Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p.137-152) and index.

Atualmente um amplo processo de mobilização social contra a violência, nas famílias, tornou-se urgente. O serviço de saúde é um espaço privilegiado para se atuar sobre o campo da violência doméstica e são encontradas inúmeras dificuldades em lidar com o fenômeno por parte dos profissionais da área. Nesse sentido, acreditamos que a falta de uma compreensão mais ampla sobre o contexto familiar é uma das dificuldades que está relacionada à falta de conhecimento sobre o assunto. A investigação, aqui apresentada, buscou conhecer e analisar a compreensão de família para pais e filhos envolvidos no episódio da Violência Doméstica contra crianças e adolescentes institucionalizados no Centro de Atendimento à Criança e ao Adolescente Vitimizado (CACAV). A metodologia adotada é de abordagem qualitativa e utilizamos como instrumento de coleta de dados a entrevista semi-estruturada aplicada aos pais e às crianças que foram vitimizadas, totalizando seis famílias. Quanto à análise desses dados, escolhemos a análise de conteúdo, modalidade temática, proposta por Bardin (1979). O referencial teórico que subsidiou nossa análise de dados foi o modelo centrado na visão do contexto ecológico do desenvolvimento humano proposto por Urie Bronfenbrenner. Identificamos, a partir das falas dos entrevistados, duas temáticas: “contexto familiar” e “violência”. Em relação à primeira temática, apreendeu-se que a visão dos pais sobre família é diferente da visão das crianças e adolescentes vitimizados, uma vez que a ótica dos pais favorece a compreensão da família como nuclear dentro de uma perspectiva que ainda permanece cultural e socialmente estabelecida pela sociedade. Já as crianças apontam que o vínculo de amor e afeição são mais significativos que laços consangüíneos, tal fato pode estar relacionado à vitimização, considerando que a violência doméstica contribui para o enfraquecimento do sentimento de família. Em relação à segunda temática, evidenciamos que o fato da criança e do adolescente testemunharem ou vivenciarem a violência doméstica tenderá a reproduzir, por sua vez, relacionamentos violentos em seu cotidiano, fazendo com que seja perpetuada a cadeia desse tipo de violência. Acreditamos que tais perspectivas apresentadas neste estudo, dentro de um contexto de significados, refletem a realidade pela qual passa a família, facilitando, assim, a prevenção desses eventos. Dessa forma, é importante considerar que a partir do conhecimento da dinâmica familiar e da forma como a violência é experienciada pelas suas vítimas e agressores é que podemos pensar em uma estratégia de intervenção capaz de romper o ciclo perverso das relações familiares violentas. / Nowadays, there is an urgent need for a broad social mobilization process against family violence. The health service is a privileged space to act in the field of domestic violence. Health professionals face countless difficulties to deal with this phenomenon. In this sense, we believe that one of these difficulties refers to the lack of a fuller understanding about the family approach, which is related to a lack of knowledge about the subject. This research aimed to get to know and analyze how parents and children involved in episodes of domestic violence against children and adolescents, institutionalized at the Care Center for Child and Adolescent Victims (CACAV). A qualitative methodology was adopted and data were collected by means of semi-structured interviews with parents and child victims, totaling 6 families. Content analysis was chosen to analyze these data, using the thematic mode proposed by Bardin (1979). The theoretical reference framework that guided our data analysis was the model centered on Urie Bronfenbrenner’s view of the ecological context of human development. Based on the interviewees’ discourse, we identified two themes: “family context” and “violence”. With respect to the first theme, we observed that the parents’ view on family differs from that of the child and adolescent victims, since the parents’ point of view favors an understanding of family as the core, within a perspective that is still culturally and socially established by society. Children, on the other hand, indicate that bonds of love and affection are more important than blood relations. This fact may be related to victimization, since domestic violence contributes to the weakening of family feelings. What the second theme is concerned, we demonstrate that, due to the fact that children and adolescents witness or experience domestic violence, they will tend to reproduce violent relations, thus perpetuating the transmission chain of this kind of violence. We believe that, within a context of meanings, the perspectives presented in this study reflect the reality the family goes through, thus making it easier to prevent these events. Hence, it should be taken into account that it is on the basis of knowledge about the family dynamics and how violence is experienced by its victims and aggressors that we can think of an intervention strategy that is capable of breaking the perverse cycle of violent family relations.

