Ireland’s Commission to Inquire into Child Abuse Volume Five
Ireland’s Commission to Inquire into Child Abuse Volume Five
Chapter 1
The Irish Society for the Prevention of Cruelty to Children (ISPCC)
Foundation of the Society
In 1875, the New York Society for the Prevention of Cruelty to Children was formed. It aimed to combat squalor, neglect and abuse in relation to children. An equivalent society, which was to become the National Society for the Prevention of Cruelty to Children (NSPCC), was established in Britain in 1884 and within five years it had 31 branches. The first Irish branch of the NSPCC was formed in Dublin in 1889. For a period of 67 years, from 1889 to 1956, the Society within Ireland operated under the auspices of the NSPCC despite the establishment of the Irish Free State in 1922. It was not until 1956 that the Irish branches ceded from the NSPCC and formed an independent Society known as, the Irish Society for the Prevention of Cruelty to Children (ISPCC). The initiative for the severance came from the Central Executive Committee of the NSPCC, on the grounds that it was ‘not practicable to go on with the work in the Republic of Ireland’. The question of finance was a very important consideration in this decision to sever links with Ireland. In particular, it was pointed out that substantial subsidies produced by the NSPCC in England should ‘rightfully be employed in aiding children in England and that this was a serious drain on financial resources’.
The ISPCC was registered as a company, which came into being on 18th January 1956. It assumed responsibility from the 1st March 1956 for all the duties and work previously performed by the NSPCC. To facilitate the smooth and efficient continuation of the work in protecting the welfare of the children in Ireland, the NSPCC made a grant to the ISPCC in the sum of £13,432.99, which was the total sum of money collected in Ireland between June 1955 and February 1956. The Patrons of the ISPCC at its inception included the President of Ireland, the Archbishop of Dublin and the Church of Ireland and Catholic Primates of All Ireland. This newly formed independent society continued to operate along the same lines as the NSPCC and it adopted the same aims.
The Society employed inspectors to carry out its functions of protecting the welfare of children. In 1968, social workers were appointed to undertake the work previously carried out by inspectors with the emphasis on social casework. And in 1970, with the formation of the health boards, the functions which had been carried out by the Society were taken over by these boards.
Purposes of the Society
The NSPCC was granted a Royal Charter in 1895, conferring on it the following duties:
- To prevent the public and private wrongs of children and the corruption of their morals
- To take action for the enforcement of laws for their protection
- To provide and maintain an organisation for the above objects
- To do all such other lawful things as are incidental or conducive to the attainment of the above objects.
These functions of the Society were adopted by the ISPCC when it was founded and were consistently re-stated in its annual reports up to the 1970s. In essence, the primary purpose of the Society was the welfare and protection of children.
The limitations of the ISPCC records
The documentation in the possession of the ISPCC is very limited. One explanation given by the Society is that a fire occurred in 1961 at their head office in Molesworth Street, and another was that some files could have been lost in the changeover in 1956. At the Phase III hearing, Mr Paul Gilligan, Chief Executive Officer of the ISPCC, admitted that:
there are significant limitations in the amount of material available to us. Unfortunately, we don’t have an explanation as to where the other material has gone, there was a fire in our head office in 1961, perhaps material was destroyed in that.
The records that do exist consist of the annual reports of the various branches of the Society from 1930–55, national annual reports from 1956, NSPCC inspectors’ handbooks and directory, index books and inspectors’ notebooks and administration files. In addition, there are some 8,000 case files, but these are confined to three specific areas – Wexford, Mayo and Cork – and only a fraction of these files relate to the pre-1970 period.
In the year 2000, the ISPCC employed an archivist to archive their existing records. However, the administration files have not been archived, according to the ISPCC, owing to lack of resources. They also engaged consultants to review the case files. An unpublished report was prepared by Seamus O Cinneide and Moira Maguire of NUI, Maynooth in 2000 entitled ‘Findings from NSPCC Records’. Their report was based on a random sampling of pre-1970 case files, with a particular emphasis on cases resulting in committal to Industrial Schools. They examined 250 case files that involved 750 children, of which 50 cases resulted in committal to Industrial Schools of 62 children. The authors of this report also pointed out another limitation with the cases files, which was that their content and quality were uneven: some files recorded the barest of details while others were quite extensive.
The role of the inspector
As stated previously, the first Irish branch of the NSPCC was established in Dublin in May 1889, with two further branches in Cork and Belfast in 1891 and subsequently branches throughout the country. In total, there were approximately 14 branches within the country. Each of these branches was staffed by an inspector who was paid a salary and was provided with a house that was intended to double up as a local office. Dublin was divided into five areas with an inspector for each area. The inspector was known colloquially as ‘the cruelty man’.
Each inspector was answerable to a local committee of interested persons, who gave their service on a voluntary basis. The inspectors were generally recruited from the ranks of retired police and army personnel. They wore a brown uniform and, with one or two exceptions, they were all men. Up to the 1960s the inspectors mainly dealt with social and environmental deprivation. Dealing with problems such as scurvy, rickets, malnutrition, and high infant mortality were part of their routine and they often provided material assistance to the families with whom they were working. The Society also intervened when charges of cruelty or neglect of children were made against families, whether poor or better off.
The inspectors operated very much on an independent basis as there was no monitoring or supervision of them by the branch committee. They did, however, have to report to the honorary secretary of each branch. The honorary secretary of each branch was the local representative of the Society who was entrusted with the responsibility for overseeing that the rules of the Society were complied with. The inspector was under the direct control of the local honorary secretary and, according to the Inspector’s Directory, an inspector had to take instructions on cases and reports from the honorary secretary or from some person appointed by the local committee for that purpose. In particular, the inspector could not take action on a case without the consent of the honorary secretary.
At the Phase III hearing, however, Mr Gilligan confirmed that ‘there was no evidence that there was any structured supervision or monitoring of their role’. The reporting structure consisted of the inspector reporting to the honorary secretary by means of record keeping. The Inspector’s Directory stipulated that ‘all books and records in an Inspector’s charge must be kept up to date’ and that ‘all branch records are subject to examination by a representative of the Central Office at any time’. An inspector was also required to maintain a daily diary of all the duties in which he had been engaged. The Inspector’s Directory stipulated that:
The Diary must be regularly kept, and produced for the Hon. Secretary’s examination and signature at least once a week. The best time for this is when the Inspector gets his pay-sheet signed, but this must be according to the convenience of the Hon. Secretary.
Primarily, the onus was on the inspector to communicate with his superiors rather than the other way around. Mr Gilligan spoke about the management structure governing the inspectors:
we didn’t come across any evidence of a sort of structured sit down and supervise situation. It would appear that it was through recordkeeping and through very clear distinct reporting responsibility seeking permission to warn a family, to seek procedures, to instigate procedures for committal or prosecution. So there was a management structure. They weren’t on their own, per se, but how structured that was in terms of sitting down and managing as we would know today…
The duties of inspectors were set out in the Inspector’s Handbook of 1947 and the Inspector’s Directory of 1960. The 1960 Inspector’s Directory defined the role of the inspector as follows:
An Inspector’s aim – first and last – is to be a force for the welfare of children. He must always do all in his power for the good of the child who is suffering, and if no other means are available, provide what is necessary at the expense of the Society. An Inspector who seeks merely the prosecution of an offender is liable for instant dismissal. Any neglect in doing for a child what is necessary and possible is shameful, and, most naturally and most justly, risks the good name of the Society, and interferes with the success of its work.
Their function was to investigate complaints of child neglect and abuse. These complaints came from a variety of sources such as the general public, the Gardaí, school officials and the parents themselves. From the research conducted by O Cinneide and Maguire, 60 percent of the cases that were reviewed by them were people who had approached the inspector themselves. The categories of referrals related directly to the Children Act 1908, and it was this legislation that drove the work of the Society. Neglect was one of the main categories of referrals, which arose primarily from poverty, poor housing conditions, absence of a parent or illegitimacy. The living conditions of many in the 1930s and 1940s were very difficult. Housing conditions were described as filthy and squalid, with no proper sanitary facilities. There were large numbers of people living in very small accommodation, possibly one room, and living on very low incomes with not enough money to feed them all.
The reports of the NSPCC from the 1940s and 1950s are revealing as to living conditions. In the year 1944-45, the Society dealt with 1,103 cases, the overwhelming majority classed under the heading ‘neglect’. No cases were listed under the headings ‘criminal and indecent assault’. Only 18 people were prosecuted, and the report indicated that ‘of real and deliberate cruelty to children there had been practically none’.
The general tenor of the Society’s reports from the 1930s to the 1950s was to describe in graphic terms cases of neglect, squalor and parental irresponsibility, as well as calling for legal adoption, and strongly criticising the excessive use of Industrial Schools as an alternative to providing a new family life for victims. ‘It must be recognised’ they reported in 1948-49, ‘that children are to a large extent deprived of home influences and it would be much better if we could avoid sending them to such institutions’. Their pleas went unheard and in 1956, when the Archbishop of Dublin, Dr John Charles McQuaid, became one of the patrons of the Society, the challenging and graphic case studies were gone; the awkward questions posed about adoption and Industrial Schools were jettisoned. The exposure of the underbelly had ground to a halt.
The role of the inspectors was, according to Mr Gilligan, ‘to ensure that change occurs for the child, that the parents are either supported or warned to make changes for the child so that the child is adequately cared for and protected’. This was emphasised in the annual reports. To that end the inspectors pursued a focused practical approach.
Mr Gilligan, at the Phase III hearing, said that the inspectors ‘were obliged to make every attempt to support the family, to persuade either through information support or warnings, the parents to take their responsibilities to care for their children seriously’. He provided examples of practical support such as ‘…trying to organise clothes, perhaps in some cases organise a job, certainly medical care for children, in some cases housing. But it is clearly practical support and also providing the parents with clear indication of what would be expected’. The inspectors also conducted supervision visits of the homes of children who were under threat to ensure a change for the better in the circumstances of the child. If no change was forthcoming, the inspectors had to look at the option of providing alternative care for the child, which could involve committal to an Industrial School.
The role of the Society in the committal of children to Industrial Schools
The Society had a role in committing children to Industrial Schools. The extent and significance of this role cannot be accurately ascertained as there are no definitive statistics in respect of the actual numbers of children who were committed by the Society. This is due to the paucity of records available. However, the Maynooth research indicated that out of a sample of 250 case files, 62 children out of 750 were committed to Industrial Schools. But this sample of cases consisted of those who had been sent to Industrial Schools and, as Mr Gilligan pointed out in evidence, ‘it would certainly be a skewed sample’. Therefore, this figure is not indicative of the numbers generally. The research also found from the sample taken, that 41 children or 66 percent of children committed to Industrial Schools were committed at the request of their parents. The 1956 Annual Report of the ISPCC indicated that 1.3 percent of referrals to the Society resulted in court proceedings. These court proceedings would include both the prosecution of a parent or parents for neglect and also a committal to an Industrial School.
Of note, is the fact that many of the witnesses who testified to the Investigation Committee concerning their time in Industrials Schools were committed by the NSPCC /ISPCC. A total of 15 Industrial Schools were investigated by the Investigation Committee. A total of 226 complainants testified about their time in these Industrial Schools. 84 of the 226 witnesses had been referred to these Industrial Schools by the NSPCC/ISPCC, which equates to 37 per cent or over one-third of the total number of complainants heard in respect of the 15 Industrial Schools.
At the Phase III hearing, Mr Gilligan conceded that the ISPCC had played a prominent role in the committal of children to Industrial Schools as they were the only child protection agency in the country at that time. He said:
I think if we were the only child protection – child protective organisation then I think it is reasonable to suspect that we certainly would have committed a significant number to the industrial schools. But I really have no idea about the overall percentage.
Moreover, the general public perception at the time was that the Society was heavily involved in committing children to Industrial Schools, hence the apprehension in the minds of the public associated with the ‘cruelty man’. Even the Archbishop of Dublin, Dr McQuaid, had reservations about the role of the Society in committing children to Industrial Schools. On 4th June 1941, soon after his appointment as Archbishop of Dublin, Dr McQuaid wrote to Frank Duff, an active lay Catholic with a social conscience, who was the mainspring of the lay Catholic social work society, the Legion of Mary. He was also the one of the few contemporary voices critical of the Industrial Schools. The Archbishop enclosed the report of the NSPCC (Dublin Branch) for 1939–40 and requested the following of Mr Duff:
Will you kindly have a look through the specimen cases in the enclosed booklet? Anyone who reads the six specimen cases encountered by the Society that year would be appalled by the poverty and suffering described. To take just one example from the Report:
A man and his wife charged with the neglect of their daughters, aged six, four and three. The man was absent from home at work from six in the morning until six in the evening; but he said his only interest was his children. He was sentenced to a few hours’ imprisonment, and was released on the rising of the Court.
Mr Duff replied on 12th June 1941. He expressed grave disquiet about the actions of the NSPCC and continued:
I have read the Specimen Cases set out in the 1939/40 Report. The details given seem bad enough, but they might be made to prove too much. The culling of six special cases from a poor city like Dublin could easily create a false impression. Moreover, I would not be satisfied that there is no exaggeration at work. I profoundly distrust every word and action of one of the Society’s Inspectors, Mrs XX. I go further and I say that I regard her as a danger. She is quite capable (by which I mean that she has already done it) of distorting facts to suit any point of view she is trying to make. She exercised an ascendancy over ex-Justice YY, and between them they simply shovelled children into Industrial Schools. I consider that no proper attempt is made by the Society to restore a home or keep a home together. This was the view held by Fr. Tom Ryan, SJ who before his transfer to Hong Kong took a keen interest in juvenile delinquency and practically lived in the Courts. He gave it to me as his considered judgment based on his long and detailed observation that the Charter of the Society for the PCC should be withdrawn, that the Society constituted a public menace. Mr Charles J Joyce, who has considerable acquaintance with the courts, has raised something similar with me.
The ISPCC counteracted these criticisms of exaggeration of cases and wilfully committing children to Industrial Schools by saying in its statement that ‘In reviewing the information available in this case, it is difficult to comprehend how any allegation of exaggeration could be upheld’. With regard to the allegation that the inspector’s behaviour was bringing about the committal of children:
It is certainly not possible for us to comment on his allegation except to say that our review of material verifies the Society’s ongoing philosophy of keeping families together and rigorous attempts to support the preservation of family integrity as illustrated in the numerous examples quoted throughout this statement and borne out by the statistics. The extent of referrals by a range of other agencies and the numerous approaches by families themselves seeking assistance from the Society demonstrates a high level of public and professional confidence in the organisation.
