E-Book, Englisch, Band 4, 99 Seiten
Wekerle / Miller / Wolfe Childhood Maltreatment
1. Auflage 2006
ISBN: 978-1-61676-314-5
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)
E-Book, Englisch, Band 4, 99 Seiten
Reihe: Advances in Psychotherapy - Evidence-Based Practice
ISBN: 978-1-61676-314-5
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)
The serious consequences of child abuse or maltreatment are among the most challenging things therapists encounter. In recent years there has been a surge of interest, and of both basic and clinical research, concerning early traumatization. This volume in the series Advances in Psychotherapy integrates results from the latest research showing the importance of early traumatization into a compact and practical guide for practitioners. Advances in biological knowledge have highlighted the potential chronicity of effects of childhood maltreatment, demonstrating particular life challenges in managing emotions, forming and maintaining healthy relationships, healthy coping, and holding a positive outlook of oneself.
Despite the resiliency of many maltreated children, adolescent and young adult well-being is often compromised. This text first overviews our current knowledge of the effects of childhood maltreatment on psychiatric and psychological health, then provides diagnostic guidance, and subsequently goes on to profile promising and effective evidence-based interventions. Consistent with the discussions of treatment, prevention programming that is multi-targeted at issues for maltreated individuals is highlighted. This text helps the practitioner or student to know what to look for, what questions need to be asked, how to handle the sensitive ethical implications, and what are promising avenues for effective coping.
The Authors
Christine Wekerle, PhD, is Associate Professor of Education, Psychology, and Psychiatry at the University of Western Ontario (UWO). She is also a Research Associate of the Centre for Research on Violence Against Women and Children at UWO. Dr. Wekerle has conducted research over the past decade in the areas of child welfare, childhood maltreatment, the overlap between substance abuse and relationship violence, and violence prevention. She recently received a mid-career award to further research on adolescent healthy functioning and violence prevention among child protective services clients (Ontario Women’s Health Council/CIHR Institute of Gender and Health).
Alec L. Miller, PsyD, is a Fellow of the American Psychological Association and is currently Associate Professor of Psychiatry and Behavioral Sciences; Chief of Child and Adolescent Psychology; Director of Adolescent Depression and Suicide Program; Director of Clinical Services at PS 8 School-Based Mental Health Program at Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. Dr. Miller has spent the last decade heading a clinical-research team and training therapists internationally in the adaptation of dialectical behavior therapy for suicidal, selfinjurious, and maltreated adolescents.
David A. Wolfe, PhD, is the first recipient of the RBC Investments Chair in Developmental Psychopathology and Children’s Mental Health at the Centre for Addiction and Mental Health, University of Toronto. He is a fellow of the American Psychological Association and past President of Division 37 (Child, Youth, and Family Services). Dr. Wolfe has broad research and clinical interests in abnormal child and adolescent psychology, with a special focus on child abuse, domestic violence, and developmental psychopathology. He has authored numerous articles on these topics, especially in relation to the impact of early childhood trauma on later development in childhood, adolescence, and early adulthood. He recently received the Outstanding Career Award from the American Professional Society on the Abuse of Children, and the John Dewan Prize for Outstanding Contribution to Psychology from the Ontario Mental Health Foundation.
Carrie B. Spindel, PsyD, received her BSc from Cornell Universty and her doctorate in clinical psychology from Ferkauf School of Psychology, Yeshiva University. Dr. Spindel has expertise in the cognitive and behavioral treatment of maltreated children and adolescents. In 2004, she was granted the Distinguished Student Practice Award for Division 12 of the American Psychological Association. She is currently a post doctoral fellow at the Cognitive and Behavioral Consultants of Westchester in White Plains, NY.
From the Reviews
Barbara L. Bonner, PhD, Professor of Pediatrics, Child Study Center, Oklahoma City, OK
Danya Glaser, MB BS, FRCPsych, Department of Psychological Medicine, Great Ormond Street Hospital for Children, London, UK
Autoren/Hrsg.