A investigação, aqui apresentada, buscou conhecer e analisar o cuidado institucional à criança e adolescente em situação de risco social, sob a visão de seus familiares e da equipe de profissionais que atua no abrigo da cidade de Jardinópolis, SP. A metodologia adotada é de abordagem qualitativa e utilizou-se como instrumentos de coleta de dados o mapa censitário, a observação livre e a entrevista semiestruturada, aplicada aos funcionários do abrigo e aos pais das crianças e adolescentes ali institucionalizados. Quanto à análise desses dados, escolhe-se a análise de conteúdo, modalidade temática. Identificou-se, a partir da caracterização do espaço pesquisado e dos atores estudados que as crianças e adolescentes institucionalizados são em sua maioria meninos, negros e pobres e o motivo pelo qual foram institucionalizados se destaca a negligência. Destacou-se ainda, que as famílias dessas crianças e adolescentes institucionalizados, são, em sua maioria, desempregados, possuem situação financeira desfavorável o que se relaciona ao baixo grau de escolaridade o que por sua vez diminuem as chances dessas famílias de se inserir no mercado de trabalho. A partir das falas dos entrevistados, emergiram três temáticas: o cuidado enquanto contexto de análise, a violência enquanto (re)construção dos espaços e a instituição como espaço de trabalho. Em relação à primeira temática, apreendeu-se que o cuidado se apresenta a partir de ações relacionadas com a alimentação, higiene pessoal, ambiental e cuidados relativos à saúde, sem incluir a prevenção de doenças. Além disso, os cuidadores ressaltam que realizam tais cuidados baseados em suas experiências como pais. Afirmam, também, que não utilizam o conhecimento técnico ao oferecer cuidados às crianças e adolescentes abrigados e que se sentem inseguros para tais prática. Dessa forma, evidencia-se a fragilidade da função cuidadora no arcabouço da construção do papel profissional. Em relação à segunda temática, verificou-se a violência simbólica, psicológica e até física praticada por esses cuidadores, aparecendo de uma forma naturalizada, necessária e integrante das relações de poder perpetradas no contexto institucional. Assim, pode-se pensar o cuidado institucional como mecanismo de controle disciplinar que a partir de Foucault abre-nos a possibilidade de maior compreensão dessa dinâmica de forças, sendo elas indefinidas, mutáveis e transitórias, de acordo com o contexto à qual se inserem. E, por fim, na terceira temática, apreendeu-se que a falta de políticas públicas adequadas e a fragilidade no modelo vigente de atenção à criança e adolescente exercem significativa influência no atendimento dentro das instituições de abrigo. De forma geral, percebese que há muita lacuna na sistematização do cuidado, dificultando que ele possa ser objetivado, mediante planejamento, com definição de objetivos, estratégias e avaliação permitindo que ele seja visto como produção de um trabalho profissional, estruturado nas reais necessidades dessa população. Pensar a criança e o adolescente como atores sociais ativos, envolvidos no cuidado da própria saúde, permite compreender que o cuidado dispensado nessas instituições de abrigamento pode e deve ser entendido como um processo dialético de mútua interação e construção. Os resultados obtidos na presente pesquisa levam a refletir, dialogar e intervir nessa realidade tão pouco conhecida. Acredita-se que a elucidação de tais significados na perspectiva dos atores sociais estudados proporcionará melhor entendimento e aproximação entre quem cuida e quem é cuidado, bem como oferecerá ao profissional subsídios que fundamentem suas ações para o atendimento das necessidades de cuidado institucionalizado manifestadas por essas crianças e adolescentes / The investigation, here presented, looked for to know and to analyze the institutional care to the child and adolescent in situation of social risk, under your relatives\' vision and of the professionals\' team that acts in the shelter of the city of Jardinópolis, SP. The adopted methodology is of qualitative approach and it was used as instruments of collection of data the map censitário, the free observation and the interview, applied to the employees of the shelter and the children\'s parents and adolescents there institutionalized. With relationship to the analysis of those data, it is chosen the content analysis, thematic modality. Identified, starting from the characterization of the researched space and of the actors studied that the children and institutionalized adolescents are in your majority boys, blacks and poor and the reason for which were institutionalized if it detaches the negligence. Still stood out, that those children\'s families and institutionalized adolescents, they are, in your majority, unemployed, possess unfavorable financial situation what he/she links to the bass of education degree that you/they reduce the chances of those families of interfering in the job market for your time. Starting from the interviewees\' speeches, three emerged thematic: \" the care while analysis \" context, the violence while (re)construction of the spaces \" and \" the institution as work space. In relation to the first thematic, it was apprehended that the care comes starting from actions related with the feeding, hygiene personal, environmental and relative cares to the health, without including the prevention of diseases. Besides, the caretakers point out that accomplish such cares based on your experiences as parents. They affirm, also, that don\'t use the technical knowledge when offering cares to the children and sheltered adolescents and that feel insecure for such practice. In that way, the fragility of the function caretaker\'s insert is evidenced in the context of the construction of the professional paper. In relation to thematic second, the violence symbolic, psychological was verified and even physics practiced by those caretakers, appearing in a naturalized way, necessary and integral of the relationships of power perpetrated in the institutional context. Like this, it can be thought the institutional care as control mechanism to discipline that starting from Foucault these he/she opens us the possibility of larger understanding of that dynamics of forces, being them indefinite, changeable and transitory, in agreement with the context to which you/they interfere. And, finally, in the thematic third, it was apprehended that the lack of appropriate public politics and the fragility in the effective model of attention to the child and adolescent exercise significant influence inside in the attendance of the shelter institutions. In a general way, it is noticed that there is a lot of gap in the sistematização of the care, hindering that he can be aimed at, by planning, with definition of objectives, strategies and evaluation allowing him to be seen as production of a professional work, structured in the real needs of that population. To think the child and the adolescent as active social actors, involved in the care of the own health, he/she allows to understand that the care released in those shelter institutions it can and it should be understood as a process dialogue of mutual interaction and construction. The results obtained in the present he/she researches they take to contemplate, to dialogue and to intervene in such little known reality. It is believed that the elucidation of such meanings in the studied social actors\' perspective will provide better understanding and approach among who he/she takes care and who is taken care, as well as he/she will offer to the professional subsidies that base your actions for the attendance of the needs of institutionalized care manifested by those children and adolescents

