Original ArticlesResearch on resilience to child maltreatment: empirical considerations
Introduction
STUDIES FOCUSING ON the short- and long-term effects of adverse childhood experiences have long been of primary importance to both researchers and clinicians interested in developmental processes. Developmental psychopathology principles recently have been applied to this research, particularly in the study of the sequelae of childhood maltreatment (Cicchetti & Toth, 1995). These principles suggest that exposure to a given heritable trait or environmental experience is moderated by a host of associated risk and protective factors, eventually leading to a variety of phenotypic expressions. These expressions may range from individuals with severe psychopathology to those who are seemingly well-adapted.
The last three decades have seen a remarkable increase in the reporting and study of child maltreatment. Because data on the prevalence of child maltreatment are affected by local and national definitions of what constitutes maltreatment, they fluctuate as definitions change; tracking trends in child maltreatment and accurately estimating costs associated with it are exceedingly difficult Cicchetti and Toth 1995, Knutson 1995. The most recent epidemiologic data suggest that there are over 2 million reports of child maltreatment (including neglect) in the United States annually. Approximately half of these reports are validated as meeting local criteria for maltreatment by state-run child protective service agencies (National Research Council, 1993).
There have been numerous reports of the short- and long-term physical and mental sequelae of child maltreatment. Recent reviews document the wide variety of outcomes related to child maltreatment, with the most frequent being related to its debilitating psychological effects (Knutson, 1995). To date, individuals who have experienced maltreatment and seek clinical intervention receive a wide variety of treatments. Efforts at preventing maltreatment or its sequelae have not been undertaken on a wide scale and, as yet, there are few data about their effectiveness (Thyen, Thiessen, & Heinsohn-Krug, 1995).
One of the interesting recent research questions has been, what are the factors related to relatively uncompromised functioning after the experience of child maltreatment? Study of resilience in the face of a known risk factor for mental health sequelae is likely to identify processes which inform clinical intervention and preventive efforts (Spaccarelli & Kim, 1995). This work is particularly important because currently there is little consensus about which are the most effective approaches to treatment of maltreated children and adults (Cicchetti & Toth, 1995).
We will review the literature on resilience to maltreatment, organizing this paper in three main sections. First, we will address the myriad methodological considerations that shape interpretation of data on maltreatment in childhood. Second, we will review the literature which specifically attempts to measure resilience to childhood maltreatment with some commentary on the methodological issues specific to each study. We draw some conclusions about the research to date and suggest areas for future investigation. The final goal of this paper is to propose a plan of action regarding standards for future research.
Section snippets
Resilience review & measurement issues
Resilience has been defined as “the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances” (Masten, Best, & Garmezy, 1990, p. 426). On the surface, this definition of resilience is simple in that it requires competent functioning despite exposure to one or more risk factors. Yet, there are several proposed theoretical models that attempt to explain the processes involved with resilience, each of which incorporates numerous complex terms
Protective factors associated with resilience
Now we will review the empirical literature in order to highlight factors that have been associated with resilience to the effects of maltreatment. The studies described below involve research on individuals who have been physically or sexually abused or neglected as children or adolescents, yet do not appear to have developed adverse behaviors typically associated with maltreatment (e.g., poor physical growth, language and cognitive delays, aggression, lack of empathy, difficulty with peer
The construct of resilience
At this stage in the research on resilience, there is as much discussion about models and theories as there are data. Even the published studies reviewed above use varying definitions of resilience and measure widely different outcomes. In the extant literature it is difficult, if not impossible, to determine which protective factors are causally related to which risk factors (Zimmerman & Arunkumar, 1994). In this vein, Rutter (1990) has argued that the field must move beyond focusing on single
Acknowledgements
The authors would like to thank Charles H. Zeanah, M.D., and Gerianne Alexander, Ph.D., for their comments on a prior version of this paper.
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