Child Maltreatment

A Review of Developmental Research on Resilience in Maltreated Children
Herrenkohl, TI., & Klika, JB. (2013). A Review of Developmental Research on Resilience in Maltreated Children. Trauma, Violence, & Abuse, 14(3), 222-234. Doi: 10.1177/1524838013487808
Abstract from article: “Research demonstrates that child maltreatment can negatively impact the psychosocial functioning of individuals well beyond the point at which the trauma occurs. Fortunately, there is evidence that many children who are maltreated succeed in overcoming some of the possible consequences that can follow exposure to this particular form of adversity. Those who do are thought to be resilient. What it means to be resilient is an issue that researchers sometimes disagree on, as is reflected by the different definitions they apply to the term and the methods they use to study the phenomenon. In this literature review, we synthesize current findings on resilience and identify areas of congruence, as well as inconsistency in research methods across the reviewed studies. We focus the review exclusively on longitudinal studies to understand the dynamic qualities of resilience. Findings of the review suggest that, while studies appear to conceptualize and measure common domains of resilience (e.g., social, emotional, behavioral functioning), the measures themselves are in some cases notably different, limiting the extent to which results can be systemically compared across studies. The review also shows that few studies, although longitudinal by design, examine resilience over extended periods of development. Consequently, little has actually been learned about how patterns of resilience unfold and are sustained. Of those studies that do examine resilience as a developmental process, the rate of stability in resilience across time is notably low. Implications for future research are discussed.”

Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioural Problems
Bethell, C., Gombojav, N., Solloway, M., & Wissow, L. (2016). Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems [Abstract]. Prevention of Mental Health Disorders: Principles and Implementation, 25(2), 139-156. http://dx.doi.org/10.1016/j.chc.2015.12.001
Key Points from article: “Compared with children with no adverse childhood experiences (ACEs), prevalence of emotional, mental, or behavioral conditions (EMB) is 1.65 to 4.46 times higher across ACEs levels.  Those without resilience and multiple ACEs have nearly 11 times greater adjusted odds of having an EMB compared with children with resilience and no ACEs.  With resilience, children with EMB and multiple ACEs have 1.85 times higher rates of school engagement and are 1.32 times less likely to miss 2 or more school weeks.  Resilience is nearly 2 times greater among children with EMB and multiple ACEs when their parents report less parenting stress and more engagement in their child’s life.  Attenuating effects of child resilience, parental stress management, and engagement suggest promotion of these protective factors. Mindfulness-based, mind–body methods hold promise for doing so.”

Development and validation of a brief trauma screening measure for children: the Child Trauma Screen
Lang, J. M., & Connell, C. M. (2016). Development and Validation of a Brief Trauma Screening Measure for Children: The Child Trauma Screen [Abstract]. Psychological Trauma: Theory, Research, Practice, and Policy. http://dx.doi.org/10.1037/tra0000235
Abstract from article: “Objective: Childhood exposure to trauma, including violence and abuse, is a major public health concern that has resulted in increased efforts to promote trauma-informed child-serving systems. Trauma screening is an important component of such trauma-informed systems, yet widespread use of trauma screening is rare in part due to the lack of brief, validated trauma screening measures for children. We describe development and validation of the Child Trauma Screen (CTS), a 10-item screening measure of trauma exposure and posttraumatic stress disorder (PTSD) symptoms for children consistent with the DSM–5 definition of PTSD. Method: Study 1 describes measure development incorporating analysis to derive items based on existing measures from 1,065 children and caregivers together with stakeholder input to finalize item selection. Study 2 describes validation of the CTS with a clinical sample of 74 children and their caregivers. Results: Results support the CTS as an empirically derived, reliable measure to screen children for trauma exposure and PTSD symptoms with strong convergent, divergent, and criterion validity. Conclusion: The CTS is a promising measure for rapidly and reliably screening children for trauma exposure and PTSD symptoms. Future research is needed to confirm validation and to examine feasibility and utility of its use across various child-serving systems.”