Background: Previous research has demonstrated that a history of childhood maltreatment can lead to significant negative consequences across multiple domains of functioning. A significant minority of individuals remain resilience to such negative consequences, necessitating further research into the factors which protect against negative outcomes in young people who have experienced adversity. A systematic review of the literature was carried out in order to assess the evidence base for factors that predict adolescent resilience following childhood maltreatment. Several factors across the individual, family and community level were identified, however, evidence regarding these factors was mixed. Factors that have been shown to predict resilience in other age groups require further validation within adolescent samples. Aim: The first aim of this study was to investigate the role of resilience in the relationship between childhood maltreatment and psychological distress. The second aim was to address a possible role for attachment in mediating the relationship between childhood maltreatment and resilience. Method: Adolescents aged 13 – 17 who were attending Child and Adolescent Mental Health Services were asked to complete measures of childhood maltreatment, individual resilience, attachment and psychological distress. Results: Resilience was shown to mediate the relationship between maltreatment and psychological distress. Attachment avoidance was found to mediate the relationship between maltreatment and resilience but not when emotional reactivity was included in the resilience index. Attachment anxiety did not mediate the relationship between maltreatment and resilience, however, maltreatment history was found to moderate the relationship between attachment anxiety and resilience. Discussion: Generalisability of this study was limited due to possible bias within the recruited sample. Implications of the significant results are discussed along with suggestions for future research.

<p dir="ltr">Loneliness is a perceived discrepancy between desired and experienced social relationships, which may arise from perceived lack of intimate attachment to another person (e.g., friend) or lack of involvement in larger networks (e.g., peer groups). The current study examined and compared how different aspects of friendship and peer group involvement predicted loneliness of Indonesian adolescents. Participants were 754 twelfth-grade Indonesian students (413 girls, mean age = 16.5 years). Loneliness was self-reported. Reciprocated friendships were calculated from within-grade nominations and friendship quality was obtained from ratings pertaining to each nominated friend. Peer groups were generated from Social Cognitive Mapping (SCM) and status indices were calculated from SCM and peer nominations. A concurrent SEM model was tested where quantity and self- and friend-perceived quality of friendship, group membership (i.e., within-group centrality), and status of the group in the larger network (i.e., group centrality status and group popularity status) predicted loneliness. All predictors had unique negative effects on loneliness with generally similar effect sizes except for friend-perceived friendship quality. An interaction between within-group centrality and group popularity status was found for boys. The results revealed that quantity and quality of friendship as well as position in the peer group and the status of the peer group were associated with loneliness. Being central in a group may be more important for those in low-status groups than high-status groups. Group-related indices were comparable to friendship indices as predictors of loneliness, which may be shaped by Indonesian culture where group involvement is valued more than intimate friendships.</p>

