The use of the Brief Child Abuse Potential Inventory in the general population in Finland

Identification and Evaluation of Non-Accidental Trauma in the Pediatric Population: A Clinical Review

Non-accidental trauma (NAT) is a major cause of morbidity and mortality for children around the world and most significantly impacts children under one year of age. Prompt and comprehensive treatment of these children relies on a high index of suspicion from any medical provider that treats pediatric patients. This review discusses those most at risk for experiencing NAT, and common initial presentations, to assist providers in the identification of potential victims. In addition, this review provides guidance on the recommended workup for these patients so that the full extent of associated injuries may be identified and the appropriate healthcare team may be assembled.

Parental burnout and borderline personality stand out to predict child maltreatment

Parental burnout is a severe disorder resulting from the exposure to chronic stress in the parental role, that can translate into neglectful and violent parental behaviors towards the offspring. This study (N = 1003 parents) aims to examine the relative weight of parental burnout, job burnout, depression, generalized anxiety disorder, borderline personality, sadism, psychopathy, Machiavellianism, narcissism, and child abuse potential, in predicting violence and neglect towards the offspring. Social desirability was controlled. When all predictors are entered together in the model, violence and neglect towards the offspring are best predicted by borderline personality and parental burnout. Our results also indicate that sadism is a robust predictor of violence, however weaker than parental burnout and borderline personality. These results emphasize the importance of preventing parental burnout and supporting parents with borderline personality.

The use of BCAP in Finland: toward correct classification rate

OBJECTIVE

Further validation of Brief Child Abuse Potential (BCAP) inventory, for setting the correct classification rate.

METHODS

Data collection from potential abusers (n = 47), visiting in the hospital clinic meant for parents having special needs due to problems with alcohol and drugs connected to other evidence-based risk factors of child abuse. The risk level was compared between these 47 parents and previously collected data from 450 parents, representing general population.

RESULTS

There were no differences between likely abusers and the general population. Among both groups, 6% had elevated abuse risk and there were no differences in appearance of dimensions including in the abuse scale.

CONCLUSIONS

Assuming child abuse based on known risk factors is not enough, when setting the correct classification rate. We need more accurate knowledge about the abuse, and the family life situation in general. However, assessing risk factors of child maltreatment systematically with the BCAP, can still serve as a fruitful basis of assessing parents' needs and worries as the basis for providing support what they need.

Parental Worries, Child Maltreatment Risk and Empowerment: How Are They Noticed in Child and Family Services?

Parental empowerment has been related to their well-being and self-efficacy. Learning more about the signs describing child maltreatment risk are crucial for the welfare of children and families. The aim of this study was to assess the risk of child maltreatment (CM) and related worrying factors of parents and associations between the CM risk, worries and parental empowerment. The study is based on self-report surveys administered to parents in primary health care and hospital settings. The risk of CM and related worrying factors were measured by the Brief Child Abuse Potential Inventory (BCAP) from 453 parents. Family empowerment was measured by The Generic Family Empowerment Scale (G-FES). Parents expressed worries such as loneliness and distress (20%), feelings of persecution (9%), family conflict (17%), rigidity (21%) and financial insecurity (4%). The BCAP found 27 parents with increased risk. Parents with CM risk expressed more empowerment in connection to services for their child and family. It is crucial to discuss worries in child and family services before they raise the risk level. Tools such as the BCAP are useful in systematically identifying the child maltreatment risk and parental worries under discussion, offering possibilities for preventing child maltreatment and increasing well-being of children.

