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A/PROF CAROLYN QUADRIO

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Title: ABUSE IN CHILDHOOD AND PSYCHIATRIC DISORDER Author: A/Prof Carolyn Quadrio Last modified by: University of South Australia Created Date: 12/4/2002 2:43:52 AM – PowerPoint PPT presentation

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Title: A/PROF CAROLYN QUADRIO


1


SIX DEGREES OF ALIENATION PARENTING FAMILY
CONFLICT
  • A/PROF CAROLYN QUADRIO
  • School of Psychiatry
  • University of NSW
  • SHARED PARENTING ORDERS
  • ADELAIDE, UNIVERSITY OF SA
  • APRIL 2008

2
OVERVIEW OF PRESENTATION
  • Child trauma and abuse
  • The spectrum of alienation
  • Parenting patterns
  • Case examples
  • Breastfeeding
  • Joint parenting considerations

3
PERSONALITY DEVELOPMENT ATTACHMENT
  • Personality develops from infant
    interaction with carer
  • Critical interaction infants needs/capacities
    and empathic responsiveness of carer
    (not time)
  • Long term mental health outcomes
  • and early attachment/trauma

4
CHILDHOOD TRAUMA ABUSE
  • Is common
  • Mostly familial/carers
  • CSA 15-30
  • Severe CPA 11
  • Witnessing DV 14
  • Psychological trauma?
  • Family conflict/violence
  • FLC cases expect higher rates

5
CSA IS COMMON
  • Epidemiological data worldwide
  • 1 in 3 female1 in 4 male children
  • 36 Australian women
  • (Mazza and Dennerstein, 2001)
  • Most CSA is unreported (80)
  • Probably higher rates in FLC
  • families more dysfunctional group

6
Child Abuse Neglect (CAN)Australian data 2004/5
  • Reports doubled last 5 years
  • 700 new reports per day
  • One new case/2 minutes
  • Most abuse is intrafamilial
  • Children in care ? 70 10 yrs

7
DV IS COMMON UN DATA
  • Most widespread and socially tolerated form of HR
    violation
  • Often prelude to coercive sex
  • Kills disables as many women as cancer gt MVAs
    malaria
  • Single biggest health risk to Australian women of
    reproductive age (6.3B pa)
  • 20-30 of marriages

8
NEW LEGISLATIONPRESUMPTION EQUAL PARENTING
  • Burden of proof on victim?
  • Reality of CAN
  • Prevalence of DV
  • vs
  • False allegations as strategy
  • Breastfeeding as strategy

9
ATTACHMENT FAMILY PATTERNS
  • children attach to primary care figures
  • not related to time
  • children in long day care
  • children in kibbutzim
  • traditional families
  • vs
  • children attach in spite of abuse
  • may even cling (traumatic attachment)

10
ALIENATION SYNDROME
SYNDROME vs REALITY
  • 90 allegations CSA in FLC are false
  • PAS syndrome explains this process
  • deliberate alienation
  • (usually Mo)
  • CSA common/false allegations not
  • no scientific validity
  • non-diagnostic
  • no probative value
  • dangerous assumption

11
ASSESSING CHILD ABUSE/NEGLECT
  • Only medical evidence conclusive but rare
  • Most symptoms non-specific
  • Anxiety, regression, sleep disturbance,
    nightmares, acting out, depression,
    hyperactivity, school problems
  • Equally reflective of disturbance of divorce
    and/or ongoing post separation conflict

12
INDICES OF SUSPICION
  • Stereotyped statements
  • Same words as parent
  • Language gt development
  • No contextual detail
  • Minor issues in same vein
  • Evoke sympathy eg CSS
  • Privy to details of legal process

13
MENTAL STATUS of ACCUSING PARENT
  • Mental illness
  • Children more exposed to abuse
  • Personality disorder
  • More prone to project BUT
  • More likely to be victim of abuse
  • Less able to protect children from abuse

14
MENTAL STATUS of ACCUSED PARENT
  • Limited if any assistance determining issue
  • Normal or no psychological disturbance
  • No perpetrator profile but some concerns
  • Previous violence
  • DA issues

15
ALIENATION AS PROCESS
  • Alienation dynamic/process NOT syndrome
  • Common in all divorcing families, esp FLC
  • No specific association with CSA
  • Can only be assessed in context of family

16
SPECTRUM OF ALIENATION
  • Motivation
  • altruism
  • self-interest
  • malice
  • Psychology
  • normal
  • anxious
  • paranoid/deluded

