Abstract:
OBJECTIVES:Public Law (P.L.) 110-351, the "Fostering Connections to Success Act," calls for state child welfare agencies to partner with Medicaid and pediatric experts to provide planning and oversight regarding the provision of health and mental health services, including medication, to children in state custody. Recent reports, media cases, and class action lawsuits suggest over-use of psychotropic medications to address the behavioral needs of children in the child welfare system. We examined geographic variability in psychotropic medication use across US child welfare agency catchment areas to determine how rates of psychotropic medication use vary in relation to child, community, child welfare, and health system-level factors. METHODS:Cross-sectional analysis of Wave 1 data for the 92 child welfare catchment areas participating in the National Survey of Child and Adolescent Well-being, a random probability sample of 2,504 children ages 2-15 years undergoing investigation for abuse and neglect. We employed multilevel regression modeling to examine the impact of catchment-level variables on medication use, controlling for child-level variables. RESULTS:Fifteen percent of children reported taking psychotropic medications. Rates of medication use across catchment areas ranged widely from 0 to 40%, a 40-fold difference. On multi-level logistic regression modeling, older age (p<.001), male gender (p<.001), emotional and behavioral problems (p<.001), and insurance (p=.05) were associated with psychotropic medication use at the child-level. At the catchment-level, stressful environment within the child welfare system was negatively associated with medication use. No other catchment-level variables examined were found to explain use. CONCLUSIONS:Striking disparities in medication use exist across catchment areas in this national sample. Of the catchment variables examined, only stressful environment was related to medication use. PRACTICE IMPLICATIONS:These findings highlight significant geographic variation in medication use that most likely reflect both under-use and over-reliance on psychotropic medication. The link between child welfare environment and medication use suggests the influence of systemic, as opposed to clinical, causes of variation in medication use. This requires greater implementation of organizational processes governing quality of care for this highly vulnerable population.
journal_name
Child Abuse Negljournal_title
Child abuse & neglectauthors
Leslie LK,Raghavan R,Hurley M,Zhang J,Landsverk J,Aarons Gdoi
10.1016/j.chiabu.2011.01.012subject
Has Abstractpub_date
2011-05-01 00:00:00pages
333-42issue
5eissn
0145-2134issn
1873-7757pii
S0145-2134(11)00076-7journal_volume
35pub_type
杂志文章abstract::Thirty-eight female inpatients with major depression were assessed for childhood abuse. History of abuse was examined in relation to recovery from a major depressive episode over a 12-month follow-up period. Forty-six percent of the women had a history of childhood abuse. Women without a history of abuse were 3.7 time...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(95)00098-6
更新日期:1995-12-01 00:00:00
abstract::Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. Patients came from a variety of separate clinical settings and geographical locations and reported a number of similar abuses. The most frequently reported types of ritual abuse are outlined, and a ...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(91)90063-j
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Few studies have examined the associations between childhood sexual abuse (CSA), co-occurrence with other types of maltreatment and adult mental health outcomes, specifically among males. The objectives of this study were to: 1) determine the prevalence of males who have experienced a) childhood maltreatment...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2017.01.018
更新日期:2017-04-01 00:00:00
abstract::The present study obtained data on childhood physical and sexual abuse in a Basque sample in order to compare abuse rates with a similar study conducted in the United States. The study also examined the relationships between childhood physical and sexual abuse, childhood social support, and abuse potential in the Basq...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(95)00053-b
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:This study aimed to describe the extent and pattern of parental child battering in Chinese families in Hong Kong. It was hypothesized that the unique feature of filial piety in Chinese culture will create a different pattern of child abuse in Hong Kong when compared to Western societies. METHOD:A telephone s...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/s0145-2134(98)00010-6
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:There is consensus in child sexual abuse (CSA) literature that intrafamilial child sexual abuse (IFCSA) has a tremendous impact on children and families while simultaneously creating challenges for practitioners. COVID-19 impacted countries worldwide and generated a global crisis resulting in impacts on dail...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2020.104779
更新日期:2020-10-19 00:00:00
abstract::Relations between parents within a neighborhood have the potential to provide a supportive environment for healthy and positive parenting. Neighborhood social cohesion, or the mutual trust and support among neighbors, is one process through which parenting may be improved. The current study investigates the associatio...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2015.12.011
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:In this manuscript, we summarize the findings of a systematic review that informed the development of the World Health Organization's recommendations related to psychosocial interventions for child and adolescent sexual abuse. METHOD:Systematic searches across 14 databases were conducted to retrieve any pub...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2019.104203
更新日期:2019-10-31 00:00:00
abstract:OBJECTIVE:This study was undertaken to reveal the prevalence and determinants of corporal punishment in preparatory (middle) and secondary (high) schools in Alexandria. METHODS:A cross sectional survey targeting preparatory and secondary school students enrolled in main stream public schools was conducted. The multist...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/s0145-2134(98)00084-2
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:This study examines staffing, funding sources, reimbursement, and financing of medically-oriented child protection teams. METHOD:A 16-item questionnaire on the composition, size, and services of the team, program costs, revenue sources, reimbursement rates, and perceptions of funding stability was mailed to ...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/s0145-2134(99)00034-4
更新日期:1999-06-01 00:00:00
abstract::The Diagnostic Inventory of Personality and Symptoms (DIPS) was used to assess psychopathology in a clinical sample of 30 women with histories of intra-familial sexual victimization, 22 women with histories of extra-familial sexual victimization, and 30 women with no victimization experiences. The present study examin...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(94)00115-b
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Child abuse pediatricians (CAPs) are often consulted for injuries when child physical abuse is suspected or when the etiology of a serious injury is unclear. CAPs carefully evaluate the reported mechanism of the child's injury and the medical findings in the context of the child's family and social setting t...