Furthermore, in 1952 there was an allegation that NSPCC inspectors were taking bribes as an inducement to send children to Industrial Schools. This was revealed in a Visitation Report of 1952 in respect of St Joseph’s Industrial School, Tralee. The Congregational Visitor had expressed concern about the payment of expenses to two NSPCC inspectors, but he was informed by the Superior of the school that the payment was a subscription to the Society’s funds.
The Society throughout the 1940s and 1950s was at pains to rebut this image of being overly eager to commit children to Industrial Schools. They pointed out again and again in their reports that committal was seen very much as a last rather than a first resort. The annual reports of the Society down through the years reiterated that the home rather than an Industrial School was the best place for children to be brought up in, no matter how good the institution was. The 1948–49 Annual Report of the Dublin Branch of the Society stated:
During the year we have had to arrange for the placing of a large number of children in Industrial Schools, chiefly because their parents were unable to maintain them, but in some cases because their home conditions were so undesirable as to make it necessary to remove them. There is no doubt that in these schools they receive care and attention and a sound education, and are brought up to be useful members of the community. Nevertheless, however grateful we may be for the devoted work of the Orders which conduct these schools, it must be recognised that the children are to a large extent deprived of home influences, and that it would be much better if we could avoid sending them to such institutions. If their own homes are impossible, good foster homes would give them a healthier and happier introduction to life. It is, however, seldom possible to find such homes, in the cases presented to the Society.
In their 1951–52, Annual Report they stated:
It is a clear working rule in all our cases that where the question of committal arises, that every effort must be made to find some other solution and committal is only sought or advised when there is no other way out.
Again in its 1953–54 Annual Report, the Society defended itself against growing criticism that they were overly zealous in committing children to Industrial Schools:
But in spite of what we have written in former reports, there seems to be a mistaken impression in the minds of many people that we regard the committal of children to Industrial Schools as a sovereign remedy for unhappiness or unsuitable conditions in the home. A poor home, they say, is better than no home. Now it is a clear working rule in all our cases where the question of committal arises, that every effort must be made to find some other solution, and committal is only sought or advised where there is no other way out.
The ISPCC in its Statement pointed out:
There does not appear to be records of the actual numbers of applications/ committals of children by ISPCC to industrial schools in each year. However annual reports do indicate that this was a small element of the work carried out by Inspectors. What is clear is that the Society’s philosophy was to work alongside parents whenever possible…
However, according to one of the social workers recruited by the ISPCC in the late 1960s, some of the cruelty men were too quick to seek committal and not sufficiently flexible and imaginative in seeking alternatives to the schools: they took the view that the schools were safe places, which turned out well-behaved citizens and that this was all that needed to be done.
An inspector had to follow set guidelines laid down in the Inspector’s Directory before committing a child to an Industrial School. The inspector would have to inform the honorary secretary of his respective branch of his intention to bring committal proceedings and the central office of the branch would also have to be informed and give their consent to the application.
From the records available, the ISPCC do not have any information to indicate that inspectors visited these schools or were familiar with them. It was not the policy of the Society to follow up on children who had been placed in Industrial Schools. The Society was aware of the stigma that attached to children who were put into these institutions and the view society had of them, particularly when they would leave the schools in search of employment. The Society, however, did not provide any form of after care for these children, nor was it engaged in thinking about it.
Alternatives to sending children to Industrial Schools
During the time period under consideration, primarily the 1930s to the 1960s there were very few alternatives to sending a child to an Industrial School if the problem could not be solved within the family. Foster care was not widely available and it appeared to be primarily for babies and young infants.
In its annual reports in the 1940s, the Society was aware that if financial assistance was directed towards helping families rather than paying a capitation grant to the schools, the children could be maintained at home and the cost to the taxpayer would be lessened. The annual reports spoke about the inadequacies of the social welfare provisions for families which hindered families from caring properly for their children’s needs. The 1947–48 Annual Report of the Dublin Branch made specific reference to this problem:
In previous reports we have drawn attention to the large number of cases where we have had to intervene to rescue children from the squalor and undernourishment directly due to poverty. No authority seems to have worked out for Dublin what should be considered as the poverty line, though there have been a number of private sample inquiries conducted in past years. In our Report for 1945-46 we indicated that a collation of such figures as were available showed that for the ordinary family to provide proper nutrition on a sum of 8/- a head should be made available for food alone. Even with the increases recently made in some of the allowances the amount available leaves many families well below the poverty line, on any calculation. A peculiar feature of the Unemployment Assistance Scale, which has brought a number of families to us, is the application of the maximum rate of allowance, viz. 38/- a week, even where there are more than five children. Even giving a man and wife and 5 children the allowances, plus 7/6 children’s allowances, this is clearly inadequate. Allowing for a moderate rent of, say, 5/- per week, the amount available per head, viz., 5/9 ½ is well below the minimum necessary to provide food alone. In the case of widow’s pensions the gap is still wider. It is true that in the worst cases the home assistance authorities sometimes intervene with an allowance for rent; but say nothing of clothing or bedding, much less for any less necessary amenities. It is small wonder that some parents give up the unequal contest and apply for the committal of their children to industrial schools on the grounds of inability to support them, when, as we have so often pointed out, they cost the public funds 15/- a head. If the parents were given, say, 10/0 a head, they could keep their children, who then would not be deprived of home influences, and the taxpayer would save 5/- a head. Possibly the worst feature of this short-sighted system is that the resultant under-nourishment is certain to produce a large crop of unemployable weeds, themselves in time to multiply and increase the dead weight round the neck of the taxpayer.
Again, in the 1948–49 Annual Report, the same point was emphasised:
In last year’s report attention was drawn to the undernourishment of large numbers of children owing to the fact that the allowances provided under the various Social Services, Unemployment Assistance, Home Assistance, Widows’ Pensions and the like, were insufficient to allow the parents to keep their children properly fed. The cases dealt with during the year disclose quite a number of instances in which there has been definite under-nourishment, owing to the fact that the parents or guardians of the children have been dependent on such allowances, and have been simply unable to support their children. There is a wide difference between the methods of administering Home Assistance in various areas, and a number of particularly glaring cases of inadequacy will be found below. Last year we drew attention to two aspects of this system. The first was that the family must often be broken up if the children are to be properly fed and clothed, so that they may grow up useful citizens. The second was that the resultant cost of providing for children removed from their parents on the ground of inability to maintain them is much greater than the amount which, if given in Home Assistance, or some other form of allowance, would enable the family to be kept together. We went on to point out the danger that the persistent under-nourishment of families dependent on various forms of public relief must result in the creation of whole families of unemployables. There is, however, a third aspect which has not been emphasised in the past, and that is the moral effect of dealing with these families under the methods pursued hitherto. The position of the family as the foundation of the State has been written into the Constitution of this country, and anything that tends to break it up should evoke the efforts of all the Social Services against such conditions; and these inadequate allowances are a constant cause of disruption of family life. It is to be hoped that this point of view will be appreciated in the future.
These pleas by the Society fell on deaf ears for the next three decades, and it was not until the 1970s that State assistance was finally given to families to help keep them together. The 1973 Annual Report of the ISPCC made reference to this:
it is a source of satisfaction to us that the comparatively recent recognition of the State’s responsibility to deserted wives and families and other changes contemplated to assist families in need are being brought about by the submissions and representations made by the ISPCC with the support of kindred bodies.
Finance
In 1963, the Government for the first time granted financial support to the Society and continues to do so to the present day. However, the ISPCC pointed out in their statement to the Investigation Committee that ‘The Society has always been dependent for survival on fundraising’.
Whilst fundraising was the main source of income for the Society, inspectors were prohibited from collecting money. The Inspector’s Directory stated:
Only under special circumstances and under instructions is an Inspector allowed to collect money, except collections under maintenance orders.
In the event of a contribution being made to an Inspector for the relief of a case he must remit the amount at once to the central office and await instructions as to its application. A receipt will be furnished to the contributor whose names and addresses should be sent with the remittance.
However in documentation discovered to the Commission from the Christian Brothers in respect of one of their Industrial Schools, St Joseph’s Industrial School, Tralee, there is a record of payments being made to two NSPCC inspectors in 1952. The Congregational Visitor to the school expressed concerns in his Visitation Report of 1952 that a payment of £9 was sought by one NSPCC inspector in respect of expenses. Reference was made to the bursar considering it to be more like a bribe to induce the inspector to bring boys to the school. The Superior was questioned about this payment and he stated that it was a subscription to the Society’s funds and this was the explanation that was given to the Visitor at the time. Reference was also made to another NSPCC inspector also seeking expenses and he was considered by the Visitor as ‘a well-known sponger’. The 1952 Visitation Report stated the situation as follows:
That Mr. X, local Inspector of the N.S.P.C.C., was having boys committed as exactly one year under their true age. When this complaint was made to me I enquired what interest this gentleman had in this falsification of documents and found that the Bursar had asked himself the same question earlier in the year, especially when he was asked to sign a cheque for £9 for X’s ‘expenses’. On being asked a third time for the cheque, the Bursar told him he felt compelled to protest against this payment as it seemed to him to be a bribe, or like a bribe, to induce X to bring boys to the school. The Superior then stated that it was a subscription to the Society’s funds.
The Superior of Tralee Industrial School had sought the advice of the Provincial in respect of the payment of expenses to NSPCC inspectors. He was told by the Provincial that a payment of £1 was to be paid to the inspectors as they incurred extra expense in bringing boys to the school as they travelled by car. However, one of the inspectors claimed that his expenses were in excess of £1 and so the Superior again sought clarification from the Provincial and only with his permission was any payment made. It is clear from documentation furnished by the Christian Brothers that the NSPCC inspectors in the early 1950s were accustomed to receiving payment for expenses. This clearly was in contravention of the rules laid down in the Inspector’s Directory quoted above.
Conclusions
- The NSPCC/ISPCC played an important role in committing children to Industrial Schools. The extent of this involvement cannot be accurately ascertained because of a lack of documentation, but it can be stated as being significant.
- It has been established by this Report and elsewhere that the main reason for children being committed to residential care was the poverty of their families. The obvious solution of giving direct aid to impoverished families in order to allow them to stay together was articulated by the Society as early as 1951. This would have meant a substantial saving to the taxpayer when compared with the cost of institutionalisation. The question should be asked why this debate did not receive wider attention throughout the relevant period and was only acknowledged in the 1970s.
Chapter 2
Gateways to the institutions
Section 1: Introduction
Many routes
In all, there were five bases on which a child or young person1 could be sent to a certified school. The first three of these, dealt with in this section, were: being ‘needy or destitute’, (though this was very much an umbrella term embracing further sub-categories), committing a criminal offence; and non-attendance at school. Each of these involved committal by the District Court. The remaining two categories, where no court was involved, are dealt with in later sections. They were: being sent by a local health authority; or, voluntary committal.
At the outset, three general points should be made. First, the statutory provision under which any particular resident might be committed could be quite random. For instance, in the case of a child, from a broken home, the most likely route would be by way of the court making a committal order on the basis of one of the many sub-heads of the ‘needy’ category. Thus, for example, if the child was breaking windows throughout the neighbourhood, one judge might say that the child was ‘unruly’; whilst another would blame the parents for ‘inadequate supervision’.
Another possible route arises from the fact that destitute children would be unlikely to see any advantage in attending school faithfully and, as the Kennedy Report para 11.4 sagely observed, ‘Truancy is often the earliest sign of family break-down.’ In addition, naturally, the court and the agencies bringing children before it tended to prefer the non-school attendance category to the offences category, in order to avoid stigmatising the child.
In short, in the case of many residents, the formal entry category to which they were assigned in the Department of Education annual reports numerical sections might seem more clear-cut than reality warranted, and this is something which should be taken into account in reading the figures that are set out in the various graphs and tables below. 2
Secondly, a significant part of the machinery by which children were sent to the schools lay in the agencies by which a child was brought before the court. For this purpose, a miscellany of persons and agencies, often part-time or unpaid and seldom trained, had grown up. These included: the Irish Society for the Prevention of Cruelty to Children (ISPCC), Gardaí, school attendance officers, and also Vincent de Paul Society members, parish priests; or children’s officers from the local health authority, possibly with guidance from Department of Health Inspectors. One of the flaws in the system was that the different elements seldom liaised effectively; for instance, health authorities hardly ever exercised their right of audience before the court.3
Thirdly, in respect of each ground of entry covered in the next three sections, the available alternatives to sending a child to an Industrial School are considered and consideration will be later given to the extent to which these were taken into account.
Section 2 ‘Needy’ children
Part I: The legislative framework
For the entire period under consideration, the governing law was section 58(1) of the Children Act 1908 (as amended by the Children Acts 1929 and 1941), by which a child could be committed to an industrial school if he:
(a)is found begging or receiving alms…;
(b)is found not having any home, or visible means of subsistence, or is [found] having no parent or guardian, or a parent or guardian who does not exercise proper guardianship; or
(c)is found destitute, not being an orphan and having both parents or his surviving parent, or in the case of an illegitimate child, his mother, undergoing penal servitude or imprisonment; or
(d)is under the care of a parent or guardian who, by reason of reputed criminal or drunken habits, is unfit to have the care of the child; or
(e)is the daughter…of a father who has been convicted of an offence of [sexually abusing his daughters]; or
(f)frequents the company of any reputed thief or of any common or reputed prostitute(other than the child’s mother); or
(g)is lodging or residing in a house used for prostitution…
By section 58(4) of the 1908 Act:
Where the parent … of a child proves to a [District Court] that he is unable to control the child, and that he desires the child to be sent to an industrial school … the court, if satisfied on inquiry that it is expedient so to deal with the child, and that the parent understands the results which will follow, may order him to be sent to a certified industrial school.4
One can summarise this intricate legislation by saying that: some of these grounds focused on diverse forms of poverty and need; some on a parent (or another person) being a bad influence on or abusing or neglecting the child; and some on a mixture of the two. Yet there was inevitably a good deal of overlap: poverty begat parental neglect and the reverse was inevitable too.
