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Biomedical subjects

L Berliner

Publications and source records attributed to L Berliner.

At least 19 recordsLinked to original sources
PubMed2001

Sex with children is abuse: Comment on Rind, Tromovitch, and Bauserman (1998).

B. Rind, P. Tromovitch, and R. Bauserman (1998) reported a meta-analysis of the relation between sexual abuse in childhood and adolescence and psychological functioning among college students. Several aspects of their work have proven to be highly controversial, including their assertion that the relation between child sexual abuse and adjustment is quite small and their questioning of whether child sexual abuse should be labeled abuse in scientific inquiry. In this commentary, the authors summarize the controversy that has ensued, place it in a historical context, discuss the limitations of B. Rind et al.'s findings, and critique the manner in which those findings are presented. The authors also argue for the appropriateness of the term abuse and for scientific terminology that reflects rather than contradicts consensual public morality.

Child↗
PubMed2001

Police reporting and professional help seeking for child crime victims: a review.

Most crimes with child victims are not reported to police, nor do child victims access other professional victim services, despite evidence that these yield positive outcomes. This article develops a conceptual framework about the barriers to such access: (a) the reluctance to define the crime episodes or their consequences as serious, criminal, harmful, or warranting intervention; (b) the extra authorities, including parents and schools, who mediate between victims and police or services; (c) developmental issues, such as concerns about autonomy; (d) attitudinal and emotional obstacles; and (e) time and expense factors. This article suggests the need for initiatives to stimulate reporting and help seeking, such as more publicity about the seriousness of juvenile victimization, more justice-system involvement with schools, more child and family friendly police services, and an emphasis on attractive outcomes such as justice and empowerment.

Adolescent↗
PubMed2001

Child Sexual Behavior Inventory: normative, psychiatric, and sexual abuse comparisons.

A normative sample of 1,114 children was contrasted with a sample of 620 sexually abused children and 577 psychiatric outpatients on the Child Sexual Behavior Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in children 2 to 12 years old. The CSBI total score and each individual item differed significantly between the three groups after controlling for age, sex, maternal education, and family income. Sexually abused children exhibited a greater frequency of sexual behaviors than either the normative or psychiatric outpatient samples. Test-retest reliability and interitem correlation were satisfactory. Sexual behavior problems were related to other generic behavior problems. This contributed to the reduced discrimination between psychiatric outpatients and sexually abused children when compared to the normative/sexually abused discrimination.

Age Factors↗
PubMed2000

Mental health service utilization by victims of crime.

Records of 318 adult and 608 child victims of crime, eligible for Crime Victims Compensation (CVC) in Washington State, were examined. Demographic, crime, and mental health information was collected. A majority of child victims had experienced sexual assault (88%); adults were victims of both sexual (38%) and physical assault (40%). The median number of mental health sessions used by children was 23 sessions, at an average cost of $975 per case to the CVC program. Adults used a median of 15 mental health sessions at a cost of $905. Patterns of treatment utilization were associated with some demographic, crime, and psychological variables. Sexual assault and PTSD diagnosis were associated with greater use for both children and adults. Therapist variables were unrelated to use. Findings are discussed in light of concerns about coverage of mental health services.

Adolescent↗
PubMed2000

Treatment for sexually abused children and adolescents.

The authors review research demonstrating the variable effects of childhood sexual abuse, the need for intervention, and the effectiveness of available treatment models. The well-controlled treatment-outcome studies reviewed do not focus on sensationalistic fringe treatments that treat sexually abused children as a special class of patients. Instead, studies demonstrate empirical evidence for extending and modifying treatment models from mainstream clinical child psychology to sexually abused children. The authors propose a continuum of interventions to meet the needs of this heterogeneous group. Interventions range from psychoeducation and screening, to short-term, abuse-focused cognitive-behavioral therapy with family involvement, to more comprehensive long-term plans for multiproblem cases. Last discussed are gaps in the research and suggestions for future research to address the pressing dilemmas faced by clinicians and policymakers.

Adolescent↗
PubMed1999

The impact of health care reform: a survey of victim and offender treatment providers.

Health care reform and, especially, managed care may have important consequences for providers of mental health treatment to sexual assault victims and sexual offenders. This study is an initial effort to identify the impact of changes in health care delivery systems on specialist providers. A survey was mailed to 380 therapists in Washington state who were identified as having specialized expertise in either victim or offender treatment. Of the total sample, 39% (N = 135) responded, including 64 providers of treatment to sexual offenders and 86 providers of treatment to victims of sexual abuse. A substantial minority of subjects (46%) reported having made changes in the type of client or treatment approach or seeing fewer clients (43%). A majority (68%) stated that requirements for documentation or reports had increased. Overall, three-quarters of respondents reported that managed care had at least a moderate level of impact on their practice. Differences between providers of treatment to victims and providers to offenders emerged only in the perceived degree of impact on practice, with therapists who work with victims reporting significantly greater impact. Comments from providers revealed that reductions in the number of sessions, increases in administrative expectations, and compromised confidentiality were considered significant threats to the delivery of effective services. It is suggested that the impact of health care reform is more likely to be experienced by victim treatment providers. Offender evaluation and treatment have rarely been covered by commercial insurance and are often sought because of external pressure. As a result, managed care will have less effect on current offender treatment practice.

Crime Victims↗
PubMed1995

The effects of disclosure and intervention on sexually abused children.

