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Child physical abuse: Reports and interventions
Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis was begun in 1998 at a time when increased numbers of police reports regarding child physical abuse was presented. The increase had been overshadowed by the research on the sexual abuse of children and showed that child physical abuse in Sweden had only been scarcely investigated since the institution of the Swedish anti spanking law in 1979.

The aim of this thesis was to investigate child physical abuse from a judicial, social, child- and adolescent psychiatric and a user perspective where a parent or equivalent was the perpetrator. One police district was investigated between 1986 and 1996 and all reports regarding child physical abuse were included. The abused children (n=126) were also followed through social services’ files and child and adolescent psychiatric service charts from birth to a 4-year follow up from the abuse incident studied. Finally, mothers of the physically abused children were interviewed.

The greatest increase in police reports during the years investigated, turned out to be concerned with violence between children. The incidence where a carer was the abuser proved to be comparable to the incidence in other Nordic countries, with the adjustment that first generation immigrants were found to abuse their children 8 times as often as native Swedish citizens and second generation immigrants. There were a wide variety of injuries inflicted on the children, where bruises were the most common. Only a few cases where injuries could be verified ended up in court. Social services contact was common among the abused children and their families prior to the abuse incident studied, as were previous reports on child abuse and neglect. Injuries from the abuse as well as familial and context characteristics had an impact on referred social services interventions. The two most important factors for a child still to be receiving social services interventions 4 years after the abuse incident were whether the mother was mentally ill and whether there had been reports on child abuse or neglect prior to the studied abuse incident. About half of the children had been receiving interventions from the mental health services at some point in time, but mainly due to other reasons than physical abuse. Mental health treatment for the physically abused children was rare even though many of the children had contact with the child and adolescent psychiatric services repeatedly before, at and after the abuse incident. The interviewed mothers conveyed a picture of satisfaction with the police’s work but were mainly critical towards the social services. The mental health service was considered to be doing a good job, but needed to do even better.

The results indicate that despite an environment that supports public values, attitudes and laws confirming a standpoint against violence towards children, there is still a gap between intentions and reality in Sweden. The thesis provides one way of looking at child physical abuse, but puts forward the urgent need of further studies.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2005. , 82 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 879
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28708Local ID: 13875ISBN: 91-7373-858-1 (print)OAI: oai:DiVA.org:liu-28708DiVA: diva2:249519
Public defence
2005-07-21, Aulan, Hälsans hus, Campus Norrköpng, Linköpings universitet, Norrköping, 13:00 (Swedish)
Opponent
Supervisors
Note
2005Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2010-12-30
List of papers
1. Physical child abuse in Sweden: A study of police reports between 1986 and 1996
Open this publication in new window or tab >>Physical child abuse in Sweden: A study of police reports between 1986 and 1996
2001 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 36, no 3, 150-157 p.Article in journal (Refereed) Published
Abstract [en]

Background: This study aims at investigating physical child abuse in Sweden during 1986-1996, a period when alarm was being raised about an increased number of police reports on physical child abuse. The study focuses on abuse committed by a parent or carer and aims at analyzing the victim and the perpetrator, family environment, injuries and judicial consequences of physical abuse. Method: All police reports on physical child abuse (0-14 years old) in a designated police district in Sweden during 1986-1996 were examined, as well as any judicial proceedings that followed. Results: Our research yielded three major findings. Firstly, a large part of the increased number of police reports had to do with violence outside the family: 145 children (0.5 per 1000 children) were found abused within the families, by a parent or a carer. Secondly, there was a tendency toward males abusing boys and females abusing girls, and the biological father was the most frequent suspected perpetrator. Thirdly, 20% of the police reports led to prosecutions, and the investigations were time consuming. Known risk factors for physical abuse, such as unemployment, violent spouse relations, substance and drug abuse and poor mental health were found in several families, often among the prosecuted perpetrators. When examining incidence of physical abuse, Sweden was comparable to the other Scandinavian countries, where legislation and social context are similar. Conclusions: The numbers of physically abused children that have been reported to the police in Sweden has increased during the investigated period. Familiar risk factors are present in our study, accompanied by new findings, such as, for instance, a gender preference towards the abuse victim.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26017 (URN)10.1007/s001270050304 (DOI)10470 (Local ID)10470 (Archive number)10470 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
2. Social services provided for physically abused children in Sweden: Background factors and interventions
Open this publication in new window or tab >>Social services provided for physically abused children in Sweden: Background factors and interventions
2004 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 13, no 4, 340-349 p.Article in journal (Refereed) Published
Abstract [en]

