Exploration and validation of clusters of physically abused children☆
Introduction
There is compelling evidence that physically abused children, as a group, differ markedly from nonabused children on many indicators of social adjustment. They tend to exhibit aggression (Bolger & Patterson, 2001), are often rated by their peers and teachers as socially withdrawn (Salzinger, Feldman, Ng-Mak, Mojica, & Stockhammer, 2001), and they tend to have low peer status and to be socially rejected at high rates (Bolger & Patterson, 2001; Rogosch & Cicchetti, 1994). There is a long history of research designed to examine such differences between physically abused and nonabused children. With the exception of recent literature on resilience among abused children, however, limited attention has been focused on diversity in outcomes for these children.
A developmental psychopathology framework (Cicchetti & Cohen, 1995) suggests that children who experience physical abuse can differ markedly in developmental outcomes (i.e., multifinality). Indeed, some abused children show evidence of resilient functioning (Haskett, Nears, Sabourin Ward, & McPherson, 2006). Although there are evidence-based interventions that show promise for maltreated children, effectiveness of most treatments has been rather disappointing (National Call for Action, 2004). Traditionally, interventions for physically abused children have been designed without considering diversity in adjustment. Understanding heterogeneity could assist in development of interventions tailored for subgroups of physically abused children who share common treatment needs. The purpose of this study, therefore, was to contribute to the understanding of diverse outcomes for physically abused children. Cluster analysis, an approach to detecting homogeneous groups within a sample of diverse individuals (Magnusson, 1998), was employed. This approach has been used to identify subtypes within samples of abusive parents (Oldershaw, Walters, & Hall, 1989), sexually abused children (Trickett, Noll, Reiffman, & Putnam, 2001), and child witnesses of domestic violence (Grych, Jouriles, Swank, McDonald, & Norwood, 2000), but there are no published accounts of cluster analysis used to derive subtypes of physically abused children.
Although there are no published reports of efforts to subtype physically abused children, some investigators have applied cluster analysis to samples of child witnesses of domestic violence. Those studies illustrate the utility of using cluster analysis to examine heterogeneity in adjustment of children exposed to family violence because characteristics of physically abused children and child witnesses of domestic violence show remarkably similar patterns of social cognitive and behavioral functioning, including risk for externalizing problems (Hughes, Parkinson, & Vargo, 1989; Marcus, Lindahl, & Malik, 2001; Wolfe, Jaffe, Wilson, & Zak, 1985). Hughes and Luke (1998) clustered a sample of 58 children exposed to domestic violence. Support was obtained for five clusters based on parent- and self-report of child behavior problems, internalizing distress, and self-esteem. One cluster was comprised of children who had few behavior problems, no anxiety, and high self-esteem. Another was comprised of children who were considered to be “hanging in there,” with low levels of problematic behavior and average self-esteem. The final three clusters were comprised of children who experienced high levels of behavior problems and/or high distress. Individual differences in internalizing and externalizing problems of witnesses of domestic violence also were examined by Grych et al. (2000). One cluster was comprised of children who experienced no behavioral or emotional problems. A second cluster consisted of children with low levels of behavior problems and only minor internalizing problems. The other three clusters included children with high internalizing and/or externalizing problems. In summary, both studies indicated there were five clusters, with one characterized by positive functioning, one with low levels of maladjustment, and other clusters demonstrating various patterns of adjustment problems.
To determine the degree to which clusters are clinically meaningful, investigators typically compare clusters on factors on which the clusters should differ if the distinction between them is relevant to clinical practice. In the current study, each cluster of physically abused children was compared to a sample of nonabused children closely matched to the abuse sample. In addition, clusters were compared to each other on several protective and vulnerability factors known to predict individual differences or resilient functioning among physically abused children. Using a multilevel approach, we considered characteristics of the individual child and features of the caregiving environment associated with positive adjustment. At the individual child level we measured social information processing operations, and characteristics of parenting included level of sensitivity and harshness of discipline.
According to the highly influential social information processing (SIP) framework (Crick & Dodge, 1994), the manner in which children receive and process social cues available during interactions with peers impacts their responses in peer interactions. A large body of literature documents a strong link between SIP and children's social behavior (Crick & Dodge, 1994). Of interest in this study were attributions for peer intentions and problem-solving skills in problematic peer situations. Those SIP operations were included due to their strong association with social adjustment. That is, children who are aggressive and who are rejected by their peers are less accurate in interpreting the intentions of peers and are more likely to attribute hostile intent to neutral peer behavior (de Castro, Veerman, Koops, Bosch, & Monshouwer, 2002). Further, socially competent children generate more effective, socially appropriate solutions to peer-related problems than do aggressive children (Lochman, Meyer, Rabiner, & White, 1991). In terms of the social information processing abilities of maltreated children (i.e., physically abused and/or neglected children), research shows that they tend to have a hostile attributional bias for peers’ intentions (Price & Glad, 2003) and such attributions predict externalizing behavior and conduct problems of maltreated children (Price & Landsverk, 1998). Deficits in problem-solving skills also have been found among maltreated children (Smith & Walden, 1999; Trickett, 1993), and generation of solutions to peer conflicts predicts maltreated children's social competence (Price & Landsverk, 1998).
