The present study had an overarching objective of seeking information to better understand the service needs of children entering foster care who are universally enrolled into behavioral health services at the time of their home removal. The first specific aim was to examine how various case attributes (i.e., aspects of a child’s background, personal and familial characteristics, and CPS involvement) related to behavioral health needs at entry, represented by global functioning ratings and service intensity scores. A second specific aim was to explore the existence of natural groupings of foster youth to examine if meaningful groupings occur in relation to demographic and risk and factors. Finally, this study sought to evaluate service needs of subgroups of foster children who are typically under-referred for services. Data were collected from records of 327 school-age youth who were automatically enrolled into treatment from one community-based outpatient behavioral health provider at the time of home removal. The results of this study showed that the average school-age child entering foster care is performing in the at-risk range of global functioning (mean CGAS score of 69.23) and requires at least short-term behavioral health intervention services and/or recovery monitoring (mean CASII Composite Score of 13.1). With respect to severity of impaired functioning, the results indicated that racial background, medical history, speech problems, school grade level (e.g., <1 year, K-3,...9-12), psychological stability, and reasons for removal significantly contributed to scores of global functioning. With regard to the intensity of service needs, the findings suggested gender, historical involvement with child welfare services, foster placement, simultaneous removal of all children, history of sexualized behaviors, and global functioning predicted level of care composite scores. Subgroups of foster youth that are typically under-referred and/or under-utilize services (i.e., preschool age children, children who did not experience physical or sexual abuse, and ethnic minorities) generally did not differ in terms of functionality or service intensity ratings from their counterpart groups; the only exception being that Caucasian/Non-Hispanic youth demonstrated lower average ratings on global functioning than children who identify with other racial backgrounds. The data showed inadequate fit for examining latent classes among youth entering foster care.

Syftet med denna kvalitativa studie har varit att undersöka förskollärares definition av omsorgssvikt, samt om emotioner påverkar att förskollärare gör en anmälan till socialtjänsten gällande omsorgssvikt. Empirin samlades in med kvalitativa intervjuer av fyra förskollärare, som hade erfarenhet av anmälan till socialtjänsten. Intervjuerna analyserades med hjälp av teori om omsorgssvikt, emotioner samt interaktionsritualer. Studien ger inblick och förståelse för förskolepersonalens kunskap och erfarenheter av omsorgssvikt samt om hur emotioner formar relationer mellan de inblandade och kan påverka en anmälan. Resultatet visade att förskollärarnas definition av omsorgssvikt inte består av ett visst antal tecken, utan att de bildar sig en helhetsuppfattning av barnets situation. Studien visar att emotioner kan påverka att en anmälan görs, både genom att förskollärarna tvekar och därmed förlänger processen, men också genom att en anmälan överhuvudtaget inte alls upprättas. / The aim of this qualitative study was to study pre-school teachers´ definition of child maltreatment, and the impact of emotions in reporting child maltreatment to the Social Services. The empirical data was collected through qualitative in-depth interviews of four pre-school teachers, who were all experienced in reporting child maltreatment to the Social Services. The interviews were analyzed using emotion theory, theory on child maltreatment and interaction ritual theory. The study provides insight and understanding of their knowledge and experience of child maltreatment, how emotions shape the relationship between the people involved as well as how emotions affect reporting. The result shows that preschool teachers´ definition of child maltreatment is not composed of one or two signs of neglect, but by forming an overall picture of the child's situation. The study also shows that emotions can affect the reporting of child maltreatment both in the sense of actually reporting, as well as hesitating and therefore prolonging the process, but also possibly that the neglect is not reported at all.

This capstone project was conducted to evaluate trainer trainee satisfaction and acceptability from social validation questionnaires for SafeCare provider training s conducted by the National SafeCare Training and Research Center. Data were collected from 82 training participants from 2007 to 2009. SafeCare is an evidence-based parenting skills program created for at-risk and maltreating parents. The National SafeCare Training and Research Center utilizes a trainer-training model to teach professionals at the community-level. Trainees are instructed in four SafeCare modules: health, home safety, parent-child and parent-infant interactions. Social validation questionnaires are administered to evaluate process and procedures, outcome measures, staff performance, and training methods. Overall, SafeCare provider training was reported as valuable across all three social validation questionnaires. Trainees also reported a strong agreement for utilizing the skills learned during training in their future field work. Training staff performance received high satisfaction ratings as well.