Factors Promoting Resilience Following Childhood Sexual Abuse: A Structured, Narrative Review of the Literature
Marriott, Clare, et al. (2014). Factors Promoting Resilience Following Childhood Sexual Abuse: A Structured, Narrative Review of the Literature. Child Abuse Review, 23(1), 17-34. Doi: 10.1002/car.2258
Abstract from article: “The aim of this paper was to review research investigating resilient outcomes for people with a history of childhood sexual abuse (CSA) and implications for practice, as well as to consider issues for clearer definitions. Fifty English language peer-reviewed studies (1991–2010) met the inclusion criteria. The reviewed papers identified a number of factors that were repeatedly associated with individuals showing resilient outcomes to CSA. These included inner resources (e.g. coping skills, interpretation of experiences and self-esteem), family relationships, friendships, community resources (e.g. church or school), as well as some abuse-related factors (e.g. older age at onset). A large number of methodological concerns within these studies were also noted, including the way in which resilience, CSA and protective factors were defined. However, despite this, many papers identified similar factors that could be utilised to develop both effective prevention programmes and resilience interventions for the survivors of CSA.”

Families, Poly-victimization, & Resilience Portfolios: Understanding Risk, Vulnerability & Protection Across the Span of Childhood
Hamby, S., Roberts, L. T., Taylor, E., Hagler, M., & Kaczkowski, W. (2016). Families, Poly-Victimization, & Resilience Portfolios: Understanding Risk, Vulnerability & Protection Across the Span of Childhood. In D. M. Teti (Ed.), Parenting and Family Processes in Child Maltreatment and Intervention (pp. 3-22). Springer International Publishing. doi:10.1007/978-3-319-40920-7_1
Abstract from article: “Three trends in violence research hold promise for advancing to the second wave of violence scholarship and practice. The first is the recognition of the web of violence, or the interconnectedness among all forms of violence and abuse. We should focus on the cumulative burden of violence exposure, not just specific types of violence. The second is the need to unpack the mechanisms and processes, so we can do a better job of targeting key underlying factors in prevention and intervention. The final shift is to a strengths-based approach, such as Resilience Portfolios. The field needs to focus more on achieving well-being, not just minimizing pathology. Opportunities and challenges of these three paradigm shifts are discussed.”

How Are We Measuring Resilience Following Childhood Maltreatment? Is the Research Adequate and Consistent? What is the Impact on Research, Practice, and Policy?
Walsh, Wendy A., et al. (2010). How Are We Measuring Resilience Following Childhood Maltreatment? Is the Research Adequate and Consistent? What is the Impact on Research, Practice, and Policy? Trauma, Violence, & Abuse, 11(1), 27-41. doi:  10.1177/1524838009358892.
Abstract from article: “The authors review the literature on resilience following childhood maltreatment and describe how variation in the measurement of outcomes at various developmental stages affects research findings, practice implications, and policy recommendations. Although the 21 studies reviewed considered competent functioning in similar domains as evidence of resilience following maltreatment, few provided prevalence estimates for specific indicators or across domains of functioning. Using the National Survey of Child and Adolescent Well-Being (NSCAW), the authors explored different ways of operationalizing resilience. The number of children demonstrating competence following maltreatment varied greatly by the indicators used; furthermore, competence in one domain (behavioral, emotional, or educational) did not guarantee competence in another. About one in five children were functioning poorly in all three domains. Because findings vary according to the operational definition of resilience, researchers must use caution in conceptualizing their analytic variables and interpreting findings. Furthermore, given the lack of cross-domain competence, services to maltreated children and their families should be comprehensive”

Individual- and Relationship-Level Factors Related to Better Mental Health Outcomes following Child Abuse: Results from a Nationally Representative Canadian Sample
Afifi, Tracie O. et al. (2016). Individual- and Relationship-Level Factors Related to Better Mental Health Outcomes following Child Abuse : Results from a Nationally Representative Canadian Sample. Canadian Journal of Psychiatry, 1-13. doi: 10.1177/0706743716651832
Abstract from article: “Child abuse can have devastating mental health consequences. Fortunately, not all individuals exposed to child abuse will suffer from poor mental health. Understanding what factors are related to good mental health following child abuse can provide evidence to inform prevention of impairment. Our objectives were to 1) describe the prevalence of good, moderate, and poor mental health among respondents with and without a child abuse history; 2) examine the relationships between child abuse and good, moderate, and poor mental health outcomes; 3) examine the relationships between individual- and relationship-level factors and better mental health outcomes; and 4) determine if individual- and relationship-level factors moderate the relationship between child abuse and mental health.”