There has been concern that disclosure and intervention might negatively impact victims of sexual abuse. In this retrospective study, 82 children and their families were interviewed about their experiences with disclosure and intervention an average of 3.5 years later. The children and parents completed a measure of distress developed for the study which discriminated between abused and non-abused children. The children reported primarily favorable experiences and provided clinically helpful descriptions of the positive and negative aspects of intervention. More contacts with intervention professionals was associated with increased distress, placement, offender removal and testifying were not. Based on the children's comments, suggestions for improving the intervention process are made.

Age Factors↗
PubMed1995

Research on the treatment of sexually abused children: a review and recommendations.

OBJECTIVE: To review findings and conclusions from 29 studies that evaluated with quantitative outcome measures the effectiveness of treatments for sexually abused children. RESULTS: The studies overall document improvements in sexually abused children consistent with the belief that therapy facilitates recovery, but only five of them marshal evidence that the recovery is not simply due to the passage of time or some factor outside therapy. There has yet to be a true large-scale, randomized trial of treatment versus control. The studies suggest that certain problems, such as aggressiveness and sexualized behavior, are particularly resistant to change and that some children do not improve. A number of considerations that merit special attention in future sexual abuse therapy outcome research are identified, including (1) the diversity of sexually abused children, (2) the problem of children with no symptoms, (3) the possible existence of serious "sleeper" effects, (4) the importance of family context on recovery, (5) the utility of abuse-focused therapy and targeted interventions, (6) the optimal length of treatment, (7) the problem of treatment dropouts, and (8) the development and use of abuse-specific outcome measures. CONCLUSIONS: The need for more treatment outcome research is highlighted by the rising demand for accountability in the health care system that will increasingly require professionals in the field of sexual abuse treatment to justify their efforts and their methods.

Adolescent↗
PubMed1994

Detection of free radicals by electron spin resonance in rat diaphragm after resistive loading.

Indirect evidence supports free radical production in the diaphragm under excessive mechanical loads in both in vitro and in situ preparations. We hypothesized that free radicals are produced in the diaphragm with loads in vivo at a sufficient concentration to be detected by electron spin resonance (ESR) spectroscopy. Anesthetized rats underwent severe inspiratory resistive loading for 2.5-3 h with maintenance of blood oxygenation and arterial blood pressure by breathing 70% oxygen. The ESR spectra of four samples (freeze-clamped at liquid nitrogen temperature) from each experimental animal were compared with the spectra from a control animal breathing air and a control animal breathing 70% oxygen. We observed 1) an approximately 30% increase in intensity of free radical signal in experimental animals (n = 10) compared with control animals breathing oxygen (n = 10; P < 0.01) and control animals breathing air (n = 10; P < 0.05), 2) that oxygen alone had no effect on the ESR spectrum, and 3) the intensity of the ESR signal decreased approximately 25% in the experimental group when samples were taken 10 min postmortem, whereas no difference in signal was observed for control animals. We conclude that the diaphragm shows an increased production of free radicals associated with respiratory failure induced by resistive breathing.

Animals↗
PubMed1992

Coping capacity among women with abusive partners.

Coping capacity, although increasingly implicated as a mediating force in how individuals respond to personal threat, is an underrecognized factor in work with women of abusive partners. To explore the utility of coping capacity as a multivariable set to guide intervention with women of abusive partners, findings are reported comparing four groups of women: those whose partners do not engage in abuse, are abusive toward them, are sex offenders of children for whom the woman is a parent, or are offenders of children for whom the woman is not a parent. Three variable sets were included: vulnerability factors that may negatively influence appraisals of threat and ability to cope with abuse; coping responses that include cognitive, emotional, and behavioral reactions to the abuse; and coping resources expected to mediate effects of vulnerability factors and to influence the mobilization (of lack thereof) of coping responses. There were significant differences in coping capacity profiles across the four groups. These appeared to be a continuum of coping capacity, with women who were most directly threatened showing the lowest and women who were least directly threatened showing the highest levels of coping capacity. In order from the lowest to the highest levels of coping capacity were (1) battered women, (2) women whose partners are offenders against their children, (3) women whose partners are offenders against children of whom they are not the parent, and (4) control group women. The paper ends with a conceptual interpretation of the mediating functions of coping resources and implications for intervention and further study.

Adaptation, Psychological↗
PubMed1991

Therapy with victimized children and their families.

The treatment of children who have been sexually abused requires intervention at the individual, parental, and family level. A treatment model is proposed to address the negative affect, distorted beliefs, sexualized behavior, and disturbed personality development often associated with sexual abuse.

Child↗
PubMed1990

The process of victimization: the victims' perspective.

Twenty-three child victims (aged 10-18 years) of childhood sexual abuse were interviewed about the victimization process, the person who abused them, and how abuse might have been prevented. Specific questions obtained information about the quality of the relationship between victim and offender, the offender's pre-abuse behavior, the explanation for the behavior given by the offender, and the child's understanding of the behavior. Results suggest that the victimization process involves three overlapping processes: sexualization of the relationship, justification of the sexual contact, and maintenance of the child's cooperation.

Adolescent↗
PubMed1986

Use of direct sagittal computed tomography in diagnosis and treatment of internal derangements of the temporomandibular joint.

Direct sagittal CT imaging of the TMJ provides several distinct advantages. Most significant is that direct imaging allows noninvasive evaluation of the disk. Direct sagittal CT scanning can confirm a clinical diagnosis of internal derangements as well as monitor splints intended for recapturing of the disk. Furthermore, the CT direct imaging allows excellent views of the bony architecture similar to those obtained with tomography. Used with clinical history and physical examination, CT can provide an excellent diagnostic modality to help provide better care for patients with internal derangement of the TMJ.

Adult↗