Subsequent legislation expanded the 1908 Act in two main respects.5 First, sub-paragraph (c) (‘is found destitute’) was in fact rather narrow in that it required the child’s parents to be in prison. The Children Act 1929 (later re-enacted in the Children Act 1941, s 10(1)(d)) in effect widened this category by providing that a child could be committed, provided that two further conditions were both satisfied: first the child ‘is found destitute and is not an orphan and his parents are or his surviving parent or, in the case of an illegitimate child, his mother is unable to support him’. And secondly, if ‘both parents consent or the court is satisfied that a parent’s consent may be dispensed with owing to mental incapacity or desertion’.6
The need for this change arose from the nineteenth century assumption reflected in the 1908 Act that the Industrial School system was meant primarily to deal with offenders whereas children suffering from parental neglect or poverty cases were to be dealt with under the ordinary Poor Law, which usually meant that the child went to the workhouse. With the development of what was by the standards of those days, a more liberal social outlook, committals on the grounds of poverty alone grew. At first, this change was effected covertly. For example, in the late nineteenth century when it was desired to have a child whose parents were too poor to rear it committed to an Industrial School, it became the practice for a social worker to give the child a penny outside the court and then have it committed for ‘receiving alms’ (under s 58(1)(a) of the Children Act 1908). Thus the 1929 Act theoretically had the effect of removing the stigma that a child, whose only crime was poverty, had to be found guilty of an offence, before he could be sent to a school. It did this by allowing the committal of a child for ‘destitution’.7 This provision of the 1929 Act was struck down in 1956, in Re Doyle.
The facts of this case may be briefly summarised as follows. Evelyn Doyle was born in 1946. In 1953, whilst her father, Desmond Doyle, was unemployed, his wife left the family. In 1954, her father consented8 to an order being made under section 10 of the 1941 Act for the committal of Evelyn to a school. His wife’s consent was dispensed with by the District Court and Evelyn Doyle was committed until her 16th birthday.
Later in 1954, Desmond Doyle obtained permanent employment as a painter. Accordingly, he applied to the Minister for Education to have his daughter discharged from care. Section 10 also provided that where the parents of a child were able to satisfy the Minister of Education that they were able to support that child, the Minister was obliged to order its discharge. The Minister refused to order the child’s release.9 Mr Doyle brought an application for judicial review in the High Court against the Minister’s refusal ([1956] IR 217). This case turned only on the wording of the 1941 Act. The claim failed on the basis that, according to the wording, the Minister’s power to discharge depended on the application being made by both parents, unreasonable as this might seem in the present case.
Mr Doyle tried again in a second set of proceedings, this time involving the Constitution, and succeeded in both the High and Supreme Court. The case was decided in 1956; though reported only at [1989] ILRM 277. Mr Doyle claimed that the detention of his daughter under section 10 was invalid as being repugnant to Articles 41 (The Family) and 42 (Education) of the Constitution, the distinction between which is not significant. He made this claim because the section seemed to enable a parent to deprive himself of what by Article 42.1 is declared to be his ‘inalienable right and duty’ namely to provide according to his means for the…education of [his] children’. The court put a good deal of weight on the notion that the parents’ right could not be alienated.
However, it is important to emphasise that up to Re Doyle, a great number of those committed were committed under the destitution coupled with parental consent ground. Speaking on this point, in the Seanad debate10 the Minister for Education, T Derrig, emphasised that he, at any rate, saw this consent requirement as an important point of principle and resisted an opposition amendment, which would have infringed it.
A further extension (also made by s 10(1)(d) of the 1941 Act) was that a child could be committed if under the care of a parent or guardian who had been convicted of an offence under Part II of, or mentioned in the First Schedule to, the 1908 Act in relation to any of his children. Cruelty was widely defined so that this head could have been, though in practice, was not, used to commit children whose parents were not positively cruel but were feckless or irresponsible or otherwise not looking after their children properly.
Yet the precise scope of these legislative categories11 probably did not make a significant difference in the numbers of children committed. The reason is that on one side there were the circumstances of dire poverty and often few alternatives to the schools and on the other side the schools were willing and sometimes eager to take the children. In this type of situation, the drafting of the legislation could make little difference. Moreover, the legislation had to be couched in broad subjective terms, and was never the subject of High Court, or even Circuit Court interpretation. As a result it was open to being interpreted in many different ways.12 Finally, as between the different sub-categories, there was no reason to draw nice distinctions when the consequences were the same. Thus it would seem precious to attempt a legalistic exegesis of the legislation.
And so throughout this report, including the later statistical section, a single united category of ‘needy’ is used which embraces all the sub-heads of section 58, outlined here, including where the child was out of control.
Section 3: Offenders
Part 1: Reformatory or Industrial School?
The second largest category of those committed were children or young persons who had been involved in an offence. The first issue here is on what basis was it decided to send a young offender to an Industrial School or a Reformatory. The main answer is age. The practice in this area can best be explained by considering the cases in three categories, according to age.
(1)A child under the age of 12 could not be sent to a Reformatory School, only to an Industrial School, and indeed the records show few children below the age of 12 being committed for offences, even to an Industrial School.
(2)A child of 12 or 13 (or after 1941, 14) could be sent to an Industrial School provided that the child was a first offender, there were ‘special circumstances’ as to why the child should not be sent to a Reformatory, and the child would not ‘exercise an evil influence over the other children’. In fact despite these conditions, children under 15 years were usually sent to Industrial Schools.13
(3)It was not open to the court, under the Act, to send the offender aged (after 1941) 15 or above to an Industrial School. Thus if a custodial sanction were to be selected, for offenders between the age of 15-17, the only option (apart from very serious crimes) was a Reformatory (1908 Act, s 57(1), as amended by 1941 Act).
Thus the Reformatory School was reserved for the tougher type of boy, who became eligible for committal between the ages of 12 and 17 (or 16, before the Children Act 1941, s 9). After the 1941 Act took effect, the legal period of detention was between two and four years. Before 1941, the equivalent was three to five years. However, the period of actual detention was usually no more than one or two years, provided that the offender’s behaviour and home circumstances were satisfactory. By contrast, children committed to Industrial School were invariably sent until they were 16.
As indicated in Table A below, the practice was that offenders were committed to a Reformatory only following a straightforward conviction.14 By contrast, those sent to an Industrial School were committed when they had been charged ‘with an offence punishable in the case of an adult by penal servitude or a less punishment and the court is satisfied that the child should be sent to a certified school’ with no conviction being recorded (1908 Act, ss 57 and 58(3)).
The position here is complicated by the fact that several ways of treating the offender were open to the District Court. In practice prosecutions against children or young persons heard by any court other than the District court were negligible, especially in the context of committal to a school. Committal to a Reformatory or Industrial School were just two among several possible sanctions and the range of sanctions was available irrespective of the particular offence committed15 since, in the case of young offenders, the law is more concerned with the offender than the offence.
Part 2: Alternative sanctions
The figures
The issue that is under examination here concerns one criticism which has been made of the schools system, namely that greater use ought to have been made, of the alternatives to the schools. To test this claim, the figures that show the use which actually was made of the various sanctions are presented below, in order to show the committal orders in their numerical context. Unfortunately only figures for a relatively brief period are available.
Table A: Juvenile offenders
| Year | Persons proceeded against | Charge proved, and order made but without conviction | Convicted | Not con-victed | Misc | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total | Male | Female | 1) Dis-missal | 2) Recognisances | 3) Pro-bation | 4) Committal to Industrial Schools | 1) Imprison-ment | 2) Place of detention | 4) Fine | 5) Reformatory Schools | |||||
| No | % of ‘Charges proved without Conviction’ | No. | % of persons convicted | ||||||||||||
| 1948 | 2,630 | 2,379 | 251 | 1,428 | 239 | 230 | 94 | 4.7 | 102 | 66 | 154 | 141 | 30 | 174 | 2 |
| 1950 | 2,453 | 2,293 | 160 | 1,490 | 167 | 116 | 68 | 3.6 | 108 | 59 | 141 | 114 | 26.8 | 187 | 3 |
| 1951 | 2,702 | 2,493 | 209 | 1,676 | 136 | 114 | 93 | 4.4 | 89 | 66 | 223 | 93 | 19.7 | 211 | 1 |
| 1952 | 2,341 | 2,157 | 184 | 1,426 | 102 | 60 | 93 | 5.5 | 93 | 63 | 251 | 88 | 17.6 | 161 | 4 |
| 1953 | 2,474 | 2,281 | 193 | 1,417 | 140 | 70 | 88 | 5.1 | 96 | 104 | 293 | 105 | 17.4 | 158 | 3 |
| 1954 | 2,057 | 1,918 | 139 | 1,216 | 101 | 65 | 71 | 4.8 | 80 | 79 | 246 | 80 | 15.8 | 98 | 21 |
| 1955 | 2,138 | 1,973 | 165 | 1,249 | 101 | 51 | 66 | 4.4 | 66 | 74 | 302 | 78 | 14.4 | 132 | 19 |
| 1956 | 2,467 | 2,294 | 173 | 1,283 | 85 | 51 | 75 | 5 | 100 | 174 | 405 | 124 | 14.9 | 142 | 28 |
| 1957 | 2,356 | 2,188 | 168 | 1,323 | 85 | 34 | 53 | 3.5 | 73 | 92 | 394 | 93 | 13.4 | 165 | 44 |
| Total | 21,618 | 19,976 | 1642 | 12,508 | 1156 | 791 | 701 | 41 | 807 | 777 | 2409 | 916 | 170 | 1428 | 125 |
| Average | 2,402 | 2,219.50 | 182.44 | 1389.7 | 128.44 | 87.8 | 77.8 | 4.5 | 89.6 | 86.3 | 267.6 | 101.7 | 18.8 | 158.6 | 12.5 |
Note: The key information here is in column 4 of ‘charge proved …’. This gives the figures for those committed and the percentages that this constitutes of the total numbers for those against whom the ‘charge was proved and the order made but without conviction’. The equivalent for Reformatories is column 5 of ‘Convicted’.
Table A was compiled from the Gardaí annual reports. Minor categories have been omitted, for instance figures for those who were committed to custody of a relative; convicted and entered into recognisances, or whipped.
The table shows that for the years it covers, there were more than 21,000 charges against juvenile offenders. The main feature of the table is the division between those convicted and those against whom the ‘charge [was] proved and the Order made without conviction’, with a small category of ‘not convicted’. The division in principle between the first two categories was that in the second no conviction was recorded. In practice, the division between the two categories was very subjective and imprecise. However a reasonable generalisation would be to say that it was thought appropriate to send the more serious offenders, perhaps those who had committed more numerous or more serious offences, to Reformatories and, to achieve this result, the law required the offenders to be ‘convicted’ though here one should bear in mind the difference between the two types of school being only one of degree. For present purposes, the importance of the table is the indication it gives as to what fraction of those who come before the court were sent to one or other of the Schools.
As can be seen, in the first category of ‘Charge proved but no conviction’, the largest group was simply ‘dismissed’. In the next most numerous class, the offender or more usually their parents entered into recognisances. Thirdly, the child or young person might be put on probation. Committal to an Industrial School came only in fourth place, being imposed on an average of 4.5 percent of those in this category.
Among the other category – those convicted – the most numerous group was fined, with those committed to Reformatories in the second most numerous group, constituting an average of 18.8 percent of those convicted
In reading these figures one should note that the age groups involved for the two types of schools are different. Broadly speaking, Industrial Schools were for the 7-15 age group and Reformatories usually for the 15-17 age group. However, whichever of the groups is considered, only a small fraction was sent to a Reformatory or Industrial School. The conclusion to be drawn is that, in general, District Justices did exercise some judgment and discrimination before they sent an offender to a school: they sent them only in relatively few cases.
In line with this conclusion, Tuairim 15 remarked:
Though proportionately more boys were detained or remanded in Ireland than in England, fewer (1:25) were committed to residential schools for indictable offences. This could mean that either boys committed fewer offences in Ireland, or that Irish magistrates are much more reluctant than English magistrates to commit boys to residential schools. The general impression we have gained from conversations with people directly concerned with juvenile offenders in Ireland is that the latter is the case.
Alternatives to the schools
The significant point for present purposes, however, is that a substantial minority were committed to the schools and the question remains whether, given the circumstances of a particular case, it would have been practicable to make greater use of the alternative sanctions.
It is worth giving the full list of the alternatives with brief comments (in italics), directed to the question of whether the District Justices could realistically have made greater use of the alternatives so as to commit fewer children or young persons?
(a)Dismissing the charge: this option was commonly adopted for first, second or third offenders. However as the offences committed by a particular offender built up, this was usually regarded as not practicable.
(b)Whipping in the case of a male (not a female)16: this punishment was probably never, ordered.
(c)Committing the offender to custody ‘in a place of detention provided under this part of this Act’17 or an approved Industrial School (the ‘place of detention’ was Marlborough House). This course was not satisfactory. Marlborough House was purely a home of detention and was not equipped for training or educating boys. The recreational facilities were so limited as to be practically non-existent. More important, no proper segregation existed, to separate boys of tender years from youths, some of whom had serious criminal records.
(d)Dismissing the offender on his entering into a recognisance; ordering the offender’s parent or guardian to give security for his good behaviour; or ordering the offender or his parent or guardian to pay a fine, damages or costs: each of these financial penalties usually did not offer viable alternatives simply because the children who went to certified schools came from an impoverished family.
(e)The District Court also had a frequently used discretion (under the Probation of Offenders Act 1907, s 1) simply to adjourn the case on the basis that if the accused committed no further offence, nothing further would be said. As with option A, when the offences of a particular offender built up, this ceased to be practicable.
(f)Discharging the offender and placing him under the supervision of a probation officer; or committing the offender to the care of a relative or other fit person (1908 Act, ss 58(7), 21(2)).
What emerges from this brief analysis is that the only viable alternatives, which might have been used to reduce the numbers of juvenile offenders sent to the Schools were the two options mentioned at point F. Accordingly, we turn now to consider these two possibilities in more detail.
(1) Probation
The Probation of Offenders Act 1907, sections 1 and 2 (see also 1908 Act, s 60) was directed at a situation in which, although ‘the Court thinks a charge is proved, it is of the opinion that, having regard to [a number of specified factors, among them “age”], it is expedient not to inflict any punishment’. No conviction was to be recorded and, the court could either dismiss the charge or discharge the offender ‘conditionally’. The first of the two possible ‘conditions’ would be to dismiss the charge on condition that the child promised to behave himself and agreed to come up for conviction and sentence if called upon to do so. Alternatively, the District Justice could put the offender under the care of a probation officer for a specified period, usually not less than a year. Where a District Justice had no probation officer attached to his court, he obviously could not invoke this supervision. This is why, in many country districts, justices used the first alternative, in the form of a six-month adjournment, to see how the offender behaved.