<p>Adolescence means an increased risk for eating disorders (ED) and the female gender is the most important risk factor. Empirical studies of the perceptions of gender ideals—as potential mediating factors between the socio-cultural context and ED—were this thesis’ primary goals. Further aims implied evaluating the psychometric properties of the Eating Disorders Inventory for Children (EDI-C) and providing normative data for boys and girls concerning self-assessed ED symptoms and related psychological traits.</p><p>The EDI-C has satisfying psychometric properties, and normative data are now provided. The vast majority of preadolescent and adolescent boys and girls (n=4725) are not preoccupied with weight concerns, but 1–3% of the boys and 9–20% of the girls here indicate feelings of anxiety and problematic attitudes. An increase of self-reported ED symptoms occurs during female preadolescence and early adolescence. </p><p>Responses to three open-ended questions—addressing perceived and personal gender ideals of adolescent boys (n=347) and girls with (n=204) and without (n=417) an ED—indicate that girls are, compared to boys, more involved in images of ideals. The perceived ideal man and ideal woman differ in body size and strength. This corresponds with different health risk behaviours reported in boys (body building) and girls (dieting). Awareness of media ideals and an ability to discriminate them from individual values was common in the normal groups and in girls who had recovered from an ED. A poor outcome was associated with thinness stated as ideals of the media, without mentioning good looks. Factors that could predict outcome at the 3-year follow-up of an ED in adolescent girls were: good looks (media ideal), maturity fears, profession (individual ideal), sexual debut, and vomiting.</p><p>The addition of a gender perspective would add a dimension to programmes aiming at preventing and treating ED in adolescence.</p>

Adolescence means an increased risk for eating disorders (ED) and the female gender is the most important risk factor. Empirical studies of the perceptions of gender ideals—as potential mediating factors between the socio-cultural context and ED—were this thesis’ primary goals. Further aims implied evaluating the psychometric properties of the Eating Disorders Inventory for Children (EDI-C) and providing normative data for boys and girls concerning self-assessed ED symptoms and related psychological traits. The EDI-C has satisfying psychometric properties, and normative data are now provided. The vast majority of preadolescent and adolescent boys and girls (n=4725) are not preoccupied with weight concerns, but 1–3% of the boys and 9–20% of the girls here indicate feelings of anxiety and problematic attitudes. An increase of self-reported ED symptoms occurs during female preadolescence and early adolescence. Responses to three open-ended questions—addressing perceived and personal gender ideals of adolescent boys (n=347) and girls with (n=204) and without (n=417) an ED—indicate that girls are, compared to boys, more involved in images of ideals. The perceived ideal man and ideal woman differ in body size and strength. This corresponds with different health risk behaviours reported in boys (body building) and girls (dieting). Awareness of media ideals and an ability to discriminate them from individual values was common in the normal groups and in girls who had recovered from an ED. A poor outcome was associated with thinness stated as ideals of the media, without mentioning good looks. Factors that could predict outcome at the 3-year follow-up of an ED in adolescent girls were: good looks (media ideal), maturity fears, profession (individual ideal), sexual debut, and vomiting. The addition of a gender perspective would add a dimension to programmes aiming at preventing and treating ED in adolescence.

The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASH) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demon-strates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASH demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale.

O grande número de crianças acolhidas institucionalmente no Brasil contemporâneo é uma constante que incomoda a sociedade e pede uma solução urgente do Estado, seja do ponto de vista da assistência social, seja no âmbito da assistência jurídica. Analisar de que modo o direito está contribuindo para a mudança deste quadro é o objetivo do presente trabalho, que retorna às origens da adoção e caminha até o panorama atual das crianças e adolescentes aptos a serem adotados, passando pelo desejo daquelas pessoas que querem adotar, bem como pelos princípios balizadores do Estatuto da Criança e do Adolescente e pela teoria da proteção integral, adotada pelo ordenamento brasileiro, para buscar uma solução juridicamente possível. Neste contexto, busca-se saber se a adoção intutitu personae, a qual não tem previsão expressa no Estatuto da Criança e do Adolescente, ainda assim é viável, a partir das normas e princípios vigentes. Os novos conceitos trazidos pela Lei n. 12.010/2009, como família natural, família extensa e família substituta, bem como o Cadastro de Adotantes são pontos de estudo centrais para a conclusão da presente dissertação de mestrado. / The large number of children living in institutions in contemporary Brazil has been a constant that troubles society and requires an urgent solution from the State, whether from the social or legal assistance point of view. Analyzing how the Law is contributing to change this situation is the purpose of this paper. It returns to the origins of adoption and goes through the current overview of children and adolescents eligible to be adopted, as well as the desire of those people who want to adopt, passing through the guiding principles of the Estatuto da Criança e do Adolescente (Statute of the Child and Adolescent) and the full protection theory adopted by the Brazilian system to seek a legally possible solution. In this context, we try to find out if the intuitu personae adoption, which is not provided by the Estatuto da Criança e do Adolescente, is still feasible based on the rules and principles in force. The new concepts set forth by Law no. 12.010/2009, such as natural family, extended family and surrogate family, as well as the Register of Adopting Parents, are focal points of study for the conclusion of this Masters dissertation.