Spanish Adaptation of the Inventory Brief Child Abuse Potential and the Protective Factors Survey

Child maltreatment is a public health problem with different consequences depending on the form of abuse. Measuring risk and protective factors has been a fertile ground for research, without involving instruments with sufficient evidence of validity. The aim of the study was to gather evidence of validity and reliability of the Inventory Brief Child Abuse Potential (IBCAP) and Protective Factors Survey (PFS) in the Mexican population. The instruments were translated into Spanish. In a non-probabilistic sample of 200 participants, the 7-factor model for the IBCAP [comparative fit index (CFI) = 0.984; root mean square error of approximation (RMSEA) = 0.067] and the 4-factor model for the PFS (CFI = 0.974; RMSEA = 0.061) were confirmed, showing adequate fit indices. Reliability was estimated and evidence of convergent, divergent, and discriminant validity was collected, controlling for effects of social desirability. We also report interpretability statistics of the scores. We achieved solid progress in the development of instrumentation that allows determining the presence or absence of protective and risk factors for child abuse.

Psychological and physical abuse towards four-year-old children as reported by their parents: A national Finnish survey

BACKGROUND

In Finnish society, child maltreatment is a health and social problem with harmful consequences. Identifying families at risk may help preventing child maltreatment recurrence.

OBJECTIVE

The aim of this nationwide retrospective cross-sectional study was to describe the child- and family-related risk factors associated with physical and psychological abuse experienced by 4-year-old children.

METHODS

This study analyzed nationwide survey data collected by the Finnish Institute for Health and Welfare. Overall, 17,009 parents (46%) visiting at a child health clinic filled out the survey consent form. For 8720 children, one or both parents completed the questionnaire (24%). Analyses were carried out using χ² tests and binary logistic regression.

RESULTS

Of the 4-year-olds, 44% had experienced at least one form of psychological abuse and 14% physical abuse. These forms of violence co-occurred in 25% of the reported cases (p < 001). Intimate partner violence (IPV) and child maltreatment co-occurred in 19.6% of psychological abuse (p < .001) and 22.5% of physical abuse cases (p < .001). Parents exposed to IPV was the risk factor most likely to predict an increased risk for both psychological abuse (OR 4.01, CI 3.41-4.72; p < .001), and physical abuse (OR 2.19, CI 1.81-2.64; p < .001). Approving of hair-pulling or pinching the child (i.e., using corporal punishment) was most likely to predict an increased risk of physical abuse (OR 13.70, CI 11.69-16.06; p < .001).

CONCLUSIONS

The findings emphasize the importance of preventing all forms of child maltreatment by identifying families at risk and supporting parenthood according to families' needs.

GPs' suspicion of child abuse: how does it arise and what is the follow-up?

Background: Child abuse is widespread, occurs in all cultures and communities, remains undiscovered in 90% of cases and has serious long-term effects. Physicians generally underidentify and underreport child abuse. To understand this low reporting rate and how the suspicion of child abuse arises, we examined GPs' experiences.Research questions: How does the suspicion of child abuse arise in GPs' diagnostic reasoning? How do they act upon their suspicion and which barriers do they encounter in their management?Methods: Twenty-six GPs participated in four focus groups. We used purposive sampling to include GPs with different levels of experience. We performed a thematic content analysis.Results: Suspicion of child abuse arose from common triggers and a gut feeling that 'something is wrong here'. GPs acted upon their suspicion by gathering more data, through history taking and physical examination. They often found it difficult to decide whether a child was abused, because parents, despite good intentions, may simply lack parenting skills and have different values. Clear signs of sexual abuse and physical violence were institutionally reported by GPs, whereas in less clear-cut cases they followed them up and built a supporting network of professionals around the family.Conclusions: A low child abuse reporting rate by GPs to CACRC does not mean a low detection rate. In trying to improve a child's situation, GPs make use of patients' trust in their doctor by involving other professionals. Awareness of the role of gut feelings in developing a suspicion may increase early detection and preventive actions.Key pointsPhysicians generally underidentify and underreport child abuse.Suspicion of child abuse arose from common triggers and a gut feeling that 'something is wrong here'.GPs acted upon their suspicion by gathering more data, through history taking and physical examination.GPs found it difficult to decide whether a child was abused, because parents, despite good intentions, may lack parenting skills.