This study aims at describing and analysing what kinds of social services are provided for physically abused children in Sweden. The social services files were examined for 113 children under 15 years of age (67 boys and 46 girls) who had been reported to the police as having been physically abused by a parent or equivalent caretaker in a particular police district. The children's social services files indicated an increased risk of a parental abusive behaviour prior to the abuse incident. There had been former interventions in 81 per cent of the families and previous reports on neglect or abuse in 44 per cent of the 113 families. After the abuse incident, investigations were opened in 80 per cent of the cases. The three most common interventions were placement in foster care, referrals to Child and Adolescent Psychiatric Service and Social Services support contacts. The study shows that there was a tendency towards more proactive work with injured children, children of immigrant parents and children of mentally ill parents.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22800 (URN)10.1111/j.1468-2397.2004.00330.x (DOI)2134 (Local ID)2134 (Archive number)2134 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
3. A four-year follow-up study of help provided by the Social services for physically abused children
Open this publication in new window or tab >>A four-year follow-up study of help provided by the Social services for physically abused children
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Even though the number of child physical abuse cases reported to the police has been increasing, little research has been performed to investigate whether interventions directed towards physically abused children are working or not. This paper examines contacts that physically abused children have with the social services 4 years after the physical abuse incidents were reported to the police. This is done in an effort to investigate the characteristics of child and parent that determine whether or not abused children are still receiving help from the social services 4 years after the abuse incidents. All physically abused children whose perpetrators had been reported to a Swedish police district between 1986-1996, were followed through the files (n = 113) of the social services. Four years later 69 children were still receiving interventions from the department. Intervention by the social services prior to a reported abuse incident increased the odds 18.7 times that a child would still receive interventions 4 years after the incident, and the presence of a mentally ill mother increased the odds 11.8 times.

Keyword
social services, child physical abuse, child and parent characteristic, interventions, follow-up
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-63718 (URN)
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2010-12-30
4. A descriptive study of mental health services provided for physically abused children in Sweden: A four-year follow-up of child and adolescent psychiatric charts
Open this publication in new window or tab >>A descriptive study of mental health services provided for physically abused children in Sweden: A four-year follow-up of child and adolescent psychiatric charts
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Since there has been a considerable increase in the number of police reports on physical child abuse in Sweden since the mid 1980s, there should be an increased number of children in need of trauma-focused mental health treatment. During 1986-1996 there were 126 children reported as being physically abused by a parent or equivalent and reported to the police in a police district in Sweden. Fifty-seven of these children (45%) had been the objects of interventions from Child and Adolescent Psychiatric Services. The aim of this study was to investigate the extent and content of this. Questions addressed were: What interventions were provided prior to, at the acute situation, and during the 4 years after the physical abuse incident? This group of children was referred to (CAPS) for different reasons, but few for physical abuse. Only 35 out of 122 referrals were made under the label of child physical abuse. Overall, interventions were almost exclusively directed toward the parents. Six out of 126 physically abused children received individual therapy. Abuse was not mentioned in the charts for 23 of the children, even though 8 of them had been referred due to  abuse. The results of this study indicate that physically abused children often have been in contact with mental health services prior to the abuse for different reasons. Individual interventions for physically abused children were rare due to for instance CAPS workloads, poor motivation among parents and children, and maybe due to professionals’ lack of knowledge regarding effective treatment.

Keyword
Child physical abuse, mental health services, intervention, therapy, follow-up
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-63719 (URN)
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2010-12-30
5. A qualitative view of physical child abuse intervention: Five Swedish mothers’ stories
Open this publication in new window or tab >>A qualitative view of physical child abuse intervention: Five Swedish mothers’ stories
2004 (English)Manuscript (preprint) (Other academic)
Abstract [en]

There has been an increase in the number of child abuse cases reported to the police since mid 1980s. This has put increased pressure on institutions dealing with the abused children. In this paper, we describe how 5 biological mothers of physically abused children perceive interventions. The interviews concerned interventions from the police department, social services, and mental health services. The mothers narrated similar stories where their statements focused on a process dealing with restrictions, significant others, and living conditions. As previous studies have indicated and as the mothers of the physically abused children also narrated, there is a general acceptance of the police department and mental health services, while many are highly critical towards social services. The common conclusion in the mothers’ narratives is that representatives from the investigated authorities should be encouraged to cooperate and to be clear when explaining the process that awaits each family. In addition to listen and recognize cries for help and learn how to handle people in a crisis situation.

Keyword
Child physical abuse, interventions, experience, process
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-63720 (URN)
Available from: 2010-12-30 Created: 2010-12-30

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