The major problem with a greater use of probation, as an alternative to committal to a school, was simply that there were so few probation officers. Between 1936 and 1945, the number was gradually increased to eight – but during the 1960s until 1969, there were only six, compared with, for instance, 50 in Glasgow. Furthermore, the time of these officers had to be divided among children and adults. Each handled a case-load of, at any particular time, of 40 plus juveniles, which included visits to homes, plus preparing reports in advance of sentence. Another significant limitation is that, up to 1969, all the professional officers were in the Dublin County Borough, although in Limerick City, District Justice Gleeson had secured the appointment as probation officers of some staff from the St Vincent de Paul Society and the Legion of Mary, for boys and girls respectively.18 In 1969, there was a significant increase in the number of probation officers and, for the first time, probation officers were assigned to provincial centres. By 1974, there was a total nationally of 80 probation officers.
The result of this lack of probation officers was that, for instance in 1957, of 1,444 children given ‘the benefit of the Probation Act’, only 34 could be put under supervision by a probation officer. By contrast, in England and (to a lesser extent) Northern Ireland, probation even by the inter-war period, was extensively used and proved successful in preventing re-offending.19
Given the lack of resources in Ireland at the time, money spent on the salaries of additional probation officers would have been well spent in terms of reducing the number of young offenders who had to be committed to a School.
(2) Fit person order
Where a court was empowered to send a child to an Industrial School, it could if satisfied that it was expedient so to deal with him, instead of sending him to a school, make a ‘fit person order’: section 58(7) of the 1908 Act. The effect of this would be to commit the child ‘to the care of a relative or other fit person named by the court’ who would exercise the same powers and responsibility towards the child as a school would have done. However, up to the 1970s, this was effectively never used. The Kennedy Committee wrote:20
From our enquiries this Committee is aware that no “fit person” orders have been made by the Children’s Court for many years and the Committee think the failure to make use of the ‘fit person’ procedure was probably due to the unwillingness of friends or relatives to undertake responsibility especially where there is no financial assistance.
The last phrase seems to suggest that if official funding had been available, persons willing and able to act as fit persons might have been found. However, as is clear from other examples, there was little thought going on in the field of childcare; so that no such experiments were tried. 21
The Gardaí
In the ‘needy’ or school attendance categories, the agencies by which the children were brought before the court were specialists, in the sense that their primary concern was the problem that had brought the children before the court. By contrast, where committal was on foot of an offence, the equivalent agency was the Gardaí. The Gardaí were generalists who also had to deal with a large number of other problems that were regarded as more important.
This would mean that the focus on what today would be called ‘juvenile justice’ would vary, depending on what other calls there were on Garda attention. Coupled with this, there was a good deal of discretion, with no consistent thought or policy22 as to when a juvenile should be prosecuted and when he should be let off with a caution or a cuff. In practice, most of this discretion resided in the investigating or arresting officer, usually at the relatively low level of garda or sergeant who would know most about the child’s background. As to prosecution in Dublin, this was mainly done by the arresting officer, usually at garda or sergeant level; in the provinces it was done usually by a superintendent. Thus in Dublin whether a child was brought to court depended a good deal on the ‘feel’ and possibly ambition of the particular garda who happened to make the arrest or deal with the offence. This may have been one of the reasons why the rate of prosecutions per head of population was so much higher in Dublin than the provinces. Outside Dublin, committal to a school for an offence was by no means common and retired officers could recall, 40 years later, individually, starkly and often regretfully, the few cases, leading to committals, for which they had had responsibility.
Some improvement was effected by the introduction of the Juvenile Liaison Scheme23 in 1963. The juvenile liaison officer – or ‘the caution man’ as many young offenders called him – was introduced to Dublin in the Autumn of 1963 and subsequently in Cork, Limerick and Waterford. In essence, ‘the caution man’ was a young garda who steered the first offender away from prosecution and court appearance and then kept an eye on his behaviour. Put simply, the JLO was a sieve, as a result of which many young offenders did not come before the court at all. Instead, they and their parents were brought before a superintendent and, in effect, ‘told off’. Several thousand youths were cautioned under this scheme.24
Section 4: Non-attendance at school
For the period under review, and in fact up until the Education Welfare Act 2000, the governing statute was the School Attendance Act 1926.25 This Act26 made it an offence for a parent to fail to send to school any child, below the age of 14 (from 1972, 1527). Moreover – and here is the significant point – if the parent was convicted of a second offence within three months of conviction for the first, the court could ‘if it thinks fit’ either send the child to an Industrial School or make a fit person order’.28 (For reasons explained earlier, the ‘fit person order’ was not regarded as a practicable alternative.) The thinking seems to have been that this would be a way of ensuring education for such children.
There were two different systems for enforcement. In the four big towns (Dublin (five areas, each with a Committee), Cork and Waterford county boroughs and Dun Laoghaire non-county borough) the enforcing authority was the school attendance committee. The committees had a membership of 10 or 12, some appointed by the Minister and the remainder by the local council; some of the members had to be chosen from among local school managers or teachers. More important, the committee functioned through full-time school attendance officers. Secondly, outside these centres of population, there were no committees or full-time SAOs. Instead the SAO was a local garda (sometimes the same officer who was also JLO; see para 00), who took on this duty, as one among many other tasks.
While the mode of operation was in principle the same, between the area in which there was a the full-time SAO and the area in which the work was carried out by a garda, in practice there were significant differences, since the SAO naturally had more time to spend on the work. Much of the SAO’s work consisted of visiting schools on a regular basis, it might be twice a week or once a month, depending on the particular school. The SAO inspected the school register. Where there was absence from school, this led to home visits, possibly over a period of months. This might also have prompted visits to doctors or clinics to check the reason given for the absence.
The school attendance officer was often the first State agent to get a glimpse of a family situation that later could involve the other support agencies. He (and it usually was a male) might find: a working mother who had to leave the children to get themselves off to school; a widow struggling on welfare pittance who was driven to putting a 13-year-old boy out to work; or a large family which was forced to keep the oldest girl at home to help with the babies – or any other of the multiplicity of problems disruptive of family life.
It was the school attendance officer’s job to give a warning to the parents (often again and again). If this failed then the parents and the child might be brought before the committee (in the parts of the country where there was a committee) for further warnings. If there was still no improvement, the parents were summoned before the court and usually fined. And if and when this happened twice and still the child had not attended school regularly, the SAO office might make application for the child to be committed to an Industrial School.
While information on how this enforcement process worked in practice is not plentiful, the available data suggests that it was widely applied from 1927 onwards, that this application intensified in the 1940s and continued at a fairly high level until well into the 1950s. It also suggests that the initial stages of the process – visits to parents and the issuing of formal warnings by school attendance officers – reached very large numbers of children and parents. The numbers experiencing the intermediate stages – court summonses and fines, which were typically of 5 or 10 shillings – were much smaller, while the third and final stage – committal to an Industrial School – was applied to an even smaller fraction of those who appeared in court.29
The numerical information available is best presented in two parts. First, as to national data relating to court prosecutions of parents, Graph 1 shows the trend in court prosecutions under the School Attendance Act, from 1930-80. The annual number of national prosecutions ranged between 6,000 and 7,000 for most of the 1930s before shooting up in the early 1940s to peak just below 13,000 in 1944. Subsequently, the numbers fell back to the level of the 1930s before beginning a steep drop in early the 1950s.
Graph 1
Source: Statistical Abstracts, 1930-80 (Fahey)
Table 1 gives the figures for actual committals, again nationwide. The table shows that, compared to the numbers of convictions of parents in Graph 1, recourse to committal was relatively rare but was still significant and followed the same trend as overall prosecutions. In 1928-29 (not shown in the Table), 68 children were committed to Industrial Schools for non-attendance at school. Such committals tended to be fewer during the 1930s but they surged again by 1938 exceeding 100 and reaching 139 in 1939 and 129 in 1944 before falling back again in the late 1940s and 1950s.
| Year | SA |
|---|---|
| 1937 | 82 |
| 1938 | 105 |
| 1939 | 139 |
| 1940 | 110 |
| 1941 | 122 |
| 1942 | 111 |
| 1943 | 126 |
| 1944 | 129 |
| 1945 | 91 |
| 1946 | 91 |
| 1947 | 53 |
| 1948 | 84 |
| 1949 | 60 |
| 1950 | 59 |
| 1951 | 61 |
| 1952 | 55 |
| 1953 | 47 |
| 1954 | 34 |
| 1955 | 37 |
| 1956 | 61 |
| 1957 | 37 |
| 1958 | 56 |
| 1959 | 62 |
| 1960 | 69 |
| 1961 | 62 |
| 1962 | 44 |
| 1963 | 45 |
| 1964 | 37 |
| 1965 | 34 |
| 1966 | 39 |
| 1967 | 29 |
| 1968 | 2 |
| 1969 | 15 |
| 1970 | 23 |
| 1971 | 17 |
| 1972 | 21 |
| 1973 | 32 |
| 1974 | 31 |
| 1975 | 21 |
| 1976 | 18 |
| 1977 | 32 |
| 1978 | 24 |
| TOTAL | 2407 |
| AVE | 57 |
Source: Annual Department of Education reports
More comprehensive data on this system are available for the Dublin County Borough than for the country as a whole since annual reports of the Dublin city school attendance committees are readily available at Pearse Street Library as part of the Dublin County Borough’s archives. This information, which is presented in Table 2, shows that in some years the number of home visits by SAOs actually exceeded the number of 6-14-year-olds on the rolls; so, no doubt many of the visits were repeat calls to the same families.
Table 2: School Attendance Enforcement in Dublin CB, 1927-80
| Year | No of school attendance officers | No of children on rolls | No of visits To parents | No of formal warnings issued | No of court convictions of parents | No of children committed |
|---|---|---|---|---|---|---|
| 1927 | 18 | 52,967 | 49,429 | 1,592 | na | na |
| 1930 | 18 | 53,626 | 50,083 | 940 | na | na |
| 1935 | 24 | 81,120 | 68,699 | 669 | na | na |
| 1940 | 26 | 63,169 | 73,835 | 879 | na | 67 |
| 1945 | 26 | 66,295 | 74,298 | 2,524 | 1,095 | 74 |
| 1950 | 27 | 68,135 | 63,322 | 3,059 | 1,218 | 46 |
| 1956 | 27 | 73,277 | 64,343 | 4,086 | na | 75 |
| 1960 | 29 | 74,956 | 55,324 | 3,165 | 956 | 47 |
| 1965 | 29 | 80,637 | 49,720 | 1,691 | na | 25 |
| 1971 | 28 | na | 38,417 | 1,754 | na | 23 |
| 1975 | 28 | 95,212 | 32,890 | 1,029 | na | 21 |
| 1980 | 29 | na | 31,221 | 1,102 | na | na |
Sources: Fahy (notes omitted). We have added the committal figures in the final column.
It seems reasonable to infer from the tables, for both the nation as a whole and Dublin, that the children committed under the 1926 Act were not arbitrarily chosen. Rather there was a process with some flexibility, from visits to parents to formal warnings, through prosecution and conviction of parents twice, before one reached committal. 30 When it came to actual committal by the court, the number of adjournments was higher than for any of the other grounds of committal.
Yet, while not arbitrary, the system was severe and far-reaching: a striking point of contrast here is that the Tuarim Report shows that those admitted to approved schools (equivalent of Industrial Schools or Reformatories) in England in 1964 for ‘truancy’ numbered 45, compared with 66 in the same year in Ireland; although England had 16 times the relevant age cohort.
A largely Dublin phenomenon?
The overwhelming number of those committed for non-attendance at school came from the Dublin County Borough, out of all proportion to its population. (For the period 1949-68, the total figure was 901 (from Kennedy) of which the CICA survey showed that 781 came from the Dublin CB.) In other words, the Dublin CB, with approximately 24 percent of the national age cohort, yielded 86 percent of the committals under this head. Indeed, in 1941-42, 14 counties committed no children for non-attendance and T Derrig, Minister for Education, stated that non-attendance was almost entirely a Dublin problem.31
All this is so despite two striking points. The first is that Dublin County Borough non-attendance rates in primary schools appear from the recorded figures to have been steadily slightly below the national average. Take the period 1940-68, since it is the period for which there are sets of figures for both Dublin CB and the nation as a whole (though not for all years). For this period the average daily attendance rate in primary schools for 6-14 (the years for which school attendance was compulsorily) was 87 percent; whereas the equivalent Dublin CB figure was 88 percent. In almost every individual year too, the Dublin CB figure is higher than for the provinces.32
The second striking contrast is that throughout the country the internal Gardaí records for 1942-62 (excluding 1952 and 1956 that were not available)33 show a relatively large number of prosecutions and convictions of parents, under the School Attendance Act. Up to the 1950s, prosecutions of parents were even more common in the provinces than in Dublin County Borough. Thus in the mid-1940s, for example, when Dublin schools accounted for about one-sixth of 6-14-year-olds on the rolls nationally, court summonses for school attendance offences in Dublin were less than one-tenth of the national total. It remains something of a puzzle why up to the 1950s the Gardaí in rural areas chose to prosecute so many parents. Subsequently, however, the balance became reversed. During the 1950s, the Gardaí began to develop a resistance to school attendance work, leading to a sharp decline in court prosecutions of parents; whereas there was a rise in Dublin. By the 1970s, the great majority of prosecution of parents were brought by the school attendance committees in Dublin (and the other boroughs with such committees), rather than by Gardaí in the rest of the country.
The most significant question then is: why were more children brought before the court for committal, in the Dublin County Borough. The following four reasons are worth considering:
(1)The most obvious and probably the major factor is that in Dublin the school attendance officers were full-time; whereas in the country the SAO was34 typically one particular garda, in each station, acting on a part-time basis, who may have assigned the function less importance than other more urgent duties. According to a post-Kennedy Dublin County Borough SAO, some of his predecessors took ‘a callous attitude and did not hesitate and search for alternatives, sufficiently, before reaching for the drastic option of committal’. One retired District Justice said disapprovingly: ‘The SAO would say – “He was a great man for statistics – They’ve had fifteen warnings.”’ At the same time it is true that there were full-time SAOs in towns other than Dublin,. For instance in Cork City, in 1970, six SAOs were employed but in a response to the Kennedy Report, Cork County Borough noted that during the entire decade 1960-70 only three children had been sent to Industrial Schools.