Extant research shows parents who are warm and responsive tend to have children who engage in more prosocial behavior (Whiteside-Mansell, Bradley, Tresch Owen, Randolph, & Cauce, 2003) and less externalizing behavior compared to children of parents lacking in warmth (Booth, Rose-Krasnor, McKinnon, & Rubin, 1994). Further, parental sensitivity can serve a protective function for children exposed to a variety of developmental risks (Pianta, Egeland, & Sroufe, 1990). In contrast, harsh discipline is associated with negative outcomes, including aggression (Strassberg, Dodge, Pettit, & Bates, 1994) and low rates of child prosocial behaviors such as helping and comforting others (Hastings, Rubin, & DeRose, 2005). Many physically abusive parents are characterized by harsh discipline and low parental sensitivity so one might assume that those parenting dimensions would be stable across abused children. A few studies, however, indicate parental warmth and discipline predict individual differences within samples of maltreated children (Farber & Egeland, 1987; Lansford et al., 2006). Thus, even for children who experience abusive parenting, there appears to be sufficient variability in sensitivity and harshness of discipline to predict differential outcomes.
The abused child participants in this study were divided into groups, using cluster analysis, on the basis of similarities and differences in their social behavior (as observed on the playground and reported by teachers). Cluster analysis is an exploratory procedure and there are no extant studies on classification of physically abused children by which to predict the number of clusters that would emerge. Based on prior efforts to subtype children exposed to domestic violence, however, we expected that there would be a cluster of children characterized by relatively positive social adjustment and at least one that would show poor social adjustment on most indices. To evaluate the validity of the clustering process, clusters of abused children were compared to nonabused children and to one another on social information processing operations and the parenting context. We predicted that clusters would vary in the degree to which they differed from nonabused children, such that clusters comprised of relatively well adjusted children would be more similar in social adjustment to nonabused children. It was expected that children in the cluster characterized by positive social adjustment would have greater breadth and higher quality of solutions to peer problems and less hostile attributional bias. Further, they were expected to experience greater parental sensitivity and less harsh discipline.
Section snippets
Participants
Extant data from an investigation designed to examine the impact of parenting and SIP on children's adjustment were used for the current study. The study was conducted in the southeastern United States in a midsized county that included the state capital. Approval for the study was granted from the university Institutional Review Board. Nineteen children from the larger data base were excluded due to missing data on one or both measures used for clustering; there were no significant differences
Clustering strategy
Cluster analytic approaches include several algorithms and methods for grouping participants into categories of homogeneous individuals such that the degree of association between participants is maximal if they belong to the same group and minimal otherwise. Readers unfamiliar with cluster analysis are referred to Everitt, Landau, and Leese (2001) for a detailed explanation of concepts and procedures related to cluster analytic approaches. In this study, cluster analyses were conducted on the
Discussion
Investigations of physically abused children historically have been designed to identify ways in which they differ from their nonabused peers. Although those studies have been instrumental in increasing the understanding of typical sequela of abuse, past research has provided limited insight regarding differences that might exist between physically abused children. To begin to fill this knowledge gap, we examined heterogeneity in social adjustment among physically abused children using cluster
Acknowledgements
The authors thank the Family Studies Research team for their valuable assistance in the completion of this study.
References (56)
Disciplining children: Characteristics associated with the use of corporal punishment
Child Abuse & Neglect
(2000)- et al.
Diversity in adjustment of maltreated children: Factors associated with resilient functioning
Clinical Psychology Review
(2006) - et al.
Beyond parenting skills: Battling barriers and building bonds to prevent child abuse and neglect
Cognitive and Behavioral Practice
(1997) - et al.
Social information-processing patterns as predictors of social adaptation and behavior problems among maltreated children in foster care
Child Abuse & Neglect
(1998) - et al.
Developmental pathways from child maltreatment to peer rejection
Child Development
(2001) - et al.
Sequelae of child maltreatment: Vulnerability and resilience
- et al.
Predicting social adjustment in middle childhood: Role of preschool attachment security and maternal style
Social Development
(1994) - et al.
