Systematic review of interventions for the secondary prevention and treatment of emotional abuse of children by primary carers

Background Emotional abuse (or psychological maltreatment, as it is more commonly called in the US) is an inadequately researched and poorly understood concept, despite increasing awareness about the harm it can cause to children‟s lives. Although it unifies and underpins all types of maltreatment it also occurs alone and when it does, tends to elude detection and intervention. There have to date been no systematic reviews of the literature on the secondary prevention and treatment involving the parents or primary carers of emotionally abused children. Objective The objective of the review was to identify studies that evaluate the effectiveness of interventions in the secondary prevention and treatment of child emotional abuse involving the parents or primary carers of children aged 0 – 19 years. Methods Studies were included if they involved any intervention which was directed at emotionally abusive parenting and that measured change in (i) emotional unavailability (ii) negative attributions (i.e. that involve the parent attributing negative intentions, beliefs or attitudes toward the child); (iii) developmentally inappropriate interactions; (iv) lack of recognition of children‟s boundaries; (v) inconsistency of parenting role; (vi) missocialisation or consistent failure to promote the child‟s social adaptation. The primary outcomes evaluated involved proxy measures of a range of parent, family and child outcomes including parental psychopathology, parenting attitudes and practices, family functioning and/or child behaviour and the child‟s development and adaptation. . A broad search strategy was developed in order to identify as many relevant studies as possible. An electronic search of a wide range of databases was carried about. No study type was excluded. The search was augmented by direct contact with academics and practitioners known in this field. The search included studies written in English, Spanish, French and German. Studies were included if the intervention was described, and the impact on at least one indicator of emotional abuse was assessed. Included studies were critically appraised by two reviewers using standard criteria. Data were extracted using a standard proforma, and a qualitative synthesis of results was carried out. Results The initial search yielded 4248 publications of potential interest. Of these, 175 were obtained for possible inclusion or as background material. A total of 21 studies of 18 interventions, met all the inclusion criteria. A further 43 studies were relevant, but did not meet all of the inclusion criteria. Studies were organised according to the type of emotional abuse targeted: emotionally abusive parenting; parents of infants with faltering growth; missocialisation: parenting interventions with substance-abusing mothers. Twelve included studies had quantitative designs. Of these, 6 comprised randomised controlled trials; 1 comprised a follow-up of a randomised controlled trial; 2 were controlled studies; and 3 had one-group pre- and post-designs. The remaining 9 were case studies. Included studies involved a wide range of interventions. The 8 studies for parents which address emotionally abusive parenting (rejection, misattribution, parent-child role reversal and anger management) involved evaluations of cognitive-behavioural training (CBT), behavioural training and parent-infant psychotherapy. Two further case studies involved cognitive-behavioural training, mentalisation and family-based therapy. The 9 interventions with parents of infants with faltering growth evaluated CBT, behavioural training, parent infant psychotherapy and interaction guidance; lay home visitors, and a range of therapeutic options based on the diagnostic condition of the parents. The 3 studies of interventions for substance abusing mothers evaluated a relational psychotherapy group for mothers, and a residential treatment for substance abuse with a parenting component. The sample sizes for quantitative studies were small and ranged from 17 to 98 participants. Ten interventions involved mothers alone, while a further 11 included fathers, either at the outset or at a later stage, and in 3 cases extended family members. Interventions for emotionally abusing parents The findings from the 8 included studies evaluating CBT, psychotherapy, and behavioural approaches suggest that group-based CBT may be an effective means of intervening with this group of parents, although it cannot currently be recommended with parents experiencing symptoms of severe psychopathology. While one comparative study showed a psychotherapeutic intervention to be more effective than a CBT focused intervention, the outcomes measured in this study (i.e. parent and child representations) favoured the former. Behavioural case work involving the use of problem-solving techniques may also have a role to play with some parents, although further research is still needed. Interventions to enhance parental sensitivity The findings from a systematic review of 81 interventions that aimed at enhancing parental sensitivity and / or infant attachment found strong evidence that short term (less than 16 sessions) interventions, with a behavioural focus and aimed exclusively at enhancing maternal sensitivity were also most effective in enhancing infant attachment security. This supports the notion of a causal role of sensitivity in shaping attachment. Interventions that included fathers as well as mothers showed higher effect sizes but results are tentative since they are based on a small number of small scale trials. Parental behaviours associated with faltering growth Nine studies evaluated a range of interventions with parents of babies with faltering growth including interaction guidance, home visiting; parent-child psychotherapy, behavioural casework and multi-component interventions. The findings show that interaction guidance and parent-infant psychotherapy may be potentially effective means of working with this group of clients along with behavioural casework, but that further research is needed before these can be recommended. Missocialisation: Parenting interventions for substance-abusing parents 5 studies (one of which was a 6-month follow-up) evaluated interventions for substance abusing mothers, including a relational psychotherapy group and a residential treatment for substance abusing adults with a parenting component. The findings show that initial gains made in the former were not sustained at 6-months and few benefits from residential intervention. Conclusions Emotional abuse is a complex issue resulting in part from learned behaviours, psychopathology and/or unmet emotional needs in the parents, and often compounded by factors in the families‟ immediate and wider social environment. As such, a „one-approach-fits-all‟ is unlikely to lead to sustained change. The evidence base is weak, but suggests that some caregivers respond well to cognitive behavioural therapy. However, the characteristics that define these parents are not clear. There is currently no evidence to support the use of this intervention alone in the treatment of severely emotionally abusive parents. Some of the evidence suggests that a certain form of emotional abuse (for example, highly negative parent affect, which may be expressed as frightened and frightening behaviours in the parent) stemming from unresolved trauma and loss, is less amenable to CBT. There is some evidence that interaction guidance and psychotherapeutic approaches can generate change in parents with more severe psychopathology. Further research is urgently needed to evaluate the benefits of both psychotherapeutic and cognitive behavioural interventions, including those which take the form of family therapy, with parents at the more severe end of the spectrum, with fathers, and with older children. There is also a need to gain further understanding about which forms of emotional abuse respond best to different treatments

