Posted on February 28, 2009 by Debbie Ausburn

That Didn't Take Long

Legal blogs already are picking up on the study that I mentioned yesterday.  The normally-solid Sexual Abuse Claims Blog quotes one report that "child abuse can permanently alter the way your genes fight stress, leaving victims of childhood abuse more vulnerable to stressful events throughout their life."  

Let's all repeat one more time - the study looked at a grand total of 36 tissue samples.   To quote a neurobiology professor, "The bottom line is that this is a terrific line of work, but there is a very long way to go either to understand the effects of early experience or the causes of mental disorders."

If you run across an expert who makes this claim about the results of childhood abuse, take a good look at the studies they are relying on.  As one of my favorite literary characters said, "Wizards should know better."

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Posted on February 27, 2009 by Debbie Ausburn

Exaggerating Results of Research Studies

News articles about a recently-published neurological study illustrate how easily a poorly-supported claim can become accepted dogma.  The current issue of Nature Neuroscience reports a study of the brain tissue of people who had died under varying circumstances.  They found significant differences in the brains of people who had suffered abuse as children.

Numerous news agencies reported the study, announcing breathlessly that child abuse "permanently alters" how the brain responds to stress, that child abuse alters the brain, and that child abuse "causes lifelong changes" to the brain.  The study, however, proved no such thing.

 

 

 

 The study did raise interesting questions that need to be explored further.  But its sampling was too limited to definitively establish anything.  The researchers studied tissue from a total of 36 brains: 12 from suicide victims who had suffered abuse as children, 12 from suicide victims who had not suffered abuse, and 12 from people who had died of causes other than suicide.   Such numbers are simply too small to prove anything other than the need for more research.  

Only one article struck any sort of cautionary note, and that with a quotation at the very end: 

“The bottom line is that this is a terrific line of work, but there is a very long way to go either to understand the effects of early experience or the causes of mental disorders,” Dr. Steven Hyman, a professor of neurobiology at Harvard, wrote in an e-mail message.

That statement should have been at the beginning of every report about the study.
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Posted on February 26, 2009 by Debbie Ausburn

Recovery from Sexual Abuse

 The Journal of Mental Health Counseling has an interesting article discussing factors that help children recover from sexual abuse.  The focus of the article is "transgenerational trauma and child sexual abuse," but it has a very helpful section summarizing recent research into factors that aid a child's recovery from abuse.  Those factors include:

 

•  Self-perception.  When children think their pre-abuse lives were positive, they are more likely to have a positive self-image after the abuse.

•  Reaction of support network.  When adults around the child deny the abuse or support the perpetrator, children are at greater risk for negative symptoms.

•  Emotional support .  Children who receive support from their primary caregivers show fewer symptoms than children who lack that support.  One study suggests that maternal support is a more important factor than the nature of the abuse or the child's relationship to the offender.

Hat tip:  The Phrenologist's Notebook

 

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Posted on February 2, 2009 by Debbie Ausburn

Exposure to Domestic Violence as Child Abuse?

The new issue of Child Maltreatment has a provocative article arguing for treating exposure to domestic violence as a form of child abuse.  This argument is gaining credibility in the mental health circles, in light of so many studies showing how children who only witness domestic violence exhibit many of the same symptoms as children who are direct victims.  

The article is worth purchasing simply for the list of research studies showing the effects of witnessing domestic violence.  Any attorney or expert working on cases involving alleged or proven abuse should be familiar with that research.   As I noted in my post about a study released last fall, competent experts must be able to rule out domestic violence as an alternate cause of symptoms and/or damages in litigation.

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Posted on November 10, 2008 by Debbie Ausburn

Psychotropic Medications Overused?

While researching my last blog post, I ran across a recent study noting that American children are prescribed antidepressants three times as often as their counterparts in German and the Netherlands.

The study naturally raises the question of whether American children really need all of those prescriptions.  In fact, one of the study's authors published a separate study, contending that psychotropic medications are overused among foster children.

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Posted on November 9, 2008 by Debbie Ausburn

Scientifically-Effective Treatment for Trauma

One of the most controversial questions I encounter in litigation involving children is predicting the costs of future mental health treatment.  Everyone agrees that children who have suffered a trauma need therapy, but few people agree on what sort of therapy or how much.  The American Journal of Preventive Medicine recently published a study concluding that only cognitive behavior therapy (individual and group) has been proven to be effective.  (Hat tip: Anxiety Insights blog). 

Defense attorneys will like this study for the same reason that plaintiff's attorneys will be skeptical - cognitive behavior therapy  requires only 8-12 sessions.  It may need to be repeated periodically at developmental milestones, such as puberty, but it does not require long-term, ongoing therapy sessions.

Other therapies that I often see recommended, such as intensive psychoanalysis or psychotropic medication, are simply not yet proven.  I have yet to see a Daubert challenge to such recommendations, but more studies like this one certainly would support one.

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