17
FIRST DEGREE
  • Altruism/protection
  • CSA is actual and/or
  • sincerely believed
  • Alienation solely to
  • protect child

18
SECOND DEGREE
  • Hurt and/or depressed parent
  • cannot conceal feelings
  • children exquisitely sensitive
  • alienation unintended

19
THIRD DEGREE
  • Immature/neurotic (gt malicious)
  • message to children
  • take care of me immature/dependent
  • or
  • dont blame me guilt prone depressive or
    passive aggressive adjustment

20
FOURTH DEGREE
  • Hurt, depressed, angry parent
  • personality disorder more/less malicious
  • unable/unwilling adequately
  • to conceal feelings
  • poor affect regulation (trauma,
  • often CSA)
  • potential for projection

21
FIVE DEGREES
  • Hurt/angry parent
  • declare feelings to children
  • recruit them as support
  • alienation is intentional to
  • break bond with other parent
  • vengeful behaviour or
  • welfare of children disregarded
  • deluded (ie genuine belief)

22
SIX DEGREES
  • Wilful and intended alienation
  • every effort to block contact
  • malicious false allegations
  • to gain advantage in FLC
  • self-interest/manipulative
  • sociopathic/malicious

23
NEW LEGISLATION
  • Joint parenting
  • Property in common?
  • Best interests of child paramount?

24
PARENTING PRACTICES
  • Intact families women do most of the childcare
    even if employed
  • Rationale for altered pattern post separation?
  • Most divorced families negotiate those in FLC
    the most acrimonious my data
  • Joint parenting requires high degree of
    cooperation

25
CHANGING PATTERNS
  • Old style access Dad as Santa Claus

26
CHANGING PATTERNS
  • New style joint parenting Mr Mom

27
CHANGED PATTERNCASE EXAMPLE
  • Fa big business no psychiatric Dx
  • Financial control domination
  • Mo 9 years exclusive childcare anxious
  • 3 children 9, 5, 18 mos (breastfed)
  • Attachments equally strong and secure
  • Fa now home based business
  • Joint parenting? One plan for 3?
  • Is change for the children or parent or ?

28
Breastfeeding Parenting Orders
  • best form of infant nutrition
  • exclusive breastfeeding for first six months and
    continue first two years
  • WHO UNICEF
  • Australia Dietary Guidelines Federal Health
    AMA Dieticians Association Colleges
    Paediatrics Midwives

29
Breastfeeding Benefits
  • maternal recovery from pregnancy and childbirth
    contraception
  • bonding and attachment
  • improved vision
  • psychomotor development
  • prevention of chronic disease later in life
    breast and ovarian cancer, cardiovascular
    disease, obesity

30
Risks of not breastfeeding
  • gastrointestinal disease
  • respiratory illnesses including asthma
  • chronic otitis media
  • sudden infant death syndrome.

31
Shared Parenting Orders Breastfeeding
  • separation affects breastfeeding
  • contested cases unlikely to improve relationships
  • not common pattern pre separation
  • paramountcy of best interests of child?
  • court orders for mothers to wean
  • (Sweet Power, 2008)

32
CASE EXAMPLE DELUSION?
  • Mo anxious fears seem exaggerated
  • Overvalued idea? Deluded? Folie a deux?
  • Fa no psychiatric Dx
  • Mo reports child has range of symptoms
  • Childs disclosures to MoGMo (no one else)
  • Court ordered supervision
  • Mo continues to report abuse
  • Supervisor alleged to be conspiring

33
Examples Domestic Violence
  • NESB
  • Fa no psychiatric Dx
  • Mo isolated and abused depression, PTSD
  • Finally leaves w children
  • Agreed contact Fa refuses to return
  • Allegations to FLC Mo depressed, suicidal
  • Orders limited contact w Mo 50/50 split

34
QUALITY vs QUANTITY
  • Quality of contact more important than time
  • Joint custody negated by parental conflict, esp
    if children caught in ongoing conflict
  • There is no one size fits all arrangement
  • Risk of exposure to continuing conflict, DV, or
    abuse contact needs to be limited

35
50/50 SHARED CARE
  • Logistically complex, parents need to be
  • organised, structured, plan ahead
  • cooperative amicable rship, keep children out of
  • child focused arrangements
  • commitment by all to make it work
  • family friendly work practices
  • degree of financial independence, especially Mos
  • a degree of paternal confidence
  • Geography
  • (B Smyth, 2005)
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