journal_title:Child abuse & neglect
pub_type: 杂志文章,多中心研究
doi:10.1016/j.chiabu.2018.10.003
更新日期:2018-12-01 00:00:00
abstract::The goal of this study was to examine the influence of animal-assisted psychotherapy (AAP) on the psychosocial adaptation of a group of adolescents in residential care who had suffered traumatic childhood experiences and who presented with mental health problems. This study recruited 63 youths (mean age=15.27, SD=1.63...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2015.09.004
更新日期:2015-12-01 00:00:00
abstract::How have contemporary social changes affected the problem of child sexual abuse? The rapid rise of this problem to public attention in the United States is in part due to the mobilization around the problem by the women's movement and the child welfare movement there. But factors shown by research to be associated wit...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(82)90055-2
更新日期:1982-01-01 00:00:00
abstract::Allegations of mistreatment by adults made by children of preschool age are often dismissed as fictitious with the suggestion that children of this age are prone to fantasy and unable to discriminate fact from fiction. This paper is intended to familiarize those with a general concern about child abuse with the resear...
journal_title:Child abuse & neglect
pub_type: 杂志文章,评审
doi:10.1016/0145-2134(91)90032-9
更新日期:1991-01-01 00:00:00
abstract::The objective of this study was to identify individual, family and caregiver risk factors for serious child maltreatment, resulting in hospitalization or death, among children and families investigated by Child Protective Services (CPS). We conducted a matched case-control study of 234 children who sustained fatal or ...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2016.11.003
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To determine if a commercially produced video, "What Do I Say Now?" (Committee for Children, 1996) leads to an increase in parent-child discussion about child sexual abuse (CSA). METHOD:Forty-five parents of children 2-6 years of age were randomly assigned to participate in either a CSA prevention workshop o...
journal_title:Child abuse & neglect
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0145-2134(98)00094-5
更新日期:1998-11-01 00:00:00
abstract::The relation of parental support to abuse has rarely been considered in research on the sequelae of childhood abuse in adulthood. In this study, using the Exposure to Abusive and Supportive Environments Parenting Inventory (EASE-PI), young adults who reported higher emotionally abusive parenting (EA) consistently repo...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/s0145-2134(96)00115-9
更新日期:1996-12-01 00:00:00
abstract::Children and young people often choose not to disclose sexual abuse, thus preventing access to help and allowing perpetrators to continue undetected. A nuanced understanding of the barriers (and facilitators) to disclosure is therefore of great relevance to practitioners and researchers. The literature was systematica...
journal_title:Child abuse & neglect
pub_type: 杂志文章,评审
doi:10.1016/j.chiabu.2017.05.009
更新日期:2017-08-01 00:00:00
abstract::The study examined the progress through the child protective system of a sample of 206 severely abused and/or neglected children brought before the Boston Juvenile Court (BJC) on Care and Protection (C & P) petitions. Overall, children were in the system an average of 5 years from the filing of the first official repo...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(92)90063-w
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Adverse childhood experiences are an important public health issue. It is well documented that they are associated with many health problems. Nevertheless, little is known about childhood emotional abuse and neglect (CEA and CEN) among Hong Kong people. OBJECTIVE:This study aimed to explore the demographic ...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2019.104288
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The present study extends field research on interviews with young children suspected of having been abused by examining multiple assessment interviews designed to be inquisitory and exploratory, rather than formal evidential or forensic interviews. METHODS:Sixty-six interviews with 24 children between the ag...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2008.12.012
更新日期:2009-08-01 00:00:00
abstract::Authoritarian ideology, including religious conservativism, endorses obedience to authority and physical punishment of children. Although this association has been studied at the level of the family, little research has been conducted on whether conservativism in the broader community context correlates with the mistr...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2014.11.019
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To explore the experiences of victims of female sex offenders with regard to disclosing sexual abuse to a professional, and importantly, the impact of professional responses on victims. METHOD:The data were derived from one-to-one semi-structured interviews with 14 (7 males, 7 females) victims of child sexua...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/s0145-2134(02)00509-4
更新日期:2003-01-01 00:00:00
abstract::As there is no "gold standard" in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from 551 children <36months of age presenting to a pediatric emergency department, we examined the extent of agreement between specialist...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2017.08.001
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:This study investigated the prevalence of child maltreatment as perpetrated by parents, its associated health outcomes, and its resilient factors among high school students in China. METHODS:A multi-level stratified random school-based survey was conducted in 2005. Twenty four high schools were randomly chos...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2008.02.010
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To evaluate and compare the psychometric qualities of three retrospective, multi-item measures of childhood sexual abuse (CSA): the CSA Frequency Scale, CSA Count Index, and CSA Multiple Characteristics Index. METHODS:Two samples of women 20-50 years old who experienced CSA were recruited from a family pract...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2007.03.016
更新日期:2007-08-01 00:00:00
abstract::Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public,...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2016.06.015
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Active involvement by parents may contribute substantially to the success of school-based programs to prevent child sexual abuse (CSA). In China, little is known about parental understanding of CSA. This study investigated Chinese parents' knowledge, attitudes, and communication practices with their children ...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/j.chiabu.2006.12.013
更新日期:2007-07-01 00:00:00
abstract::This research examined cognitive coping strategies associated with resilience in a nonclinical sample of child sexual abuse (CSA) survivors. In Study 1, 180 college women completed surveys assessing self-enhancing cognitive distortions of reality, known as positive illusions, and CSA history. CSA survivors and nonvict...
journal_title:Child abuse & neglect
pub_type: 杂志文章
doi:10.1016/0145-2134(96)00062-2
更新日期:1996-08-01 00:00:00