Michele Knox

Background: Child maltreatment (CM) makes up a significant portion of events under the larger umbrella term of adverse childhood experiences (ACEs). Therefore, we need to develop a competent healthcare workforce that is prepared to assess and report CM in order to create a comprehensive framework for assessing and addressing ACEs. The objective of the present study was to examine the obstacles to reporting CM among a sample of future physicians. Methods: Two samples of medical students and residents (N = 196) completed the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale and rated how likely they would be to report suspected CM. Results: Medical students were found to have more negative feelings about and perceive more obstacles to reporting CM compared to residents in our sample. Scores on the Reporting Responsibilities subscale were not significantly associated with increased likelihood of reporting CM. However, lower scores on the Concerns about Reporting subscale were related to an increased likelihood of reporting CM. Conclusions: Future physicians who perceived fewer obstacles to reporting CM reported being more likely to report suspected CM. Misinformed fears about outcomes such as retaliation, removal of the child from the home, and being sued may interfere with future physicians’ adherence to mandated reporting responsibilities. Efforts should be made early in physician education to identify and address common myths and misconceptions around mandated reporting and its outcomes.

Violent video game (VVG) use has repeatedly been found to be associated with hostile expectations about others, desensitization to violence, decreased empathy and prosocial behavior, and aggressive thoughts and behaviors. Although these research findings have been widely publicized, VVGs remain the most extensively played games and represent a multi-billion dollar industry. Although VVGs are typically rated “mature,” indicating they are not suitable for youths, they are often purchased for youths. This may be in part because there is currently no system available to consumers that thoroughly describes the content of video games, and much of the public is unaware of the types of violence that characterize game play. The purpose of this paper is to describe the violent content of some of the top VVGs, based on sales. For the purposes of this issue, acts of senseless, unprovoked violence will be described in detail.

There currently is not a well-established, psychometrically sound measure for assessing health care provider concerns about and attitudes toward reporting maltreatment. The purpose of this study is to examine the psychometric properties of the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale. The factor structure and reliability of the scale were analyzed. Two subscales, Reporting Responsibilities and Concerns about Reporting, were identified. The total scale and the subscales were shown to have good internal consistency. Potential uses for the scale in evaluating and improving mandated reporting by health care providers are proposed.

The purpose of the current study was to examine the effects of training first year medical students using a Child Advocacy Studies Training (CAST) elective course. The 9-month course was taught by a multidisciplinary group of professionals and addressed prevention, identification, reporting, and responding to all forms of child and adolescent maltreatment. It was hypothesized that, relative to students in a comparison group, students who completed the elective course would report being significantly more prepared to identify signs of maltreatment, to report a case of suspected maltreatment, and to recommend or secure needed services for a maltreated child or adolescent, more likely to report suspected maltreatment, even if they did not know for sure it happened, and demonstrate improved knowledge in the areas of maltreatment identification and reporting. Results supported all five of the study’s hypotheses and indicate that the CAST program may be an effective method of better preparing future physicians to address child and adolescent maltreatment.

The present study involves an evaluation of the effect of the American Psychological Association's ACT Raising Safe Kids (RSK) program on parenting outcomes for families served by Community Health Centers. The ACT‐RSK program is a primary family violence and child physical abuse prevention program for parents of young children. Parents were trained in effective parenting including nonviolent discipline, child development, anger management, social problem‐solving skills, effects of violent media on children, and methods to protect children from exposure to violence. Results indicate improved nurturing and positive parenting behaviors and lower rates of psychologically and physically aggressive behavior toward children. These improvements occurred independent of children's age and prior levels of aggression. Use of this model within healthcare settings has the potential to more effectively address parents’ needs for parenting guidance while reducing the likelihood of child maltreatment.

Parental hostility and parental depression are associated with childhood behavior problems, but these have been studied independently in the literature. This study examined the relationships between parental hostility and depression and childhood aggression and conduct problems. Parental hostility was hypothesized to predict children's current and future (two months later) aggression and conduct problems. Participants were primary caregivers of children 0 to 10 years of age. Results indicate that hostility is a better predictor of present and future childhood aggression and conduct problems than depression. Implications of this finding for preventing and treating childhood aggression and conduct problems are discussed.

Twenty-four children and adolescents aged 9-17 who were referred for treatment for anxiety were assigned to either a game-based biofeedback group or a waiting list comparison group. The eight-session biofeedback intervention included psychoeducation, identification of triggers and signs of anxiety, and in vivo practice. The intervention used computer-based gaming technology to teach and practise relaxation. Analyses using ANCOVA revealed significant differences in post-test scores of anxiety and depression measures between the two groups. The intervention group reduced anxiety and depression scores on standardised tests. Findings suggest that biofeedback-assisted relaxation training can be useful in decreasing anxiety and depressive symptoms in anxious youths.