Inappropriate parental expectations of age-appropriate behaviors and unawareness of developmental milestones can increase instances of child maltreatment. Additionally, experiences of child maltreatment can have a negative impact on the developmental trajectory of a child. The present research describes a parental aide, the tDevelop, delivered to parents at risk for child maltreatment through SafeCare Parent-Child Interaction (PCI) training with the aim of increasing identification of developmental milestones and age-appropriate activities. Two high-risk families with children close to 24-months of age were recruited from a residential program for young mothers working to develop self-sufficiency skills. The families were presented with the tDevelop along with traditional PCI information, including Planned Activities Training and age-appropriate activities. Data from a multiple-probe, single-case experimental design, suggest that mothers are able to recognize developmental milestones with increased accuracy upon intervention with the tDevelop. These findings suggest that the enhanced PCI protocol may enhance parental identification of developmental milestones.

Childhood emotional maltreatment is associated with damaging consequences, although relatively little is known about the mechanisms underlying its effects. This dissertation investigated the concurrent influences of adult attachment and mindfulness on internalizing symptoms and emotional processing in young adults with and without a history of emotional maltreatment. Study 1 revealed that a sequential mediation model, with adult attachment orientations as first-step mediators and mindfulness as a second-step mediator, fit the data better than a simultaneous mediation model. In addition, moderation analyses revealed that high self-reported levels of mindfulness protected against the development of internalizing symptoms, even in at-risk individuals. Study 2 replicated these findings in a new sample, while also extending the results beyond a self-report outcome, using behavioural measures of emotional processing. Emotional maltreatment, adult attachment, and mindfulness predicted the amount of perceptual information required to correctly identify fearful faces and the amount of interference demonstrated in response to positive and negative emotional words. Cumulatively, these findings suggest that childhood emotional maltreatment can disrupt attachment relationships and encumber the development of mindfulness, contributing to internalizing symptoms and the biased processing of emotional information. However, alternative outcomes are possible, given the presence of high levels of mindfulness and secure attachment representations. This has implications for clarifying developmental theories and evaluating clinical interventions that may mitigate the negative effects of childhood emotional maltreatment.

Bakgrund: Under år 2012 ökade anmälningarna av barnmisshandel. Barnmisshandel oavsett art innebär alltid en kränkning för barnet och om det dessutom sker av en anhörig har barnet förlorat den person som ska stå för den fasta tryggheten. Både fysisk misshandel, psykisk misshandel eller omsorgsvikt skadar barnet allvarligt och innebär stora hälsoproblem för barnet. Därför var det av stor vikt att identifiera barnet i ett tidigt skede för att kunna ge stöd och agera utefter behov. Syfte: Syftet med studien var att belysa distriktssköterskans erfarenhet av att se och identifiera kännetecken på ett misshandlat barn. Metod: En induktiv ansats valdes och fyra distriktssköterskor i Hallands län med erfarenhet av ämnet intervjuades. En intervjuguide med semistrukturerade frågor användes och materialet analyserades utifrån kvalitativ innehållsanalys. Resultat: Att arbeta som distriktssköterska innebar att vara barnets ombud och alltid se till barnets bästa och arbeta utifrån barnperspektivet samt att främja dess hälsa. Det var av stor vikt att så tidigt som möjligt få inblick i barnets familjesituation samt att skapa en bra relation till föräldrarna för att kunna identifiera ett misshandlat barn så tidigt som möjligt. Slutsats: Med ökad kunskap om kännetecken och symtom på barnmisshandel och kunskap om hur en tidig upptäckt av barnmisshandel kan ske, ökar barnets möjlighet till tidig stöttning och hjälp. Med fortsatt forskning, utbildning och utveckling av redskap ökar chanserna att upptäcka de misshandlade barnet i ett tidigt skede.