(2)It may be that in a rural and (for the era under discussion) largely crime-free society, convicting the parents made a stronger impact than would be the case in Dublin and more often had the desired effect of causing the children to be sent to school. An alternative explanation could be that, in rural areas, both Garda knowledge and social pressure reinforced by the Church in favour of obeying the rules would, in the era under discussion, be significant. Thus the Gardaí would find it easier to encourage attendance without involving the courts. One feature of inner city Dublin emerged when a retired Dublin SAO was asked whether there was any pressure from the schools (meaning Industrial Schools who were looking for residents). To the question, as it was intended to be understood, he replied: ‘none whatever’. However, significantly, initially, he had misunderstood the question as referring to the national school, which the youth was failing to attend. On that basis, his answer was to the effect that such a youth might be a potential delinquent, disrupting the school and sometimes the school principal would encourage the SAO to get him sent away.
(3)There was probably some element of the courts making a committal under the guise of the School Attendance Act, although the real or main reason was that the child had committed an offence or offences. The reason for this subterfuge was in order to protect his reputation. There were more young offenders in Dublin so this effect might have inflated the Dublin figures.
(4)Another difference in conditions concerns a pupil’s difficulty in travelling to school in a rural area. Take, for instance, the response from a rural Garda station to a circular minute from the Commissioner. The query related to non-school attendance figures for the local national school. The response from the local Garda station put forward fairly strongly mitigating factors such as: pupils residing more than three miles from the school (so putting the pupils outside the scope of the Act); need to attend to farm tasks, like harvesting; the journey having to be made over the fields and marshes; bad weather or wet paths, making clothes damp so that the children contracted colds (in the pre-antibiotic or even in some cases pre-electricity era), at a time when a child might have no protective clothing. The memo concludes:35
Taking all the circumstances into account, I suggest that the average attendance in the Division [figures given at about 85 percent] was satisfactory during the period and that the enforcing authorities are carrying out their duties in a satisfactory manner.
Significantly, the assumption underlying the letter is that the purpose of the Act and the enforcement mechanism was to maintain a satisfactory general school attendance level, rather than being directed at particular individuals.
Concluding comment
In a way, non-attendance was the most extreme of the three major grounds for committal. Need was a ground with a complex of difficult causes and, thus, hard to resolve. As regards offences, it could be argued that there needed to be some sharp sanction to pull up multiple juvenile offenders. Non-attendance, however, was not such an extreme problem that it called out for an extreme sanction.
The enormity of committing a child for several years, simply for failure to attend school, was appreciated even at the time. For instance, the 1931-32 Department of Education Report noted an increase in the numbers committed on this ground and ‘again urged that the procedure….should be adopted only after every effort has been made to arouse both in parents and in truants a sense of the importance of complying with the provision of the Act’. One finds at the stage of the exercise of the Minister’s power of early discharge, strong advice by Managers, against the discharge of residents detained under the truancy ground, even in the conditions of almost total occupancy of school places in 1943. Though by the 1960s an increasing proportion of children committed for minor offences or offences under the School Attendance Act were committed for short periods. This change probably reflects the greater leverage of the Department on the schools, because of falling numbers.
It is striking too that if thought had been given to the problem, it would have been noticed that there was available a possible alternative, namely the ‘day industrial school’, as was suggested by the Cussen Committee. Yet, so far we can ascertain, it did not figure in any official or Order thinking. It was well-known concept that had been provided for, as a reform to earlier legislation, in the 1908 Act, and had been road-tested successfully in Scotland.
Perhaps the most staggering aspect of all this is the discrepancy between the rates of committals from Dublin County Borough and elsewhere. Four factors have just been considered as reasons for this discrepancy. It seems probable that the most influential single factor was the different attitude of the Dublin school attendance officers, compared with the Gardaí, in deciding whether to seek a committal. This is an arbitrary basis on which to determine the institutionalisation of so many children.
Section 5: A court
The involvement of a court
The question remains whether a court should have been the instrument through which children and young persons were directed to a Reformatory or Industrial School.
The original reason for this procedure goes back to the historical fact that the magistrates courts rather than local authorities were initially chosen as the agency that decided whether to make a committal, in the original (pre-Independence) 1858 Act. At that time it was local authorities that provided such rudiments of the welfare state as there were. For instance, the Poor Law Commissioners, acting through local bodies, administered the workhouses. So it would not have been off the map of official thinking if the function of committing children had been vested in local authorities.
However, there was a strong reason why it would have seemed essential that the children could be sent away only on the basis of a court order: it was an aspect of the rule of law (a later generation would speak of ‘human rights’) that when such an important issue as individual liberty was hanging in the balance, each case should be decided by a court.36 More especially was this so, when, in the nineteenth century, Industrial Schools were originally intended for offenders, whilst destitute children were to be dealt with under the ordinary Poor Law and, accordingly, many of the grounds of committal were cast as criminal offences.
The involvement of the courts in this field has been widely criticised37 and calls for three comments.
(1)In common with similar systems in other jurisdictions, committal may be regarded as the product of two distinct policies: on the one hand, to discover and strengthen the good in the youth’s character, on the other, to control an offender or anti-social element for the protection of the rest of society.
Whichever policy view was adopted, one result was common: namely that zeal for the civil or human rights of the person, the deprival of whose liberty was at issue, took second place to the priority of improving or controlling the youth.
Thus most of the usual safeguards that are the hallmark of the adult criminal justice system were denied to those whom a court was considering sending to an Industrial School. There was next to no legal representation and the facts relied on by the Garda/ISPCC Inspector/SAO were seldom controverted so that the issue of whether they had to be proved beyond reasonable doubt scarcely arose. Although there was an appeal, it was seldom used.
(2)Realistically, one must accept that the fine distinctions just mentioned between the District Court’s criminal and protective jurisdictions was understood by few people, whereas the entire virtue of law is that it should be clear and accessible to the layperson. Many former school residents have complained about being dragged through what they see as criminal proceedings (‘I have a criminal record and cannot be called for jury duty’ said one former resident) and condemned to detention for several years, despite the fact they had not been convicted of any offence. The features of the process that struck most people were that it was administered through a court, most of whose other business consisted of minor crime;38 and resulted in detention for several years in institutions.39
Likewise, Dennis O’Sullivan40 reports:
The residents regarded themselves as having been convicted of an offence in a court. As might be expected, not one pupil in the Interview Sample could list the official reason for his committal. They repeatedly defined the location of their prosecution and committal as a ‘court of law’ – the fact that it was held in a special building or a special room, on a different day or at a different time from the regular court sessions had no significance for them. One pupil summed up this interpretation quite vividly when he suggested to the researcher that when the “book” was finished, it should be called ‘Jailbirds’.
Members of the Letterfrack School staff, also stated that they did not like this method of committal. They said that even very young children remember appearing in court and talked about it among themselves. The general view was that committal through the courts was logical only if the schools were regarded as places of detention.41 In England, the Children and Young Persons Act 1933 had established a significant distinction. It confined the courts’ involvement with children or juveniles to those who were accused of an offence.
(3)Given the wider range of circumstances, which may underlie the child’s behaviour, ranging from their character to the environment of their upbringing – a more leisurely and informal examination of these causes was necessary than could be afforded at a court hearing. Thus it was one of the central recommendations of the Cussen Commission42 that before a Justice should make any order, the child should be examined by a doctor:
And if the doctor is unable to form a definite opinion, the Justice should, if the case was one calling for detention in a School, order the child to be sent to an Institution specially certified for such cases which we recommend in our Report should be established, where the opinion of the Chief Medical Officer whose appointment we also recommend, would be available.
In fact, this seldom happened at any rate before the 1970s.43
Concluding comment
In summary, this discussion shows that whatever the theoretical objective, in practice the involvement of a court meant that the committed child or young person incurred the inevitable disadvantages of identification with criminals, and having no thorough investigation of his or her circumstances. All this was without the usual advantage of due process.
Section 6: The hearing
Part 1 Children’s Court
The 1908 Act, 44 established for the first time, in Britain and Ireland, ‘Juvenile Courts’ to hear any indictable offence other than homicide against children and young persons (anyone under 17).
Post-independence, this jurisdiction was transferred to the District Court. In Ireland, the Courts of Justice Act 1924, went a step further. It retitled the court as the Children’s Court and made provision for the setting up of courts in separate buildings, in Dublin, Cork, Limerick and Waterford. However, only one such court has ever come into being. It was part of the Dublin Metropolitan District Court and was established in 1923 and situated in Dublin Castle, until it moved to Smithfield.
When the schools were in being, the Dublin Children Court sat every day (except Monday) and heard applications for committals to the schools on Wednesday mornings. In general, in the provinces, the Children’s Court sat weekly or less frequently. All cases involving applications for committal to Industrial Schools or Reformatories, school attendances (including convictions of parents and crimes committed by children) were heard on the same day though usually a different day or at a different time from the proceedings for adults. Such cases were also held in a private room separate from the ordinary court.
Then, as now, in order to reduce the formal trappings of the law and to try to create a less formal atmosphere, in the Children’s Court there was no dock and the Justice sat at a table instead of a dais and wore no robes. The police did not wear uniform. After their appointment (at first in Dublin), probation officers sat with the Justice and advised him on individual cases.
Only those directly involved in the case could attend the hearing. The only two exceptions permitted by the 1908 Act were anyone given specific leave by the court to attend, and the news media. By a generally respected convention, media reports of the Dublin MDC did not identify the child or young person; though this is not true of the provincial courts.45
Part 2: Procedure46
The hearing
The following impressions are based, in part, on several interviews with people who were District Court Justices or clerks during the 1960s as well as a study of the court records.
A hearing might last 5-15 minutes, though one should recall that for each application, even if ultimately unsuccessful, there would usually be more than one hearing.
The case in favour of committal was presented by the applicant. The applicant would be the ISPCC ‘cruelty man’ (or less often the Catholic Protection and Rescue Society) or SAO/garda. It depended on which ground was being relied on. The child was also present, but the big factor shaping the procedure was that the child was almost always unrepresented.47 Even by the late 1960s or early 1970s when larger social changes had reduced both the numbers committed and the period for which they were committed, there was not very much legal representation. What there was of it came more from students or young lawyers accessed through the newly-established (in 1969) Free Legal Advice Centre rather than under the criminal legal aid scheme.48
A parent (or guardian) was also required by law to be present and the mother frequently was before the court. The parent was usually uneducated and, in an age of deference, they were unlikely to be able to make the best of any case against committal.
In any case, as regards the facts, there was usually no reason to contest the evidence of the ISPCC Inspector or SAO49. Sometimes, the District Justice would ask sharp questions of the applicant. But in most cases, the only evidence was that of the applicant giving sworn testimony who would explain the circumstances of the case including family background to the court. There would seldom be any other evidence: in the nature of things a neighbour, for example, who had provided the initial information about cruelty or abuse, would not want this disclosed and the judge would usually accept the testimony of the applicant.
However, while the Justice would usually have no reason to doubt the basic facts adduced by the applicant, there would often be more to be said. This might be because the Justice considered that the circumstances, appreciation of which would involve a deal of subjectivity, were not as severe as the applicant believed, or because the Justice considered that some recourse other than the desperate remedy of committal, perhaps probation or, in the 1970s, intensive work on the family by a social worker, was possible, but there was a lack of relevant background information available to the court.50 There were, it is true, probation officers and part of their duty was to advise the court as to the home background of the child or young person before the court. However, for most of the period under examination there was a grave shortage of probation officers in Dublin and none in the provinces.
A recurring theme from many former Justices was that to commit to an Industrial School was a last resort. According to a former District Justice: ‘One didn’t commit if the home was in any way right.’ Few District Justices would make a committal without trying hard to find an alternative.
Frequently, a court would be used, probably knowingly, to put pressure on the parents to reach a satisfactory solution, without a committal order. Particularly common examples of the latter situation occurred in the school attendance category: the child and mother would be presented with a stark choice: the child must go to national school or Industrial School. This often had the desired effect. But also in the case of an offence, if a trivial or first offence were involved, there would be a summons and a lot of adjournments.
Selecting the school
By section 62(1) of the 1908 Act the Manager’s permission was necessary before a child could be sent to his or her school. Thus a suitable school, or if necessary, schools would be phoned or written to (in advance of the hearing) to inquire whether, if the child were committed, they had room for, and would accept, the child?51 Practice seemed to vary as to whether it was the District Court clerk or Gardaí/ISPCC man/SAO who actually made communication.
Equally, we know very little about the extent to which a Justice might favour one school over another. For instance would a Justice prefer a local school? What level of knowledge of the school had they? Were efforts made to keep children of the same family together?
When a school had been found for the child (who in some cases would have had no prior warning that they were to be sent away) they were taken there in a police car or under police escort. In addition the NSPCC (as it then was) stated, in 1941, that a woman would accompany all girls and boys under seven years.52
Although the court sent basic particulars of the child to the school – name, age, reason for committal – the school received no information of the child’s previous medical, educational or social history.
The Children (Amendment) Act 1957, section 5 provided for an appeal to the Circuit Court against a District Court committal order. The appeals were by way of re-trial (though the special provisions regarding the Children’s Court did not apply to the appeal53). It has not been possible to find court records indicating how frequently an appeal was taken or succeeded. However anecdotal evidence suggest that there were few if any appeals in the needy category; but there were some appeals, especially in the 1960s, in the case of offences, some of them successful. For school attendance committals, the annual reports for the Dublin County Borough area show that there were a few successful appeals in the late 1960s; but otherwise none.
Given the lack of legal representation, it is not surprising that, despite the complexity of the area, there have been no post-independence judicial review High Court cases discovered seeking to have a committal set aside on technical or jurisdictional grounds. There were, however, a significant number in the nineteenth century.54 (Possibly one reason for the difference is that the District Justices were lawyers and the magistrates were not.)
Part 3: The Justices and the schools
In determining whether to commit a child much depended on the Justice’s appreciation of the particular child and his or her circumstances. This was accepted on all sides, as can be seen for instance from the schools’ reaction to refusals to commit. Summarised here are some of the flash points between the schools and the District Justices.
