. We documented the views obtained and compared them with the ACR guidelines. The percentage of compliance with each individual view was assessed with the chi-square test. The total number of compliant views per survey was evaluated with ANOVA. RESULTS. Two hundred twenty-seven patients (105 female) with a mean age of 0.8 year (SD, 0.67 year; range, 0.01–3 years) were evaluated. These 227 surveys (baseline, n = 27; postintervention, n = 200) were performed at 69 different outside hospitals. Compliance significantly (p = 0.006) improved from 25.9% (7/27) during baseline to 54.0% (108/200) after intervention. There was a nonsignificant trend of improved compliance between the first (51.9%; 41/79) and last 7-month (62.3%; 33/53) periods of intervention. Among individual views, only rib oblique views showed significantly (p = 0.02) improved compliance after the intervention, from 51.9% (14/27) to 73.5% (147/200). CONCLUSION. The compliance rate with ACR guidelines for skeletal surveys in suspected child abuse at outside general hospitals significantly increased after implementation of a quality improvement process.
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    Consultations in Child Abuse Pediatrics
    (Sage, 2020-07) Hicks, Ralph A.; Laskey, Antoinette L.; Harris, Tara L.; Hibbard, Roberta A.; Pediatrics, School of Medicine
    This study describes a hospital-based child abuse pediatrics consultation service. Medical records for all child abuse pediatrics consultations during 2006 to 2009 were reviewed. Descriptive statistics were used for data analysis. Of 2495 consultations, 13 were excluded due to insufficient information, 1682 were examinations for suspected sexual abuse, and 800 were examinations for nonsexual abuse concerns. Among the latter group of 800 patients, the most common reasons for consultation were fracture (33.5%), nonburn skin injury (16.8%), burn (15.4%), and intracranial injury (13.2%). Median patient age was 11 months (range = 3 days to 16 years). Case fatality rate was 3.9%. Final diagnosis was classified as definite/likely abuse in 40.0%, questionable/unknown in 24.5%, definite/likely accident in 23.6%, no injury in 4.6%, neglect in 4.0%, and a medical condition in 3.2%. Therefore, among consultations requested for suspected child maltreatment, a child abuse pediatrician concluded that abuse was definite or likely in less than half of patients.
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    The Impact of Life Domains on Delinquent Behaviors in Five Caribbean Countries: A Partial Test of Agnew’s General Theory of Crime and Delinquency
    (Springer, 2022-02) Roh, Myunghoon; Cho, Sujung; Nolasco Braaten, Claire Angelique; Kim , Jangmin; Kim, Jeongsuk; Gentle-Genitty, Carolyn; School of Social Work
    The current study tests the applicability of Agnew’s (2005) general theory of crime and delinquency to a sample of Caribbean Community (CARICOM) youths and explains the hypothesized direct and indirect/mediated effects of family attachment and peer delinquency on delinquent behaviors. Data for this study were obtained from a 2014 cross-sectional survey of 512 adolescents from the five members of the CARICOM. This study utilizes mediation analysis. Results reveal that adolescents with abuse experience from family members and unsafe school environments are more likely to engage in delinquent behavior. Furthermore, peer delinquency is significantly related to delinquent behavior and mediates the link between child abuse, family history of violence, unsafe school environment, and subsequent delinquent behavior. Finally, child abuse generated a lower level of family attachment, and then a higher level of family attachment led to a lower likelihood of subsequent delinquent behavior.
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    “They Aren’t Going to Do Jack Shit”: Text-Based Crisis Service Users’ Perceptions of Seeking Child Maltreatment-Related Support From Formal Systems
    (SAGE, 2021-09-10) Schwab-Reese, Laura M.; Cash, Scottye J.; Lambert, Natalie J.; Lansford, Jennifer E.; Medicine, School of Medicine
    Many of the children reported to child protective services (CPS) exhibit signs and symptoms that allow others to recognize their abuse or neglect and intervene; others, especially adolescents, must disclose their experiences to be identified. Relatively little is known about young people’s disclosure experiences, but individual, interpersonal, and cultural factors appear to influence when and how young people disclose. Technology-facilitated approaches, such as text- or chat-based hotlines or crisis services, may be one way to help young people share their maltreatment experiences and seek help. The current study contributes to the small body of literature that includes nonsexual maltreatment disclosures and sheds some light on how to support young people during their disclosures. We conducted a qualitative content analysis of all conversations from a text-based crisis service that resulted in a report to CPS (n = 244). Many of the texters had previously sought support from their peers or parents, and some had engaged with more formal systems. Many young people were hesitant to reach out to formal systems in the future, in part because of negative experiences during past disclosure experiences. Young people may be more likely to seek support through their preferred communication medium, so providing text- and chat-based communication may be one way to encourage and facilitate disclosure. As these resources become increasingly available, determining best practices for receiving disclosures through technology-facilitated platforms will be critical.
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