Children exposed to intimate partner violence (IPV) and/or maltreatment have a higher risk for developing delinquent behavior. This study examines these problems using secondary data which consisted of 150 adolescents in ages 12-18. All participants received treatment for alcohol and/or drug use at clinic centre at the time. The result suggests that delinquent behaviors in adolescents with substance use are associated with witnessing injury and sexual coercion among parents above and beyond being a victim of maltreatment. Violence against others is associated with witnessing sexual coercion among parents but is not related with none of the adolescents victimization variables. Implications of the presents study's result are discussed. / Barn som exponeras för våld mellan föräldrarna och/eller misshandel har en högre risk för att utveckla kriminellt beteende. Den föreliggande studien undersöker detta problem med hjälp av sekundärdata bestående av 150 ungdomar i åldrarna 12-18 år. Alla deltagare i studien fick behandling mot alkohol och/eller drogproblem på en behandlingsklinik vid tillfället. Studiens resultat föreslår att kriminalitet hos ungdomar med alkohol och/eller drogproblem är associerat med att bevittna föräldrars skador och sexuella tvång utöver att vara offer för misshandel. Våldsamt beteende mot andra är associerat med att bevittna föräldrars sexuella tvång men inte relaterad med någon av de olika variablerna för misshandel. Implikationer från den föreliggande studiens resultat diskuteras.

Intimate partner violence (IPV) is a leading cause of death and injury for women in the United States. Although African American women are one of the groups most likely to be killed by an intimate partner, there has been little research to identify factors associated with risk among this group. To address this gap in the literature, the current study investigated ecological risk factors associated with physical and psychological IPV. Next, Africultural coping was explored as a moderator hypothesized to decrease the association between childhood maltreatment (CM) one of the strongest predictors of IPV, and IPV outcomes. It was hypothesized that Africultural coping would moderate the association between the level of retrospectively reported CM and recent reports of psychological IPV victimization, such that there would be a weaker relationship between CM and IPV for women who reported higher levels of Africultural coping. Results of multiple linear regressions indicated that higher levels of CM predicted both psychological and physical IPV, while controlling for the participants’ age. Hypothesized moderators were limited in their association with IPV. Implications for research, policy, practice, and wellness promotion for African American women are discussed.

Childhood maltreatment increases risk for Posttraumatic Stress Disorder (PTSD). Maladaptive patterns of attention to threat-related stimuli warrant examination as possible contributing risk factors. It remains unclear whether persistent threat-processing biases are differentially apparent in adults who were maltreated as children and either did, or did not, develop later PTSD. The present study examined associations among attention bias, childhood maltreatment, and PTSD in adults. We hypothesized that attentional bias toward threat significantly mediates associations between childhood maltreatment and adult PTSD symptoms. 183 adults with and without childhood maltreatment histories participated in this study, which involved completion of a range of clinical measures; attention bias was measured by the Dot Probe task. We found that attention bias toward happy faces partially mediated the relationship between childhood maltreatment and PTSD avoidance and numbing symptoms. Childhood maltreatment, happy face attention bias, and perceived racially discriminative experiences all accounted for significant variance in PTSD symptoms.

Substantial evidence indicates that maltreatment places abused children at great risk for illiteracy and damaging self-perceptions of competency and worth. Given that academic ability and self-concept are reciprocally related and mutually reinforcing, it was hypothesized that participation in an intensive literacy intervention would positively impact the reading, writing, and related self-perceptions of maltreated Struggling Readers from the Ontario Child-Welfare system. Using a mixed methods approach, 24 participants (ages 14-24) completed achievement and self-perception measures and were interviewed about their literacy experiences and views, pre and post intervention. Repeated measures analyses and pairwise comparisons measured the impact of intervention on the literacy skills and related self-evaluations of these youth and assessed how the literacy skills and related self-evaluations differed from maltreated youth without reading difficulties (n = 22). Interviews were analyzed thematically. Results converged to provide empirical support for the benefits of literacy intervention on skill and self-perception development for this high risk group of youth. Qualitative analyses further revealed unanticipated, dramatic and meaningful life changes. Participants manifested improved communication and metacognitive skills, increased autonomy and internal motivation, and amplified feelings of empowerment and hope for the future.