A dendrite method for cluster analysis
Communications in Statistics
(1974) - et al.
Perspectives on developmental psychopathology
- et al.
The role of self-organization in the promotion of resilience in maltreated children
Development and Psychopathology
(1997)
The role of overt aggression, relational aggression, and prosocial behavior in the prediction of children's future social adjustment
Child Development
A review and reformulation of social information processing mechanisms in children's social adjustment
Psychological Bulletin
Relational and overt aggression in preschool
Developmental Psychology
Hostile attribution of intent and aggressive behavior: A meta-analysis
Child Development
On the relation between social information processing and socially competent behavior in early school-aged children
Child Development
Cluster analysis
A partnership directed school based intervention for child physical abuse and neglect: Beyond mandatory reporting
School Psychology Review
Peer-mediated treatment of socially withdrawn maltreated preschool children: Cultivating natural community resources
Journal of Child Clinical and Adolescent Psychology
Invulnerability among abused and neglected children
Patterns of adjustment among children of battered women
Journal of Consulting and Clinical Psychology
Subgroups of physically abusive parents based on cluster analysis of parenting behavior and affect
American Journal of Orthopsychiatry
Links among gender, inhibition, and parental socialization in development of prosocial behavior
Merrill-Palmer Quarterly
Resilient early school-age children from maltreating homes: Outcomes in late adolescence
American Journal of Orthopsychiatry
The importance of degree versus type of maltreatment: A cluster analysis of child abuse types
The Journal of Psychology
Cited by (10)
Evaluation of Bikers Against Child Abuse (BACA) program: A community intervention for child abuse victims
2017, Evaluation and Program PlanningCitation Excerpt :Gustavo, McGinley, Hayes, Batenhorst, and Wilkinson (2007) found that parenting practices were significantly associated with adolescents’ prosocial behavior, indirectly related through sympathy. Literature addressing prosocial behaviors in abused children indicated that those who were physically maltreated and had parents who were more sensitive and used less harsh discipline practices had prosocial skills that were developmentally appropriate (Sabourin Ward & Haskett, 2007). In addition, resilience in children who were maltreated and had protective factors such as child prosocial skills, child internalizing well-being and caregiver well-being were associated with lower likelihood of clinical levels of aggressive behavior (Holmes, Yoon, Voith, Kobulsky, & Steigerwalk, 2015).
Differentiated associations between childhood maltreatment experiences and social understanding: A meta-analysis and systematic review
2013, Developmental ReviewCitation Excerpt :Furthermore, Calvete and Orue (2011) found no correlation between ‘exposure to violence’ at home (which included witnessing and experiencing violent acts at the hands of unspecified others, as well as verbal aggression) and the interpretation of intent in ambiguous vignettes; however, when also including exposure to violence at school and in the community in a structural equation model, the path from exposure to violence at home to hostile attributions became significant (if still weak). Finally, Ward and Haskett’s (2008) sample of physically abused 5–10-year-olds gave no more hostile attributions to ambiguous provocative vignettes than did controls when analysed using an ANOVA; however, a cluster analysis showed differences between subgroups, with a ‘Hanging in There’ group (little prosocial but little maladjusted behaviour) giving more hostile attributions than a ‘Socially Well Adjusted’ group (appropriate social behaviour, rarely rejected by peers). The findings from our systematic review clearly corroborate the hypothesis that there is a meaningful association between child maltreatment and poorer performance on a range of indicators of social understanding.
Parent emotional expressiveness and children's self-regulation: Associations with abused children's school functioning
2012, Child Abuse and NeglectCitation Excerpt :Inter-rater agreement was assessed for approximately 25% of the observations using a second coder and was .94 for Aggressive behavior. Validity of this coding system has been established with samples of young maltreated children (Sabourin Ward & Haskett, 2008). Correlations between the 2 aggression variables (i.e., observed aggression on the playground and teacher-reported aggression on the TRF) indicated a significant and moderately high relation, r = .48, p < .001.
Using risk adjustment approaches in child welfare performance measurement: Applications and insights from health and mental health settings
2010, Children and Youth Services ReviewAdverse Childhood Experiences and Their Life-Long Impact
2023, Adverse Childhood Experiences and their Life-Long ImpactReliability and Validity of Behavior Observation Coding Systems in Child Maltreatment Risk Evaluation: A Systematic Review
2022, Journal of Child and Family Studies
- ☆
This research was supported by a grant from the National Institute of Mental Health awarded to the second author. Portions of this research were presented at the annual meeting of the American Psychological Association, 2006.
- 1
Now at: Wake County Public Schools, Raleigh, NC, USA.