Algorithms for Skein Manipulation in a Genus-2 Handlebody

We present a series of algorithms for skein manipulation in a genus-2 handlebody, implementing a novel strand sorting method to reduce any skein to a skein in a 2-punctured disk. This reduction guarantees resolution as a linear combination of basis elements of the Kauffman Bracket Skein Module. Manually, these skein manipulations prove to be computationally intensive due to the inherent exponential nature of skein relations (i.e., a skein diagram with $n$ crossings yields $2^n$ new skein diagrams, each in $\mathbb{C}[t,t^{-1}]$, the Laurent polynomials with complex coefficients). Thus, as the number of crossings in a skein diagram increases, manual computations become intractable and automation desirable. We enable the automation of all skein computations in the genus-2 handlebody by first converting the skein diagram into an equivalent array, reducing the task of performing skein computations to that of implementing array operators, and then proving that we can always recover the resulting complex Laurent polynomial.Comment: Presented at the American Mathematical Society (AMS) Spring Southeastern Sectional Meeting, April 2023, Atlanta G

Apuntes sobre el film noir

Originalmente este artículo, seminal para los estudios sobre el cine negro producido en el Hollywood Clásico, fue concebido como programa de mano para un ciclo de siete film noirs proyectados en la primera edición de «Los Angeles International Film Exposition» celebrada en noviembre de 1971. Schrader lo publicó posteriormente, en la primavera de 1972, en la revista Film Comment. Desde ese momento se convirtió en un punto de partida fundamental para trabajos y reflexiones posteriores.Originally this article, seminal for the studies on the film noir produced during the Classic Hollywood Era, was conceived as a program for a cycle of seven film noirs projected in the first edition of «The Angels International Film Exposition» celebrated in November, 1971. Published schrader it later, in the spring of 1972, in the magazine Film Comment. From this moment it turned into a key point for later works and reflections

Gatumba Massacre, Background Essay

On August 13th 2004, 166 people were killed and 106 were wounded at the UN’s Gatumba refugee camp in Burundi. Nearly all the victims were members of the Banyamulenge community, a Congolese Tutsi ethnic group who were deliberately targeted in the attack. The massacre was carried out by the Forces Nationales pour la Liberation (FNL), a Hutu supremacist rebel group fighting in Burundi’s civil war. Understanding the Gatumba Massacre requires understanding what forced those Banyamulenge refugees to flee their homes in the Democratic Republic of the Congo (DRC), and why the FNL targeted them. This background essay addresses the context historical and events that led to the Gatumba Massacre. This essay is co-authored by Christopher P. Davey, Jean Paul Iranzi, Ezra Schrader, and Fidele Sebahizi.https://commons.clarku.edu/gatumba_background/1000/thumbnail.jp

Student perspectives on using Google Glass recordings to assess their communicative and clinical skills with standardized patients