The Justices of the Dublin Metropolitan District Court55 figured largely in these disputes. The schools deplored the reluctance of many District Justices to make committals or alternatively, to do so only after an offender had committed so many crimes that a school would have no rehabilative effect on him.56 In the 1960s, they complained, too, that committals were for too short a period for any good to be done.57
There were fundamentally different understandings of the objectives and potentials of the school. Some District Justices seem to have disapproved of the schools, regarding them as places of ‘containment’ to which children were to be sent only as a last resort. By contrast, the schools themselves would claim that the schools were primarily educational not penal, institutions, which could be successful in educating a child and saving him or her from a life of crime or misery. The Managers claimed too that the District Justices’ view had the potential to be a self-fulfilling prophecy since it meant that only ‘incorrigibles’ would be sent to the schools. The schools’ resentment occasionally led to protests to the Department of Education or Justice through their representative organisations. However because of the independence of the courts from the executive organ of government (an arrangement which the schools seem not to have understood or to have overlooked), these protests appear to have been batted away.
As early as 17th April 1936, the Christian Brothers Managers Meeting complained (because there had been a dip in numbers in the mid 1930s):
The general view of the Managers is that the numbers in the Institutions will decrease, and that as a result of this decrease, one or two of our Schools will have to be closed. While it is probable that the passage into Law of the Widows and Orphans Act is a contributory cause of the decrease in the numbers the belief is that Government Policy is the main cause. The Guards and the Justices have received instructions to be slow in committing children to Industrial Schools, and this policy of the Government is evidently directed by financial considerations.
Again, on 16th March 1950, Fr Ryan, Superior of the Oblate Order, wrote to the Department a letter complaining against the decline of committals. In response, MO’S wrote a private memo headed Scoil Ceartucain, Daingean on 29th April 1950:
Justices are very slow to commit boys to either Industrial or Reformatory Schools if they think there is any hope of improving them at home. They feel that these Schools do not fulfil the purpose for which they were established. They feel, like ourselves, that there is something wrong, in the system though they cannot suggest a remedy.
A prominent legal man who has considerable experiences of boys committed to these schools said recently (but not in public) that these schools were only ‘forming criminals’. If that is the experience it is no wonder that justices are slow to commit the boys.
A Departmental memo of 13th September 1955 referred to a complaint from Fr Reidy that no boys were being committed by Justice McCarthy58 to the Reformatory until the boy had been before the court for the fourth time. The memo continues:
As a result of this allegation to the Minister, together with the allegation that the District Justices generally were not carrying out the law sufficiently strictly in this regard, the Department instituted an inquiry into committals during the years 1953 and 1954. This inquiry found that in the Dublin Children’s Court during that period, of the total commitments of boys to the Reformatory, 23.33% were made on their first offence, 24% on their second, 29.33% on their third, 13.33% on their fourth, 2.67% on their fifth and 5.34% on the sixth or more than sixth offence.
On 18th May 1965, the Resident Managers Association took the unusual course of writing to the Minister for Justice to express their disquiet at ‘the set-up in the Children’s Court’. They said that they would ‘welcome an investigation into the present system under which the School Attendance Act is being applied ‘and asked the Minister to review a deputation to discuss the matters concerning them. The reply dated 25th May1965 from the Minister (Brian Lenihan BL) declined to meet a deputation because the subject of discussion would have been the exercise of a judge’s function. The reply continued:
On the other hand, it seems to me that it would be open to you to write to the District Justice [Carr] and ask him if he would meet you for a general discussion. But may I suggest that your letter should make it quite clear that what you wish to do, is to bring to his notice certain problems that arise in the Schools and knowledge of which would, you think, be valuable to him in exercising his discretion in the committal of children. And if I might offer (in confidence and with the intention of being helpful to you) a further word of advice, it would be to say nothing whatsoever that might seem to mean that you thought the School Attendance Officers in Dublin are not being treated fairly by the Courts. In the disputes that have arisen between them and the Court, I myself have no doubt that the District Justice has been fully justified and indeed has shown more forbearance than could reasonably have been expected of him.
(Unfortunately we have no information with which to explain the loose threads left hanging in this extract; in particular, we do not know whether there was a meeting with the District Justice.)
At a time of skirmishing around a claimed fee increase, a Department of Education official wrote a memo for the Minister in June 1964, which stated:
Managers constantly bemoan the fact that there are insufficient committals to make their schools economical, and this they attribute to the abuse, by District Justice, of the Probation Act. Many Managers feel that the Department should use its position to do something about this. But the Minister could hardly be expected to do anything that could be construed as interfering with the Justiciary (sic) and there is no way to compel courts to resort to committal in preference to the Probation Act.
Moreover, the view of the Department is that thinking both here and abroad is against long term detention in institutions which are situated in rural areas and are not equipped for psychiatric treatment, or the training of children from urban areas. In general, with the exception of Artane, they lack any kind of after-care or organisation. It is because the courts feel that the industrial schools do not achieve their object that as a result of pressure from the Department for Justice a new place of detention on modern lines is being set up to deal with youthful offenders committed for short periods. In any event it would be well to bear in mind that the Schools exist for the children and not vice–versa.’
It is significant that District Justices McCarthy (1941-57), and Kennedy (1968-83), who were the Dublin Children Court Justices for most of the period 1943-83, had expressed what might be characterised as somewhat critical views of the schools, while finding it unavoidable to commit many children to them. District Justices O’Riain and Eileen Kennedy were also known for the fact that they paid visits to the schools so that they knew something about conditions in the schools to which they were making committals. In particular, we have been told by her court clerk that District Justice Kennedy spent two or three days each year making personal visits to schools.
Attitude of the schools
At this point, we ought to make explicit a feature that is implicit at several points of this report. It is simply that, in general, the Orders encouraged the sending of children to the schools. It perhaps could be said that this was natural: over more than a century, the Orders and, in particular, Managers had invested a good deal of labour and idealism – as well as capital – in the schools. They wished to keep the schools going, mainly because they considered them a force of good, at any rate compared with the alternative fate to which a child would have been left. The inevitable result was that, irrespective of individual circumstances that might have seemed to tell in the opposite direction, the Orders exercised their influence in favour of sending children to schools and for a lengthy period. This is evidenced for instance in: private comments of the Department of Education; opposition to children being sent to the schools for a short period; private deliberations of the schools and their representative bodies including the schools’ reaction to District Justices’ occasional reluctance to commit.
The family backgrounds of many of the complainants to the Investigation Committee are set out in the sections dealing with the individual schools.
Part 4: Committal rates relative to applications
A rather straightforward way of testing the care taken by District Justices in deciding whether to make a committal order is to count the average number of applications compared to the number of children actually committed. One can then calculate the percentage of applications in which, despite the fact that the child was unrepresented, the court decided to refuse the application. These figures were not published in the Department’s annual reports but were collected in the survey done for this report. This has been done for each of the three grounds of committal by the court: need; offences; failure to attend school. However because of the fact that some of the court records were not available, figures mainly for the Dublin Metropolitan District Court have been collected.
In addition, interviews with those involved, contemporary District Court Justices and clerks, showed they were unanimous that a committal was by no means automatic. This bears out the impression which emerges from the statistics.
Committal rates in Dublin MDC for all three categories of committal
The rates are shown by reference to the three categories of committal (needy children, offenders and non-School attenders). Although the ratio started out in 1935 as very high for all categories, between 80-100 percent, there was a decline over the years. But there is marked difference in the rate of decline for the three groups. There was a rapid decline in the committal ratio for both the offences and school attendance offences group (down to about 35 percent by 1950). However, within seven or eight years, there was an increase in the committal rate for offences. This may have been a judicial reaction to the increase in the juvenile crime rate in the Dublin of the 1950s. The rate of decline in respect of committals on the ground of need was much slower: by 1950 the rate was still as high as 80 percent for this category and this was only slightly lower by 1970.
Why was there this discrepancy in committal rates between the three categories? One can suggest the following explanations. First, the rate of needy committals were high because, once need and destitution had been established, there was often little the Justice could do except commit and, unfortunately, no amount of procrastination would alter this situation. Secondly, with offenders, there were, as shown already, a large number of alternatives to committal to a school, much more so than with the other two categories.
Moreover there is a further point, namely that in the Dublin Metropolitan District Court, there was a particularly high number of adjournments in school attendance order committals, whether the child was ultimately committed or the case was dismissed. The exact number has not been determined, but it would not have been uncommon for there to be as many as five to eight appearances before a decision either way was finally taken. When one couples this with the fact already discussed of the low rate of committals to applications this means that, in reality, for every committal under this head, there might have been 20 court appearances. Probably, the District Justice, and perhaps the SAO, wished to give the child a fright so as to encourage him or her to go to school, without imposing the draconian sanction of a committal.
Provincial committal rates
The number of committals per head of relevant population was significantly lower in the provincial courts surveyed than in Dublin Metropolitan District Court. However, though with significant variations often from year to year and between different courts, the average rate of committals per application was higher than in the Dublin CB; though admittedly often this was with a mere handful of committals.
Section 7: The period of detention in the school
The basic question in this section is how long did a child who was committed to a school spend there? Part I, therefore, deals with the law and practice as to the period fixed by the court. Part 2 (on which see also Appendix 2) surveys the figures in order to determine the average length of time for which a child was committed. However it is a significant point that the Minister had discretion to release a child before the date fixed by the committal order. This subject – early discharge – is the subject of the following section.
Part I: Fixing the period in the committal order
For Reformatories, the ‘period of detention’ (the term used in legislation) was laid down as not less than two or more than four years or in any case not beyond the age of 19.59 In practice, the period of actual detention was usually between one and two years, provided that the offender’s behaviour and home circumstances were satisfactory.60
The position in regard to Industrial Schools was more complicated. Those committed by the courts, in practice the great majority of the residents, were committed until the age of 16.61
Thus the period for which any child or young person was committed by a court depended on their age at the time of committal. It is significant here that those who were committed for the category of ‘need’, the great majority, were often committed at very tender years indeed. Consequently, they had to reside for many years in both a junior and a senior Industrial School.
The fixing of the date of release in the committal order under the legislation appeared, clearly enough, to allow the court a discretion (‘…not in any case extending beyond…the age of sixteen years’) Nevertheless, up to the 1960s in the thousands of cases checked, in both the Dublin Metropolitan District Court and provincial courts, the Justice always did make the order apply right up to the time when the child would be 16 or, in the case of those committed for non-attendance at school, 14: the District Court judges and clerks who operated the legislation indicated that they believed that the order had to specify the period as running to the child’s 16th birthday.
It was not until late 1962 (rather suddenly) that, at any rate, the Dublin Metropolitan District Court switched to committing, in school attendance cases, until the child’s 14th birthday.62 About the same time, there were changes in respect of the other two categories. Offenders were committed for one or two years and in poverty cases, where children were young, they might be committed for a shorter period, presumably in the hope that their family circumstances could have changed in the meantime (a hope which earlier courts had not entertained in the apparently perpetual economic gloom).
This sea-change was reported approvingly in this extract from a Departmental memo of 15th November 1964, in anticipation of a meeting with Resident Managers Association:
District Justices are lately resorting to committals for short terms varying from a month to a year in the case of young offenders. Normally a young offender of say 10 or 11 years of age would be committed to age 16 which does seem a long period of detention whereas an 18 year old, for a similar offence, would be sent to prison for a month or two less remission.
Thinking both here and abroad is against long term detention in institutions which are situated in rural areas and are not properly equipped for psychiatric treatment, or the training of children from urban areas and in general with the exception of Artane lack any kind of after-care organisation. It is because the courts feel that the industrial schools do not achieve their object that as a result of pressure from Department of Justice a new place of detention on modern lines is being set up to deal with youthful offenders committed for short periods. In any event it would be well to bear in mind that the Schools exist for the children and not vice-versa.
By contrast the Schools took the view that a child had to remain in a School for a reasonably long period of time in order to gain from the education and training. The following is from a complainant who was sent to Letterfrack in January 1971 and remained there until January 1973:
The Justice said ‘I will give him three months in an industrial school. The Garda Sergeant said, no, they won’t take him for that. He says, I will give him 6 months, and he said they won’t take him for that. He said, how long will they take him for? At least two years. Right, he says, I will give him 2 years and that was it’.
Thus, up until the early 1960s, the net result was striking. In the case of a Reformatory School, an offender was sent away usually for one to two years, which was in line with a normal criminal sanction. By contrast, for committal to an Industrial School, the age of release was fixed at 16 and the length of the committal period varied depending upon the random factor of the age of the child at the date of committal. The justification offered for this variation is that committal was seen not as a punishment but as a period for which the child or young person needed protection or education until they were old enough to fend for themselves. In any case, the reality comes through in the following Dáil exchange:63
Deputy Dillon: May I bespeak the good offices of the Minister with special reference to this category of children so that they will not be left permanently in industrial schools….?
J Lynch: …the word ‘permanently’ might create a wrong impression. They would all be entitled to be released at 14 years of age.
Deputy Dillon: For the purposes of childhood, that is surely permanently.
There was a possibility of an extension so that a child could remain in the schools up to the age of 17 to complete their education or training.64 In practice, this was seldom invoked.
Part 2: The length of time for which children were committed
There are three distinct and rather different sources for the actual period for which residents were committed by the courts to Industrial and Reformatory schools. Basically each tells the same story. Accordingly only a summary is presented at this point.
Comparison of the three sources
The comparison between the three sets of figures are these. First those in Table B1 cover only residents sent from the Dublin Metropolitan District; whereas Tables B2 and B3 were compiled from schools throughout the country. Secondly, Table B1 covers all the Dublin MD residents; whereas, as explained, Table B2 was compiled for a sample only of the national population and then only for the 1951-60 period. The position regarding Table B3 is a little more complicated: it is confined to the 1940s and in one case is based on a 19 percent sample.
The figures in Table B1 are for a different period from those in Table B2. Accordingly, in order to compare them properly, the average period of committal according to the Table B1 figures for the 1951-60 period has been calculated, since this is the only period covered by the Table B2 figures. The average figures are:
| 1951-60 | Needy | SA | Offences | |
| Table B1 | Dublin MD | 6.5 | 4.8 | 3.5 |
| Table B2 | National | 8.8 | 4.2 | 4.1 |
Similarly, in comparing the figures from Tables B1 and B3, only the B1 figures for the 1942-51 period have been used, which is approximately the period covered by B3. The average figures are:
| 1942-51 | Needy | SA | Offences | |
| Table B1 | Dublin MD | 8.7 | 4.4 | 3.8 |
| Table B3 | National | 8.4 | 4.43 | 3.6 |
In fact, for each time period, the national and Dublin County Borough figures are very similar to each other. The only exception is that during 1951-60 the figures for the needy category in Dublin MD are shorter than the national figures. But, generally, the figures from the three sources are a consistent story: committal for the needy category of about 8 years; school attendance of 4-5 years; and offences 3-4 years.
