he Long-term Consequences of Child Maltreatment: Should we rethink Prevention?? Jennie G. Noll, PhD Professor, Human Development and Family Studies Director of Research & Education, Network on Child Protection & Well-being The Pennsylvania State University
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The Long-term Consequences of Child Maltreatment: Should we rethink Prevention ??
Jennie G. Noll, PhD Professor, Human Development and Family Studies Director of Research & Education, Network on Child Protection & Well-being The Pennsylvania State University. The Long-term Consequences of Child Maltreatment: Should we rethink Prevention ??. Child Maltreatment. - PowerPoint PPT Presentation
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The Long-term Consequences of Child Maltreatment:
Should we rethink Prevention??
Jennie G. Noll, PhDProfessor, Human Development and Family StudiesDirector of Research & Education, Network on Child Protection & Well-beingThe Pennsylvania State University
Child Maltreatment
“ANY RECENT ACT OR FAILURE TO ACT ON THE PART OF A PARENT OR CARETAKER WHICH RESULTS IN DEATH, SERIOUS PHYSICAL OR EMOTIONAL HARM, SEXUAL ABUSE OR EXPLOITATION; OR AN ACT OR FAILURE TO ACT, WHICH PRESENTS AN IMMINENT RISK OF SERIOUS HARM.”
Physical & Medical NeglectPhysical abuseSexual abuse
Other (Emotional, Family violence, Parent’s drug/alcohol abuse)
U.S. Department of Health and Human Services, 2012
6.3 MILLION CHILDREN WERE SUBJECTS OF CHILD MALTREATMENT ALLEGATIONS
3.2 MILLION CHILDREN WERE INVESTIGATED
1.2 MILLION VICTIMS OF MALTREATMENT 17.1 victims per 1000 children (~1 in 58)
800,000 REACHED “ENDANGERED” STANDARDS
2,400 FATALITIES ATTRIBUTED TO CHILD ABUSEThe National Incidence Study of Child Abuse & Neglect , 2010
National Prevalence Rates
% of children involved in protective services at least once by age 17
Age
1987
2005
1989
1991
1993
1997
1995
1999
2003
2001
Year
6 10 381814 26 4222 30 34
Time 2; mean age=12.22
Time 3; mean age=13.42
Time 1; mean age=11.06
Time 4; mean age=18.05
Time 5; mean age=19.85
Time 6; mean age=24.89
2007
2009
2011
2013
2015
2017Time 8; mean age=36.47
Time 7; mean age=34.47
96% retained
89% located/agreed
Offspring 0-9; M=4.08
Offspring 2-18; M=10.29
Offspring 4-20; M=12.29
ChildhoodSexualAbuse
Psychosocialdistress
Physiologicalstress
Competencies: cognitive ability family/social support self-esteem
acute responses to trauma in childhood/
early adolescenceTimes 1-3 (mean ages 11, 12 & 13)
outcomes in late adolescenceTimes 4 & 5
(mean ages 18 &19)
Psychosexual: risky sex behaviors
Physica l Heal th: HPA dysreg/DHEA obesity accelerated puberty
Prefrontal cortex; executive functioning, decision making, working memory, activated in novelty or danger
Chronic stress “turn off” frontal inhibition impairing these functions
Implications for adolescent risk-behaviors; substance use, risky sexual behaviors
Split-Second Decisions and Judgment Activate the Anterior Cingulate
WJ Gehring & AR Willoughby, Science 295, March 2002
Maltreatment
HPA axisdysregulation
Brainmaldevelopment
Neurocognitiveimpairment
High-risk Social/Emotionalfunctioning
Outcomes: Alcohol, tobacco substance use
Neurocognitive mechanisms for Alcohol and Substance Abuse
Psychological Mechanisms for Alcohol and Substance Use
Trauma
PTSD
Re-experiencing
symptoms
Avoidantsymptoms
Arousalsymptoms
Numbingsymptoms
Alcohol and Substance Abuse
Psychological Mechanisms for Alcohol and Substance Use
Substance abuse can develop from untreated trauma
PTSD avoidant and numbing symptoms
Trauma-focused therapies not as effective for SUD patients
SUD treatments not as effective for trauma victims
Alcohol and Substance Abuse Findings
Substance Abuse Disorder (P<.01)
Abused = 19%Comparison = 5%
Alcohol Use Disorder (P<.05)Abused = 13%Comparison = 3%
Noll et al. (2007) Journal of Interpersonal Violence
Main Effect Findings
Early Adulthood:↑persisting PTSD↑psychiatric diagnoses ↑clinical depression ↑alcohol & drug abuse↑suicide attempts↑inter-partner violence↑sexual violence / rapes↑obesity
Trickett, PK., Noll, JG, & Putnam, FW. The impact of sexual abuse on female development: lessons from a multigenerational, longitudinal research study. Development and Psychopathology 2011; 23:453-476.
Adolescence:↑earlier pubertal timing ↑depressive symptoms↑PTSD symptoms↓cognitive abilities↓age at first voluntary intercourse↑teen pregnancy rates↑self harm↑sleep problems↑revictimization↑substance use
University Park CampusChildren, Youth & Families Consortium
Social Science Research Institute College of Medicine / Department of Pediatrics
College of
Liberal Arts College of
Health & Human Dev’l
College of Education
Hershey
Clinical
Support Resea
rchSu
pportFaculty Co-fund
Faculty Co-fund
Faculty Co-fund
Faculty Co-fund
Faculty Co-fund
Four Broad Areas of Impact:Basic Science
biologic substrates of early trauma and chronic stress abuse
promote optimal heath for victimsprevalence, epidemiology
PreventionPrimary prevention Secondary prevention programsTargeted prevention program (integrated data research)
PSU’s Network on Child Protection and Well-being
Four Broad Areas of Impact:Treatment & Translation
personalized, evidence-based treatment approaches
dissemination and implementation science-breaking down barriers to service-increasing family engagement-enhancing access for rural families-reduce costs -education and awareness for community
providers
PSU’s Network on Child Protection and Well-being
Four Broad Areas of Impact:Engagement
Collaboration with stakeholders, including families, community groups, and state, federal and international organizations
Serve as PSU’s clearinghouse for information and resources
Provide interdisciplinary educational opportunities to promote awareness and understanding