Fachgebiete
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
- Sozialwissenschaften Soziologie | Soziale Arbeit Soziale Arbeit/Sozialpädagogik Soziale Arbeit/Sozialpädagogik: Familie, Kinder, Jugendliche
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Kinder- & Jugendpsychiatrie
- Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Kinder- und Jugendlichenpsychotherapie
- Sozialwissenschaften Soziologie | Soziale Arbeit Soziale Gruppen/Soziale Themen Kindesmissbrauch, Sexueller Missbrauch, Häusliche Gewalt
Weitere Infos & Material
1;Table of Contents;10
2;1 Description;12
2.1;1.1 Terminology;17
2.2;1.2 Definition;21
2.3;1.3 Epidemiology;23
2.4;1.4 Course and Prognosis;26
3;2 Theories and Models of the Effects of Childhood Maltreatment;28
3.1;2.1 PTSD Symptomatology Model;28
3.2;2.2 Social Cognitive Information Processing Models;29
4;3 Diagnosis and Treatment Indications;31
4.1;3.1 Psychiatric Impairment and Specific Disorders Associated with Childhood Maltreatment;32
4.1.1;3.1.1 Mood Disorders;32
4.1.2;3.1.2 Suicidal/Self-Harm Behaviors;32
4.1.3;3.1.3 Anxiety Disorders;33
4.1.4;3.1.4 Posttraumatic Stress Disorder (PTSD);34
4.1.5;3.1.5 Dissociation;36
4.1.6;3.1.6 Behavioral Problems and Disorders;37
4.1.7;3.1.7 Substance Use Disorders;39
4.1.8;3.1.8 Eating Disorders;40
4.1.9;3.1.9 Personality Disorders;42
4.1.10;3.1.10 Asymptomatic Victims;42
5;4 Treatment: Intervening with Childhood Maltreatment Victims;43
5.1;4.1 Methods of Treatment;44
5.1.1;4.1.1 Trauma-Focused Cognitive Behavior Therapy;44
5.2;4.2 Mechanisms of Action: Components of Trauma- Focused Cognitive Behavioral Treatment;45
5.2.1;4.2.1 Child- Treatment: Coping Skills Training;46
5.2.2;4.2.2 Child- Treatment: Cognitive Processing;46
5.2.3;4.2.3 Child- Treatment: Gradual Exposure;47
5.2.4;4.2.4 Child- Treatment: Psychoeducation;48
5.2.5;4.2.5 Parent- Treatment;48
5.2.6;4.2.6 Parent- Treatment: Orientation;48
5.2.7;4.2.7 Parent- Treatment: Coping Skills Training;49
5.2.8;4.2.8 Parent- Treatment: Gradual Exposure;50
5.2.9;4.2.9 Parent- Treatment: Psychoeducation;51
5.3;4.3 Efficacy and Prognosis;51
5.3.1;4.3.1 Empirical Support of TF-CBT for Childhood Sexual Abuse;51
5.3.2;4.3.2 Empirical Support for TF-CBT for Childhood Physical Abuse;52
5.4;4.4 Variations and Combinations of Methods;52
5.4.1;4.4.1 Dialectical Behavior Therapy;52
5.5;4.5 Problems and Issues in Carrying Out the Treatments;60
5.5.1;4.5.1 Individual Problems;61
5.5.2;4.5.2 Family Problems;61
6;5 Case Vignette;63
7;6 Further Reading;67
8;7 References;68
9;8 Appendix: Tools and Resources;71
9.1;Childhood Maltreatment Assessment Tools;71
9.2;The Children’s Impact of Traumatic Events Scale – II;72
9.2.1;Vicky Veitch Wolfe (2002);72
9.3;The Children’s Impact of Traumatic Events Scale – II: Scoring Form;81
9.3.1;Vicky Veitch Wolfe (2004);81
9.4;The Childhood Experiences of Violence Questionnaire;90
9.5;Childhood Experiences of Violence Questionnaire;91
9.5.1;Things that may have happened to me;91
9.6;The End;99
(p. 20-21)
Research links childhood maltreatment with a wide range of psychological and behavioral difficulties. Maltreatment can disrupt the normal course of development and can have short- and long-term implications requiring assessment and intervention. The most common diagnoses are in the areas of mood, anxiety, substance use, and antisociality (MacMillan & Munn, 2001).
A maltreated child is prone to revictimization and psychiatric symptomatology across the course of his or her life. It is important to note that while not all children and adolescents suffer psychological consequences related to earlier maltreatment, many children do in fact experience significant psychological impairment. Maltreated children and youth carry a long-term high personal burden of suffering and cost to service systems that has important consequences for the next generation. While maltreated youth are at higher risk for single disorders, they also are more likely to experience co-occurring or overlapping problems in adulthood.
There are few consistent linkages between maltreatment and problem behavior profiles, with two exceptions: (1) sexual abuse and sexual acting out, and (2) physical abuse and aggression. Children who are sexually abused engage in sexualized behaviors beyond what is developmentally appropriate. Such behaviors include sexualized play with dolls, inserting objects into genitalia, excessive masturbation, seductive behavior, age-inappropriate sexual knowledge, and seeking sexual stimulation from others. A sexually inappropriate behavior is one key factor that distinguishes sexually abused children from a clinic population without a history of abuse. This suggests that sexualized behavior may be a unique consequence of sexual abuse compared to other types of abuse.
Due to the pernicious impact of violence on females, with higher rates of sexual abuse and incest, childhood maltreatment is a critical risk factor for many of the problems women face: partner violence, ill health (e.g., gynecological health, chronic pain, arthritis, irritable bowel syndrome), depression, self-harming (cutting) and suicidal behaviors, anxiety, substance abuse, disordered eating, and posttraumatic stress disorder. In terms of risky sexual practices, childhood maltreatment is associated with adolescent females’ greater number of partners, earlier onset of "wanted" sex, and larger age differentials between partners. While adolescent girls are less likely to be risk takers than boys, those who do get involved in substance use and risky sexual behavior tend to suffer poor health outcomes and problems throughout life. A subset of at-risk girls will emerge street-involved, homeless, and/or working in the sex trade, elevating their chances of further victimization and disease exposure. Perhaps because females rely more on relationships for personal development and self-definition, maltreatment may be experienced as more disruptive to role functioning due to the impact of social betrayal.
3.1 Psychiatric Impairment and Specific Disorders Associated with Childhood Maltreatment
Depressive symptoms have commonly been associated with childhood maltreatment. Individuals with a history of child abuse and neglect report two- to three-fold increased likelihood of dysthymia and major depressive disorder during adolescence and young adulthood, as compared to nonabused individuals. Child sexual abuse victims exhibit significantly greater social withdrawal and internalizing symptoms such as depressed mood, anhedonia (i.e., lack of pleasure in previously reinforcing activities, like leisure, sex etc.), and feelings of worthlessness and guilt. Common emotional effects include guilt (i.e., feeling responsible for the abuse), helplessness and hopelessness, sleep disturbance, appetite disturbance, and low self-esteem.
