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Biomedical subjects

David A Wolfe

Publications and source records attributed to David A Wolfe.

8 recordsLinked to original sources

Child abuse in religiously-affiliated institutions: long-term impact on men's mental health.

OBJECTIVE: To describe the long-term impact of physical and sexual abuse of boys by someone in a trusting, non-familial relationship. This clinical study reports on the psychological functioning of men (N = 76) with substantiated claims against a residential religiously-affiliated institution for multiple and severe incidents of sexual, physical, and/or emotional abuse during childhood. The abuse was perpetrated by several adults in positions of authority and trust at the institution. METHODS: Each participant received a clinical interview and was administered psychological tests and a structured interview for DSM-IV diagnoses. The same clinician completed all of the assessments. RESULTS: DSM-IV criteria were met for current PTSD (42%), alcohol (21%), and mood-related disorders (25%). Over one-third of the sample suffered chronic sexual problems, and over one half had a history of criminal behavior. CONCLUSIONS: The clinical findings provide direction for assessing victims of historical abuse, and underscore the importance of awareness, prevention, and treatment needs for those who have been abused in institutional settings. Conclusions are limited due to participants' involvement in civil action, unknown pre-existing conditions, and the lack of a suitable comparison group.

Adult↗

Predicting abuse in adolescent dating relationships over 1 year: the role of child maltreatment and trauma.

Three mediators of the relationship between childhood maltreatment and dating violence perpetration during midadolescence (i.e., trauma-related symptoms, attitudes justifying dating violence, and empathy and self-efficacy in dating relationships) were tested over 1 year with a sample of students from 10 high schools (N = 1,317). Trauma-related symptoms had a significant cross-time effect on predicting incidents of dating violence for both boys and girls. Attitudes and empathy and self-efficacy did not predict dating violence over time, although they were correlated with such behavior at both time points. Child maltreatment is a distal risk factor for adolescent dating violence, and trauma-related symptoms act as a significant mediator of this relationship. The importance of longitudinal methodology that separates correlates from predictors is discussed.

Adolescent↗

Maltreatment and trauma: tracking the connections in adolescence.

Posttraumatic stress disorder is one of the most common and often prolonged consequences of childhood maltreatment. In this article the authors consider theories of trauma continuity, with emphasis on a relational path to maladjustment that links childhood maltreatment to elevated trauma symptomatology and intimate victimization in adolescent dating relationships.

Adolescent↗

The effects of children's exposure to domestic violence: a meta-analysis and critique.

A wide range of children's developmental outcomes are compromised by exposure to domestic violence, including social, emotional, behavioral, cognitive, and general health functioning. However, there are relatively few empirical studies with adequate control of confounding variables and a sound theoretical basis. We identified 41 studies that provided relevant and adequate data for inclusion in a meta-analysis. Forty of these studies indicated that children's exposure to domestic violence was related to emotional and behavioral problems, translating to a small overall effect (Zr = .28). Age, sex, and type of outcome were not significant moderators, most likely due to considerable heterogeneity within each of these groups. Co-occurrence of child abuse increased the level of emotional and behavioral problems above and beyond exposure alone, based on 4 available studies. Future research needs are identified, including the need for large-scale longitudinal data and theoretically guided approaches that take into account relevant contextual factors.

Adolescent↗

Legal and policy responses to children exposed to domestic violence: the need to evaluate intended and unintended consequences.

Greater training and specialization in working with children exposed to domestic violence has resulted in new policies, interagency protocols, and legislation in many states. This paper examines court-related responses in criminal, child protection, and family court custody proceedings, which highlight legislative changes and resulting systemic change. Although this legislation originated with the best of intentions to assist and protect children, some of the most striking outcomes have been negative and unintended. Laws that mandate reporting of children exposed to domestic violence can clash with inadequate training and resources, or inadvertently revictimize abused women. Similarly, child custody legislation that raises a rebuttable presumption that a violent spouse will not receive custody or joint custody of children after parental separation has resulted in greater skepticism about abuse allegations We propose that efforts at law reform can be enhanced by a more thoughtful analysis of potential intended and unintended consequences, and should be accompanied by a comprehensive evaluation plan to monitor implementation effects.

Child↗

Dating violence prevention with at-risk youth: a controlled outcome evaluation.

This study evaluated a community-based intervention to help at-risk teens develop healthy, nonabusive relationships with dating partners. Participants were 158 14-16-year-olds with histories of child maltreatment who were randomly assigned to a preventive intervention group or a no-treatment control group. They completed measures of abuse and victimization with dating partners, emotional distress, and healthy relationship skills at bimonthly intervals when dating someone. Intervention consisted of education about healthy and abusive relationships, conflict resolution and communication skills, and social action activities. Growth curve analyses showed that intervention was effective in reducing incidents of physical and emotional abuse and symptoms of emotional distress over-time. Findings support involvement of youths in reducing the cycle of violence as they initiate dating in midadolescence.

Adolescent↗

Readiness to change as a predictor of outcome in batterer treatment.

The current study examined stage of change as a predictor of outcome in batterer treatment. Men (N=119) were classified into the transtheoretical model's stages of change and assessed 3 times over treatment. Hierarchical linear modeling revealed significant variation in men's progress, predictable from their stage of change. As hypothesized, men in the precontemplation stage showed little positive change in empathy, communication, or abusive behavior, whereas men in the contemplation and action stages showed positive growth in all of these domains. These effects occurred in the initial 10 weeks of treatment, after which men progressed at a more homogeneous rate. Interpretation is complicated by pretreatment differences that draw into question stage-related patterns in final outcome. Implications for general models of abuse cessation and for stage-specific trajectories are discussed.

Adult↗

Child neglect: developmental issues and outcomes.

OBJECTIVE: This article highlights the manner in which child neglect, the most common form of maltreatment, affects children's development. METHOD: The review is organized according to three developmental periods (i.e., infancy/preschool, school-aged and younger adolescents, and older adolescents and adults) and major developmental processes (cognitive, social-emotional, and behavioral). Although the focus is on specific and unique effects of various forms of child neglect, particular attention is paid to studies that allow comparisons of neglect and abuse that clarify their similarities and differences. RESULTS: Past as well as very recent findings converge on the conclusion that child neglect can have severe, deleterious short- and long-term effects on children's cognitive, socio-emotional, and behavioral development. Consistent with attachment and related theories, neglect occurring early in life is particularly detrimental to subsequent development. Moreover, neglect is associated with effects that are, in many areas, unique from physical abuse, especially throughout childhood and early adolescence. Relative to physically abused children, neglected children have more severe cognitive and academic deficits, social withdrawal and limited peer interactions, and internalizing (as opposed to externalizing) problems. CONCLUSIONS: The current review offers further support for the long-standing conclusion that child neglect poses a significant challenge to children's development and well-being. Limitations with regard to the state of the knowledge are discussed and directions for future research are outlined.

Adolescent↗