Section 8: Early discharge
Part I: Early discharge by exercise of the minister’s power
Removal of children without consent
Children occasionally left their school without the consent of the Minister or the school: strictly speaking, this was illegal. Examples from the files include failure to return from holidays; removal of the children from the jurisdiction; and absconding. Examples of this kind of exit from the schools are dealt with in the individual sections on the schools.
The main subject of this section is early discharge by virtue of the Minister’s statutory power. A resident’s need to remain in a school depended very much on circumstances. For instance in the case of the needy category, the prosperity of the resident’s family might change over the relatively long periods involved, most obviously by the father obtaining employment or securing better accommodation.
In such circumstances a parent or guardian of a child detained in an Industrial School had the right to apply to the Minister for Education for the release of the child. The relevant legislation was, in the first place, section 69(1) of the 1908 Act65, which gave the Minister discretion to release any child or young person committed. Secondly, in contrast to the 1908 Act, the Children (Amendment) Act 1957, section 5 was mandatory, though it applied only in the case of those committed under section 58 of the 1908 Act, in other words, not offenders or those committed for non-attendance at school. It provided that where the Minister was satisfied that the circumstances that led to the making of the committal order had ceased and were not likely to recur, and further that the parents are able to support the child, the Minister was obliged to order the child’s discharge.
The 1957 Act was enacted by virtue of the Department’s understanding of the Doyle decision. A second consequence of Doyle was that the Minister was bound to discharge the child where a child who had been committed to an Industrial School under the provisions of the School Attendance Act 1926, had attained the age of 14 years of age, and the parents applied for the discharge of the child.66
Procedure for exercise of minister’s discretion
One might have expected that if where there was a change in family circumstances there would have been an official, self-activating system to bring up and determine the question of whether a child should have been released from a school. In fact, there was no such mechanism and the statutory arrangements that did exist, had to be triggered usually by the parents.
Typically the process would go through the following stages:
(1)Parent sends letter either directly to Minister or to local deputy67 who relays it to the Department.
(2)Department completes form and sends it on with child’s details to Resident Manager and (as appropriate) SAO / ISPCC / Gardaí,68 for their observations and recommendation.
(3)Department receives report and makes judgement on whether the family situation is favourable for the child’s release.
(4)Release or continued detention.
Up to the Doyle case in 1956, it was usual for the head of the RISB (Reformatory and Industrial School Branch of the Department) to take what was, in effect, the final decision on applications for release. From 1956 on, however, the matter was submitted to the Minister personally. The head of the RISB made a complete resumé for the information of the Minister including the information on file, expanded by means of reports from the Gardaí, Managers and the ISPCC. However the parents were not shown any of the comments for their response to them, something which, by today’s standards, would certainly be required by fair procedure.
Attitudes of Department and of Minister
As regards the attitude to the question of discharge, put simply the Department leaned in favour;69 the School Manager was, more often, against. To amplify, especially after 1956, the Department strengthened this position, taking the view that it had to be very careful about the matter, since the constitutional rights of parents were in question. Thus, the Minister for Education, Jack Lynch remarked that any Minister would be inclined ‘in favour of the application, since the home is in the strongest force for good in a young person’s life’.70
This trend was intensified following the Kennedy Report after 1970, which stated:
The whole aim of the Child Care System should be geared towards the prevention of family breakdown and the problems consequent on it. The committal or admission of children to Residential Care should be considered only when there is no satisfactory alternative.
One of the persons whom the Department consulted was the Manager of the relevant school. Their counsel was usually against early discharge. (No case of the school authorities taking the initiative to secure a release has been discovered). Leaving aside any financial disincentive, the Resident Manager would probably have considered that the best was being done for a child in the school and would have been inherently unlikely to draw back and determine dispassionately that any particular child would be better off outside. Generally speaking, the reasons advanced by the schools against early release were as follows:
(1)Too short a stay in the school would mean that the resident would not be able to acquire self-control or to benefit from any course of study or training.
(2)Early release would have an unsettling effect on discipline among the other residents in the school.
(3)The children might well be returning to a home in which the neglect or deprivation from which they had been rescued would be resumed. The consequence could be that they would deteriorate and would be sent to a reformatory or eventually prison.
These factors are elaborated in the following quote from the minutes of a General Meeting of the Resident Managers’ Association of 30th June 1944:71
Specified cases were mentioned where parents of discharged children came begging for monetary assistance from the school a few months after the children’s discharge… Many of the children whose friends are most persistent in seeking their release have been taken from homes in which their parents either neglected them or showed themselves unable to exercise proper control over them. To send these children back to the same conditions from which they had to be removed, before they have acquired any sense of self-discipline or self-control, is to expose them to temptations and dangers which they cannot be expected to overcome or avoid. Many examples could be given of children, released in this manner, who very soon got into trouble with the law. At the present time a not inconsiderable number of these children are under detention in the Reformatory Schools.
Part 2: Grounds for early discharge and case studies
Grounds
No list of criteria for or against early discharge was stipulated in legislation or any circular or other official document. Nor were reasons given to the applicant for a refusal; nor was there any system of informal precedent used in taking the decision. However, a survey of some of the applications on file in the Department shows that the following factors were taken into account.
Reasons for early discharge
- Formerly unemployed parent securing a job.
- Child needed to support family and being offered a job. This seems to be a highly significant factor. There are numerous documents from businesses (eg Waterford Glass) supporting the release of a child, to whom they had offered employment.
- Improvement of housing.
- Garda good character reference.
- Time of release coming closer.
Reasons for continued detention
- ‘Get into trouble if returned to family’. This might be because there other family member were a bad influence or even ‘circumstances favouring her seduction’.
- Unsatisfactory behaviour at the Industrial School or making progress in the school and unlikely to do so if returned to his home environment.
- Absconding or not returning after the holidays.
- Poor financial circumstances, character or home condition of the parents.
- ‘Parents not having proper control over children’.
- Requirement of six months good behaviour, set by some schools before the resident was being let out.
Part 3: Figures on early release
The figures to be given in Appendix 3 show both a fairly small number of applications, an average of 16 percent in relation to the schools’ population, and a reasonable success rate, with an average of 72 percent. The average reduction, varying from one category to another, was about five years. Moreover, broadly speaking, these increased through the 1950s, despite the fact that, at the same time, the populations of the schools was decreasing. It can be deduced from this that the system seems to have responded faithfully to improvements in the circumstances of the residents’ families.
However, what is inevitably missing is any reference to residents whose parents or guardians never applied for early discharge in the first place. It is a significant feature of the machinery that it had to be initiated by the parents who would often have been uninformed: there was, for instance, no official agency charged with the duty of reviewing each case, either periodically or where there were signs of a change in the child or in their family circumstances. Thus, one can never know how many of what would have been successful applications for discharge were never brought to the Department’s attention. The most that one can do is to point to the perhaps small numbers who did apply (6.1 percent of the average population). This may mean that the system of early discharge was not very well-known. No doubt, too, some applications failed that should have succeeded. Some of the case studies show that the parents had to be prepared to repeat their applications and it seems likely that there would have been some (not shown here) who perhaps out of deference or ignorance would not have been prepared to try again. Among other flaws in the system, the parents were not given the opportunity of commenting on unfavourable recommendations from the authorities; and even when a parent was given the right to a ‘reference’ to the District Court, from a refusal by the Minster in the Children (Amendment) Act 1957, section 5, it seems to have been seldom, if ever, used.
Section 9: Residents placed voluntarily or sent by health authorities:
Residents placed voluntarily
As mentioned, there were five paths of entry to the schools, of which the first three that involved committal via the District Court were by far the most numerous. The other categories were those who entered voluntarily or who entered at the behest and expense of the health authorities.
Children entering voluntarily
The smallest group were those children entering voluntarily because their parents or guardians were – whether temporarily or permanently – not in a position to look after them, yet were prepared to pay the cost of their maintenance. At the time of the Kennedy Report72 there were 97 percent (or 4 percent) of the Industrial Schools’ population in this category with 80 percent and 16 percent in the court and health authority categories, respectively. However in an earlier period, when those committed by the court would have been more numerous, children maintained voluntarily were even less significant. For the period 1949-50 to 1968-69, the average ‘voluntary’ population figure was 101, or 2.2 percent, of the entire schools’ population. The full figures are given below.
O’Cinneide and Maguire73 write about this admittedly small group:
The interviews with some of the Sisters provide stark insights into the conditions under which some children were taken into care. Many of the Sisters of Mercy recalled parents simply appearing on the school’s doorstep asking that their children be taken in, and in other cases children were simply abandoned on the convent steps. One of the more poignant recollections was that of Sr Anne Tubridy, who worked in the Cappoquin Industrial School. She recalled one incident in which a father brought his children to the school asked the Sisters to take the children in, which they did. The man then went home and killed his wife and himself. Sr. Goretti, who worked in the industrial school in Newtownforbes, remembered two girls who were brought to the school by their father after their mother died drowned in the bog.
Invariably some of the parents who voluntarily placed their children in industrial schools defaulted on their payments. This was also true in the case of children committed by the courts, whose parents were ordered by the courts to contribute to their children’s maintenance. However, when the parents defaulted on court-ordered payments, the local authorities had the authority to prosecute them. There is no evidence that religious orders had the same access to court proceedings to force defaulting parents to pay. Their only option, when the parents of voluntarily-placed children failed to make scheduled payments, was to take the children to court and have them formally committed to the school. This seems to have been a rarity.
Residents sent by health authorities
The remaining major category was children placed in certified schools by the health authorities. As with children placed voluntarily and directly in the schools, by parents, such children entered without the involvement of a court and could be withdrawn without legal formality;74 if and when family circumstances permitted. As regards the number of residents in this category, these figures rose steadily from 212 in 1946 to 500 in 1970, while those sent by the courts fell and the total was reducing from 6,800 to 1,740. In other words they represented a much higher proportion in 1970 than 1946 (30 percent compared to 3 percent).
Until it was repealed in 1991 the law that authorised a health authority or board to place a child in an Industrial School was section 55 of the Health Act 195375 (or its precursors), by which a health authority was empowered to provide for the assistance of a child by: boarding the child out; sending him to an Industrial School approved by the Minister for Health; or where the child was not less than 14 years of age, by arranging for his employment.
These powers applied only if two conditions were satisfied. The first was a means test. The second was that the child had to be an orphan or illegitimate and deserted by the mother or, alternatively, that the parent/guardian had to consent. The result was that cases occasionally arose that should reasonably have been sent to a school, yet which did not come within the scope of the law, for instance children whose mothers had gone into hospital or who had left home. Mary E Murray of the Department of Health wrote on 12th November 1968:
Section 55 is still reminiscent of the Poor Law. At present children are being dealt with under this section who are not legally entitled to the services but who nevertheless are greatly in need of assistance, and the regulations have to be ‘stretched’ to allow this assistance to be provided.
Prior to the establishment of health boards (Health Act 1970), social services dealing with children in care were provided through boards of public assistance which, though with a locally defined jurisdiction, were usually distinct from local authorities.76
In the early 1950s, the number of children sent to the schools by boards of health increased, probably because of the need to find somewhere to house children who would earlier have lived in county homes. Whatever the causes, a pattern developed in late 1940s by which health authorities wanted to put children in Industrial Schools despite the preference of the Department of Health for boarding out. Accordingly, they got the schools to apply to Department of Health for ‘approval’. Following a visit to the country home in Cashel, the Department of Health’s inspector noted resignedly on 7th April 1948:
Some 20 boys and girls appear to have been sent to Industrial Schools from the County Home during the past few months. It is now the considered policy of the County Manager to have children committed to Industrial Schools. There is therefore no point in asking that any of the children mentioned in this report should be boarded-out with suitable foster-parents.77
On the other hand, because of the falling numbers of residents, some schools notified local authorities that they were looking for residents. Thus, the Sisters of the Poor Clares in 1959 requested the Department of Health that St Joseph’s Industrial School, Cavan should be approved for the purposes of the reception of children under the Health Acts. They stated that their request had been prompted by the fact that their numbers had now fallen to about 45 children in the Cavan School while the accommodation was for 100. Following approval, the Mother Abbess wrote to various county councils explaining their new status:
You will I trust forgive my trespassing on your valuable time, but I feel you would like to be informed of the progress of our orphanage attached to our convent, in which there are a number of children from the county. Recently we have modernised the whole school. On our staff we have now three sisters who are trained nurses. You will be interested to know that we have expanded the scope of our social services. Our children, if they have the ability, may now attend our secondary school as far as leaving certificate. We now have the orphanage registered not only as an Industrial School, but also under the Health Act. As a result we are able to accept children of any age. We can keep little boys from infancy till about seven years and little girls from infancy till 16 or 18 years as the case may be. I feel you will be interested particularly in the fact of our registration under the Health Act. NA A122/75Section 47: Approval of St Clare’s Orphanage, Co Cavan.
The judgment of Cussen78 in 1936, on the health authorities’ performance was that:
as a whole [they] would appear not to have sufficiently appreciated their responsibilities under law in regard either to the schools or the children, and the evidence which we have adduced indicated that they still display little interest in the work of the schools beyond the payment of a weekly capitation grant.
However, O’Cinneide and Maguire’s impression is more favourable (admittedly in respect of particular areas). After examining the board of health and public assistance minutes for Birr and Offaly and Dublin for 1922-43, they write:79
These children were sent to industrial schools, seemingly as a last resort, when accommodation in county homes and mother and baby homes became overcrowded and suitable foster homes could not be found, or if a child was deemed unsuitable for boarding out. These committals were usually effected at the behest of public assistance officers, or at the request of the matrons of county or mother and baby homes. All requests for the committal of children had to be approved by the Board of Health (later the County Council), and often the Board sought the approval of the Minister for Local Government and Public Health, particularly if they were unsure whether the proposed school was in fact an ‘approved’ school.
The procedures that prevailed in Dublin seem to have been unique in that when a relieving officer, foster parent, or matron wished to have a child sent to an industrial school the child was first brought into the workhouse for examination and assessment, and then sent to the approved school. Although on the surface it seems to have been an onerous and unwieldy process, this step was taken to ensure that children were fully inspected before being sent to an approved school, and also that all other options for providing outside of the industrial school had been explored.