Introduction This exploratory study evaluated student perceptions of their ability to self- and peer assess (i) interpersonal communication skills and (ii) clinical procedures (a head and neck examination) during standardised patient (SP) interactions recorded by Google Glass compared to a static camera. Methods Students compared the Google Glass and static camera recordings using an instrument consisting of 20 Likert-type items and four open- and closed-text items. The Likert-type items asked students to rate how effectively they could assess specific aspects of interpersonal communication and a head and neck examination in these two different types of recordings. The interpersonal communication items included verbal, paraverbal and non-verbal subscales. The open- and closed-text items asked students to report on more globally the differences between the two types of recordings. Descriptive and inferential statistical analyses were conducted for all survey items. An inductive thematic analysis was conducted to determine qualitative emergent themes from the open-text questions. Results Students found the Glass videos more effective for assessing verbal (t22 = 2.091, P = 0.048) and paraverbal communication skills (t22 = 3.304, P = 0.003), whilst they reported that the static camera video was more effective for assessing non-verbal communication skills (t22 = −2.132, P = 0.044). Four principle themes emerged from the students' open-text responses comparing Glass to static camera recordings for self- and peer assessment: (1) first-person perspective, (2) assessment of non-verbal communication, (3) audiovisual experience and (4) student operation of Glass. Discussion and conclusion Our findings suggest that students perceive that Google Glass is a valuable tool for facilitating self- and peer assessment of SP examinations because of students’ perceived ability to emphasise and illustrate communicative and clinical activities from a first-person perspective

Configuration Interaction calculations of positron binding to Be(3Po)

The Configuration Interaction method is applied to investigate the possibility of positron binding to the metastable beryllium (1s^22s2p 3Po) state. The largest calculation obtained an estimated energy that was unstable by 0.00014 Hartree with respect to the Ps + Be^+(2s) lowest dissociation channel. It is likely that positron binding to parent states with non-zero angular momentum is inhibited by centrifugal barriers.Comment: 12 pages, 2 figures, Elsevier tex format, In press Nucl.Instrum.Meth.Phys.Res.B positron issu

Organisations-IDs in Deutschland – Ergebnisse einer Bestandsaufnahme im Jahr 2020

Ein Persistent Identifier (PID) für wissenschaftliche Organisationen, wie Forschungseinrichtungen oder Forschungsförderorganisationen ist ein weiteres entscheidendes Puzzlestück zur Förderung der Standardisierung im wissenschaftlichen Publikationsprozess – insbesondere mit Hinblick auf den bereits etablierten Digital Object Identifier (DOI) für wissenschaftliche Werke und der ORCID iD für wissenschaftliche Autor*innen. Die Anwendung dieser PIDs ermöglicht automatisierte Datenflüsse und garantiert die dauerhafte Verknüpfung von Informationsobjekten. Darüber hinaus sind PIDs elementare Bestandteile zur Umsetzung von Open Science. So kommt z. B. der Anwendung eines PID für wissenschaftliche Organisationen bei der Analyse von Publikationen und Kosten der Open-Access-Transformation an einer Einrichtung eine zentrale Bedeutung zu. Um mehr über den Status quo der Nutzung und Verbreitung von Organisations-IDs in Deutschland zu erfahren, wurde im Rahmen des DFG-geförderten Projekts ORCID DE im Zeitraum vom 13.07.2020 bis zum 04.12.2020 eine „Umfrage zum Bedarf und Nutzung von Organisations-IDs an Hochschulen und außeruniversitären Forschungseinrichtungen in Deutschland“ unter 548 wissenschaftlichen Einrichtungen in Deutschland durchgeführt. An der bislang größten Befragung zu Organisations-IDs in Deutschland beteiligten sich 183 Einrichtungen. Bestandteil der Studie waren unter anderem Fragen zur Kenntnis, Verbreitung und Nutzung von Organisations-IDs an wissenschaftlichen Einrichtungen. Darüber hinaus wurden Anforderungen an Organisations-IDs bzw. ihre Metadaten (z. B. Relationen und Granularität) erfragt. Der vorliegende Beitrag bietet einen umfassenden Überblick über die Ergebnisse der im Rahmen des Projekts durchgeführten Umfrage und stellt einen Beitrag zur Förderung und zu einer gesteigerten Bekanntheit von Organisations-IDs dar.A persistent identifier (PID) for research organizations represents another important piece of the puzzle to promote standardization in the scholarly publication process – especially considering the already established digital object identifier (DOI) for research outputs and the ORCID iD for researchers. The use of these PIDs enables automated data flows and guarantees the permanent linking of information objects. Furthermore, PIDs are fundamental components for the implementation of Open Science. For example, when analyzing publications and costs of the Open Access transformation at an institution, the application of a PID for research organizations is crucial. In order to learn more about the status quo of the use and dissemination of organizational identifiers in Germany, a "Survey on the Need for and Use of Organizational Identifiers at Universities and Non-University Research Institutions in Germany" was conducted among 548 research institutions in Germany in the period from July 13, 2020 to December 4, 2020 as part of the DFG-funded ORCID DE project. This survey constitutes the largest survey on organizational identifiers in Germany to date; it counts 183 participating institutions. Among other things, the survey included questions on the knowledge, distribution, and use of organizational identifiers at research institutions. In addition, requirements for organizational identifiers and their metadata (e.g., relations and granularity) were queried. The present paper provides a comprehensive overview of the results of the survey conducted as part of the aforementioned project and contributes to the advancement and an increased awareness of organizational identifiers.Peer Reviewe