Are negative/unrealistic parent descriptors of infant attributes associated with physical abuse?

Abstract

Parents' perceptions of child behavior influence their responses to the child and may be important predictors of physical abuse. We examined whether infants 12 months of age or younger who were described with negative or developmentally unrealistic words were more likely than other infants to have been physically abused. As part of a prospective observational multicenter study investigating bruising and familial psychosocial characteristics, parents were asked to (1) describe their child's personality, and (2) list three words to describe their child. Four independent raters coded parent responses using a qualitative content analysis, identifying descriptors of infants and classifying each as positive, neutral, or negative/unrealistic. A medical expert panel, blinded to the psychosocial data, separately categorized each case as abuse or accident. We then analyzed the potential association between negative/unrealistic descriptors and abusive injury. Of 185 children enrolled, 147 cases (79%) were categorized as accident and 38 (21%) as abuse. Parents used at least one negative/unrealistic descriptor in 35/185 cases (19%), while the remaining 150 cases (81%) included only positive or neutral descriptors. Of the infants described with negative/unrealistic words, 60% were abused, compared to 11% of those described with positive or neutral words (p < .0001; age group-adjusted OR = 9.95; 95% confidence interval [3.98, 24.90]). Though limited by sample-size, this pilot study informs future work to create a screening tool utilizing negative/unrealistic descriptors in combination with other predictive factors to identify infants at high risk for physical child abuse.

The emotional tone of child descriptions during pregnancy is associated with later parenting

“…Associations between negative descriptors of the child and poor outcomes were also found by Young and colleagues (2018) who demonstrated that negative descriptions of a child postnatally are associated with risk for child maltreatment. Our work builds upon these findings by demonstrating that negative descriptions of the child's future personality can indicate risk for poor parent–child interaction before the child is born.…”

“…Findings from a study investigating risks for infant abuse revealed that infants between 7 and 12 months of age were at greater risk for physical abuse by parents who described their personalities using negative or developmentally inappropriate words (e.g., “needy” and “drama queen”) (Young et al., 2018). In another study, the tendency to label novel, ambiguous infant facial expressions with negative emotion words was associated with reduced sensitive parenting behavior with their own child (Dayton et al., 2016).…”

“…In another study, the tendency to label novel, ambiguous infant facial expressions with negative emotion words was associated with reduced sensitive parenting behavior with their own child (Dayton et al., 2016). Thus, attention to the emotional tone of the words caregivers use to describe their own (Young et al., 2018) or even other infants (Dayton et al., 2016) may reveal risk for poor parenting outcomes. Based on past research, the emotional tone of words used in “prenatal” caregiver descriptions of the child could be early indicators of risk for poor caregiving before the child is born.…”

The assessment of representational risk (ARR): Development and psychometric properties of a new coding system for assessing risk in the parent–infant relationship

“…However, descriptions of their caregiving experiences can indicate more subtle underlying hostility. Such negative experiences of the child or the parenting role are associated with physical abuse and poor outcomes for the child (Young et al., 2018) and this is most likely mediated by harsh parenting behavior (Nix et al., 1999).…”

Social history: A qualitative analysis of child abuse pediatricians’ consultation notes

“…Although cross-sectional and retrospective studies provide correlation or association with child abuse and neglect, they do not provide evidence on the cause and effect of abuse or other variables that may mediate the cause and effect. Risk factors associated with abuse include a caretaker’s history of child abuse, negative caretaker perceptions of their child, caretaker affect or behavioral problems including substance abuse, caretaker cognitive and affective deficits, housing instability, non-biological caregiver in the home, chaotic or volatile family situations (Douglas & Mohn, 2014; Duffy, Hughes, Asnes, & Leventhal, 2015; Lindberg, Beaty, Juarez-Colunga, Wood, & Runyan, 2015; Miyamoto et al, 2017; Wathen & MacMillan, 2013; Young et al, 2018). Protective factors that increase family strengths and reduce the likelihood of child abuse and neglect include supportive social networks, stable family relationships, nurturing parenting skills, parental employment and adequate housing (Kumpfer & Magalhães, 2018; Saul et al, 2014; Schofield, Lee, & Merrick, 2013; Stith et al, 2009; Swenson & Chaffin, 2006).…”