As redes de proteção à criança e ao adolescente constituem uma política pública recente no contexto nacional. O Conselho Tutelar é uma instituição que aciona o funcionamento das redes, sob a égide jurídica do Estatuto da Criança e do Adolescente (ECA). Nesse campo problemático e complexo, quais os significados e representações da função social do Conselho Tutelar construídas pelos seus atores principais? Esta pesquisa teve como objetivo analisar o funcionamento dessa instituição, a partir das práticas discursivas de seus agentes. Trata-se de um estudo qualitativo, referenciado na Teoria das Representações Sociais, segundo Moscovici e Jodelet. A coleta de dados ocorreu em cinco sessões de grupo focal, análise de documentos, prontuários e observação participante da rotina institucional, num Conselho Tutelar que atua num município de pequeno porte (85 mil habitantes) no interior do país. Os dados foram analisados através da técnica denominada Análise de Conteúdo, que consiste na identificação dos temas recorrentes e emergentes, seja nas regularidades ou singularidades discursivas. As unidades de significado foram organizadas em categorias temáticas que explicitaram os aspectos cognitivos, afetivos e políticos do dispositivo grupal. Enquanto resultados, afirma-se que os discursos indicam posicionamentos defensivos, ambivalentes e paradoxais no que tange ao trabalho do Conselho Tutelar e a Doutrina de Proteção Integral. Os enunciados trazem à tona incompatibilidades entre a esfera pública e a esfera privada. As condições institucionais, concretas e subjetivas, contribuem efetivamente para o sofrimento psíquico dos conselheiros tutelares, com destaque para a impotência e regressão psicofamiliar frente às pressões da sociedade. As representações sociais, objetivadas na prática desses agentes públicos, desvelam que o dispositivo acabou tomando a forma do mal social que visa a combater. Conclui-se, enquanto tese, que o Conselho Tutelar, tal como está estruturado no país, funciona como um dispositivo ideológico e propagandístico, sendo pouco capaz de atender aos anseios sociais por promoção de direitos, inclusão e cidadania. Frente ao julgamento ético e moral, as vítimas tendem a ser culpabilizadas, incorrendo na amenização ou negação dos danos, justificando a violência para fins idealistas na educação exemplar. Diante da condição paradoxal, constatou-se um processo de estereotipia, discriminação e demonização da clientela. / The child and adolescent protection network is a recent public politics in the national context. The Guardianship Council is an institution that actuates the networks functioning, under the legal aegis of the Child and Adolescent Statute (CAS). In this complex field, what are the meanings and representations of the function of the Guardianship Council constituted by its main actors? This study aimed to analyze the functioning of this institution, from its agents discursive practices. Its a qualitative study, having as reference the Theory of the Social Representations, according to Moscovici and Jodelet. The data collection occurred in five sessions of focal group, analysis of documents, records and participating observation of the institutional routine, at a Guardianship Council that acts in a small city (85 thousand inhabitants) in the countrys interior. The data were analyzed through the Content Analyzed, which consists in identifying the recurrent and emerging themes, on the discursive regularity or uniqueness. The meaning units were organized into thematic categories that show the cognitive, affective and political aspects of the group device. While results, its affirmed that the speeches indicated defensive, ambivalent and paradox positions regarding the Guardianship Councils work and the Integral Protective Doctrine, findings revealed an incompatibilities between the public and private spheres. The institutional conditions, concrete and subjective, contribute to the psychic suffering of the guardianship counselors, highlighting the psych familiar impotence and regression. The social representations, objectified at these public agent practices, unveiling that the device, ended taking the shape of the social ill that aims to combat. Its concluded, as thesis, that the Guardianship Council, as it is organized in Brazil, works as an ideological and propagandistic device, it is incapable to attend the social expectations by rights, social inclusion and citizenship. In view of the ethical and moral judgment, the victims tend to be blamed, incurring mitigation or denial of the damage, justifying the violence to idealistic ends at the exemplary education. Concluding, it has been found a process of stereotyping, discrimination and demonizing of the communities.