Resilience in Physically Abused Children : Protective Factors for Aggression
Holmes, Megan R. et al. (2015). Resilience in Physically Abused Children: Protective Factors for Aggression. Behavioural Sciences, 5 (2), 176-189. doi: 10.3390/bs5020176
Abstract from article: “Aggression continues to be a serious problem among children, especially those children who have experienced adverse life events such as maltreatment. However, there are many maltreated children who show resilient functioning. This study investigated potential protective factors (i.e., child prosocial skills, child internalizing well-being, and caregiver well-being) that promoted positive adaptation and increased the likelihood of a child engaging in the healthy, normative range of aggressive behavior, despite experiencing physical maltreatment. Logistic regression analyses were conducted using two waves of data from the National Survey of Child and Adolescent Well-Being (NSCAW-I). Children who were physically maltreated were more likely to exhibit clinical levels of aggressive behavior at Time 1 than children who were not physically maltreated. Children’s internalizing well-being, children’s prosocial behavior, and caregivers’ well-being were associated with lower likelihood of clinical levels of aggressive behavior at Time 1. Children’s internalizing well-being and children’s prosocial behavior remained significantly associated with nonclinical aggression 18 months later. These findings highlight the role of protective factors in fostering positive and adaptive behaviors in maltreated children. Interventions focusing on preventing early aggression and reinforcing child prosocial skills, child internalizing well-being, and caregiver well-being may be promising in promoting healthy positive behavioral adjustment.”

Resilience in Survivors of Child Sexual Abuse: A Systematic Review of the Literature
Domhardt, Matthias, et al. (2014). Resilience in Survivors of Child Sexual Abuse: A Systematic Review of the Literature. Trauma, Violence, & Abuse, 16 (4), 476-493. doi: 10.1177/1524838014557288
Abstract from article: “This review article summarizes empirical research on resilience in survivors of child sexual abuse (CSA) and discusses protective factors that are associated with adaptive functioning in spite of sexual victimization.”

Understanding strengths in relation to complex trauma and mental health symptoms within child welfare
Kisiel, C., Summersett-Ringgold, F., Weil, L. E., & McClelland, G. (2016). Understanding Strengths in Relation to Complex Trauma and Mental Health Symptoms within Child Welfare [Abstract]. Journal of Child and Family Studies, 26(2), 437-451. doi:10.1007/s10826-016-0569-4
Abstract from article: “Strengths can have a potent effect in mitigating the impact of trauma on mental health needs and functioning. Yet, evidence is limited on the role that strengths may have in ameliorating trauma-related or mental health symptoms over time. Providing a comprehensive assessment that includes strengths, as well as needs, is an important step in making appropriate service recommendations for youth in child welfare. This study assessed 7,483 children and adolescents entering an intensive stabilization program through the Illinois child welfare system. The interaction of individual, child strengths in relation to complex trauma exposure, traumatic stress symptoms, risk behaviors, and other mental health needs were examined. Results indicated strengths are relatively stable over time and inversely associated with several negative outcomes, including risk behaviors (−.32, p < .001), emotional/ behavioral needs (−.33, p < .001) and overall functioning (−.47, p < .001). Traumatic stress symptoms were also related to increases in these negative outcomes. Overall, strengths had a buffering effect on traumatic stress symptoms and outcomes over time. The role of strengths in relation to traumatic stress symptoms, however, was less consistent. Youth with histories of complex trauma exposure had significantly fewer useable strengths than youth without this exposure. However, strengths improved for both youth with and without complex trauma exposure over the course of stabilization services. These findings suggest that early identification and development of child strengths can mitigate risk-taking behaviors, mental health, and functional difficulties among youth in the child welfare system. Implications for more targeted trauma-informed and strengths-based assessment, and treatment/service planning are discussed.”

What is resilience?
Herrman, Helene, et al. (2011). What is resilience? The Canadian Journal of Psychiatry, 56 (5), 258-265. doi: 10.1177/070674371105600504
Abstract from article: “While everyone—including front-line clinicians—should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists and other health professionals also need to consider how best to support, throughout the lifespan, those people affected by severe adversity. The first step in achieving this is a clear understanding of the definitions and concepts in the rapidly growing study of resilience. Our paper reviews the definitions of resilience and the range of factors understood as contributing to it, and considers some of the implications for clinical care and public health.”