Before the establishment of social workers in 1970, the grades of staff employed in placing children in care in a school or to board them out were: children officers, public health nurses or, in some cases superintendent assistance officers. None of these were trained in the specialised and difficult work of trying to bind up the wounds of a fractured family. From 1970, when the health boards were established and they employed social workers to deal with children in care, policy towards these children in care changed, and the social workers saw it as their duty to try to avoid breaking up the family, unless there was no alternative. Where there was no alternative, then boarding out was the preferred option. If social workers were driven to placing the children in an Industrial School, sometimes because there were next to no short-term refuges for children in care, then they tried to ensure that it was a local school and visited him or her generally more often than the annual visit paid by Department of Education Inspectors. In some cases, they took a closer interest, for instance encouraging the School to send the child to be educated at an outside national school; or to allow them to go home at weekends, if home conditions permitted.
Section 10: Population and entry figures, including geographical distribution
Part 1: Population
There were three ways by which a child might enter an Industrial School: by far the largest category was committals through the court (this embraced the three sub-categories: needy, offenders; or School Attendance Act). The other two categories were sending by the local health authority or voluntary admission. In the case of Reformatories, effectively all the residents were committed by the courts. The figures presented in Table 1 cover the total population, that is the total number of residents, from all parts of the country in Industrial Schools at a particular time. (The time when schools filled up forms for transmission to the Department was originally 31st July and, after 1959, 30th June).
Table 1: Population of Reformatories and Industrial Schools
| Year | Industrial Schools | Reformatory | Total (Industrial and Ref Schools) | |||
|---|---|---|---|---|---|---|
| Courts committals | Health authority | Voluntary | Total Industrial School | |||
| 1937 | 6074 | Not available | Not available | [6074] | 122 | 6196 |
| 1938 | 6131 | [6131] | 150 | 6281 | ||
| 1939 | 6226 | [6226] | 201 | 6427 | ||
| 1940 | 6434 | [6434] | 226 | 6660 | ||
| 1941 | 6593 | [6593] | 248 | 6841 | ||
| 1942 | 6627 | [6627] | 262 | 6889 | ||
| 1943 | 6699 | [6699] | 280 | 6979 | ||
| 1944 | 6525 | [6525] | 288 | 6813 | ||
| 1945 | 6565 | [6565] | 273 | 6838 | ||
| 1946 | 6510 | 212 | 77 | 6799 | 237 | 7036 |
| 1947 | 6357 | 289 | 66 | 6712 | 232 | 6944 |
| 1948 | 6208 | 338 | 78 | 6624 | 251 | 6875 |
| 1949 | 6069 | 334 | 70 | 6473 | 233 | 6706 |
| 1950 | 5859 | 324 | 76 | 6259 | 222 | 6481 |
| 1951 | 5764 | 342 | 89 | 6195 | 218 | 6413 |
| 1952 | 5572 | 386 | 86 | 6044 | 206 | 6250 |
| 1953 | 5316 | 390 | 103 | 5809 | 192 | 6001 |
| 1954 | 4975 | 428 | 110 | 5513 | 167 | 5680 |
| 1955 | 4728 | 469 | 92 | 5289 | 179 | 5468 |
| 1956 | 4443 | 474 | 111 | 5028 | 209 | 5237 |
| 1957 | 4193 | 470 | 118 | 4781 | 222 | 5003 |
| 1958 | 4118 | 510 | 106 | 4734 | 216 | 4950 |
| 1959 | 3869 | 484 | 99 | 4452 | 221 | 4673 |
| 1960 | 3734 | 493 | 114 | 4341 | 234 | 4575 |
| 1961 | 3686 | 388 | 99 | 4173 | 218 | 4391 |
| 1962 | 3361 | 465 | 100 | 3926 | 162 | 4088 |
| 1963 | 3100 | 410 | 108 | 3618 | 157 | 3775 |
| 1964 | 2832 | 394 | 113 | 3339 | 149 | 3488 |
| 1965 | 2522 | 369 | 124 | 3015 | 131 | 3146 |
| 1966 | 2209 | 402 | 101 | 2712 | 158 | 2870 |
| 1967 | 1948 | 412 | 88 | 2448 | 160 | 2608 |
| 1968 | 1667 | 498 | 73 | 2238 | 128 | 2366 |
| 1969 | 1351 | 462 | 81 | 1894 | 110 | 2004 |
| 1970 | 1137 | 500 | 103 | 1740 | 86 | 1826 |
Sources: 1936-45: Figures were sourced from Department of Education annual reports. They do not give the numbers of those sent in by health authorities or the voluntary cases because these figures are not available from the Department of Health or anywhere else, for the 1937-45 period. Thus for these years the total figures given in the table have been put in square brackets. It should be noted that the numbers for the missing categories were always small compared to those committed by the courts, even after the sharp increase in the early 1950s. Thus it seems likely, so far as one can say, that, for the years in question, the total figures given only underestimate the correct figure by around 50.
For the post-1945 period, figures were sourced from Department of Education files.
Most of the same information may be presented in the form of a graph, as follows.
Graph 1
For Industrial Schools, there was an increase to a peak of 6,800 in 1946 and then fairly steady decline in population from 6,000 to 1,500 during 1950-70, an average reduction of approximately 250 per year.
In case of Reformatories, with much lower figures, there is a reduction in the mid 1950s and then an increase during 1955-60 even above the original figures. Thereafter there was a steady decline.
Part 2: Inflow through the courts
The sets of figures just given show the ‘total population’ in the Industrial Schools. By contrast, the remainder of this section treats figures that are different in two respects. First, they deal only with those committed by the courts (since the figures for the other two categories, which are small anyway). Secondly, this measures not population, but the annual inflow of those committed to the Industrial Schools by the courts. The comparison between the population and inflow is as follows. The population of the schools for any particular year is the product of two distinct elements.
(1)The inflow figures over the preceding years.
(2)The length of time each child spent in a school.
In the remainder of this section, we concentrate on the inflow figures.
Table 2: Inflow into Industrial Schools and Reformatories
| Year | Industrial School | Reformatories |
|---|---|---|
| 1937 | 1000 | 45 |
| 1938 | 985 | 71 |
| 1939 | 1040 | 126 |
| 1940 | 1125 | 125 |
| 1941 | 1066 | 99 |
| 1942 | 1004 | 105 |
| 1943 | 1032 | 154 |
| 1944 | 941 | 121 |
| 1945 | ||
| 1946 | 946 | 108 |
| 1947 | 883 | 98 |
| 1948 | 991 | 144 |
| 1949 | 779 | 92 |
| 1950 | 833 | 97 |
| 1951 | 770 | 104 |
| 1952 | 732 | 82 |
| 1953 | 626 | 82 |
| 1954 | 551 | 89 |
| 1955 | 542 | 66 |
| 1956 | 596 | 93 |
| 1957 | 572 | 110 |
| 1958 | 592 | 105 |
| 1959 | 623 | 125 |
| 1960 | 608 | 128 |
| 1961 | 671 | 131 |
| 1962 | 647 | 103 |
| 1963 | 611 | 84 |
| 1964 | 446 | 110 |
| 1965 | 439 | 85 |
| 1966 | 407 | 89 |
| 1967 | 275 | 104 |
| 1968 | 211 | 120 |
| 1969 | 162 | 103 |
| 1970 | 154 | 136 |
| 1971 | 241 | 63 |
| 1972 | 219 | 52 |
| 1973 | 165 | 29 |
| 1974 | 136 | 25 |
| 1975 | 139 | |
| 1976 | 105 |
Sources: Annual reports, Table N80
Graph 2: Inflow into Industrial Schools
Source: Annual reports, Table N
The total number of committals peaked during the 1937-43 period. During that period there were over 1,000 committals each year, except for 1938 when there were only 985. A fairly steep decline started in 1950 with an average committal of 644 per annum in the 1950s. Thereafter there was a rise until 1963 when they again started a steep decline reaching 191 by 1968 and averaging 160, during the 1968-78 period.
Graph 3: Regional comparisons for inflow to Industrial Schools, 1936-59
Here the data is presented not to show the raw figures, but the number of those committed, for every 100,000 of the 0-15 age cohort. The other feature here is that, the figures are related to the parts of the country from which the residents came.
Graph 3
Source: Annual reports of the Department, Table N.
The annual reports gave regional data according to the location (county or county boroughs) in which a resident had their permanent home. 81 The county boroughs were Cork, Dublin, Limerick and Waterford (since Galway did not become a county borough until 1985). Unfortunately, as part of the ‘streamlining’ of the annual report, Table N ceased to be published and so our plot ceases in 1959. (The graphs appear to show an upward trend, as of 1959, for Dublin County Borough and the national figures. However we know, from the CICA survey (in the case of Dublin CB) and the annual reports, Table N, that what appears as an upward trend because the graphs end in 1959, in fact was reversed as from 1963 (Dublin) and 1962 (National).
Graph 3 shows a comparison of the annual committal rate (standarised in each county per 100,000 of relevant age population) for: Dublin CB; the three other county boroughs (aggregate); the State overall and finally, ‘rural areas’ (a broad term used, to embrace the State outside Dublin, Cork, Limerick and Waterford County Boroughs).
It can be seen that the committal rate did decline for each of these groups over the period 1936-59. The rate for Dublin was consistently the highest in the country throughout the period. Indeed for the period 1937-78 there was a grand total of 25,000 committals nationally, of which 9,500 or 38 percent came from the Dublin CB. To put this in context, the average census figure shows 24 percent82 of the national age cohort living in the Dublin CB. The rate for the rural areas was less than half this rate. The national committal rate falls in between these two rates, as one would expect, but closer to that of the rural areas. The committal rate in the three other county boroughs is closer to that of Dublin than the rest of the State. The rates for Dublin and the other county boroughs are more variable than the national (or other counties) rates because the base population is smaller for these two groups.
Graph 4 (below) is more detailed in that it shows the committal rates, for individual counties and county boroughs per head of population. The figures for the children committed are the percentage of the age cohort for each area.
Graph 4: Percentage of age cohort
Graph 4 shows that with a few exceptions, for each county or county borough there was in most cases a steady reduction from 1936 to 1960. This is shown by the fact that the point for (say) County Roscommon for 1936 is above that for County Cork in1936 and so on down to 1961.
One significant feature of the graph is that it shows whether a county or county borough held the same ranking (that is its relative position, in terms of committal per head of population) from one census to the other. The significance of this is that the counties and county boroughs have been ranked in descending order of the number of committals for each member of the age cohort, as one moves from left to right. Thus if, as occurs occasionally, the graphs were to cross, this would indicate that the county that had ‘risen’ against the next county had increased its ranking; in other words, it was committing more children per head of population, relative to the other county than had been the case in the earlier census. The main example of this is that the rate for 1946 for a number of counties running from Kildare to Offaly is higher than that for the same counties in 1936-37. Finally, in line with Graph 3, Dublin County Borough has the highest rate and that Limerick, Waterford and (a few places later) Cork County Boroughs also have high rates.
It was harder to see any other pattern in this graph. One may however, regard it as significant that there were no senior boys schools north of the Dublin–Galway line and only 11 out of about 50 in any category. Bearing this in mind, one might expect to find some correlation between the average rank of a county and proximity to a school. The graph does give some support for the view that proximity to a school means that a child is more likely to be sent to a school. For instance Kerry (two girls and one senior boys) come in several positions above Donegal, Sligo (two girls) or Mayo (one girls); though otherwise the counties have a good deal in common, each being rural, impoverished and remote from Dublin.
Part 3: Committals analysed by three sub-categories
As mentioned already, there were three grounds on which the District Court could commit a child to a school: needy, offences, school attendance (truancy); and in this part, we present the annual figures for each of these three grounds.
Table 3: National committal figures
| Year | Needy | % of total | Off | % of total | School attendance | % of total | Total |
|---|---|---|---|---|---|---|---|
| 1937 | 841 | 84% | 77 | 8% | 82 | 8% | 1000 |
| 1938 | 812 | 82% | 68 | 7% | 105 | 11% | 985 |
| 1939 | 834 | 80% | 67 | 6% | 139 | 13% | 1040 |
| 1940 | 868 | 77% | 147 | 13% | 110 | 10% | 1125 |
| 1941 | 832 | 78% | 112 | 11% | 122 | 11% | 1066 |
| 1942 | 769 | 77% | 124 | 12% | 111 | 11% | 1004 |
| 1943 | 806 | 78% | 100 | 10% | 126 | 12% | 1032 |
| 1944 | 732 | 78% | 80 | 9% | 129 | 14% | 941 |
| 1945 | 778 | 82% | 77 | 8% | 91 | 10% | 946 |
| 1946 | 788 | 83% | 67 | 7% | 91 | 10% | 946 |
| 1947 | 762 | 86% | 68 | 8% | 53 | 6% | 883 |
| 1948 | 809 | 82% | 98 | 10% | 84 | 8% | 991 |
| 1949 | 653 | 84% | 66 | 8% | 60 | 8% | 779 |
| 1950 | 718 | 86% | 56 | 7% | 59 | 7% | 833 |
| 1951 | 636 | 83% | 73 | 9% | 61 | 8% | 770 |
| 1952 | 607 | 83% | 70 | 10% | 55 | 8% | 732 |
| 1953 | 511 | 82% | 68 | 11% | 47 | 8% | 626 |
| 1954 | 462 | 84% | 55 | 10% | 34 | 6% | 551 |
| 1955 | 451 | 83% | 54 | 10% | 37 | 7% | 542 |
| 1956 | 488 | 82% | 47 | 8% | 61 | 10% | 596 |
| 1957 | 478 | 84% | 57 | 10% | 37 | 6% | 572 |
| 1958 | 473 | 80% | 63 | 11% | 56 | 9% | 592 |
| 1959 | 489 | 78% | 72 | 12% | 62 | 10% | 623 |
| 1960 | 489 | 80% | 50 | 8% | 69 | 11% | 608 |
| 1961 | 540 | 80% | 69 | 10% | 62 | 9% | 671 |
| 1962 | 524 | 81% | 79 | 12% | 44 | 7% | 647 |
| 1963 | 498 | 82% | 68 | 11% | 45 | 7% | 611 |
| 1964 | 339 | 76% | 70 | 16% | 37 | 8% | 446 |
| 1965 | 305 | 69% | 100 | 23% | 34 | 8% | 439 |
| 1966 | 276 | 68% | 93 | 23% | 39 | 10% | 408 |
| 1967 | 166 | 61% | 78 | 29% | 29 | 11% | 273 |
| 1968 | 120 | 63% | 69 | 36% | 2 | 1% | 191 |
| 1969 | 82 | 51% | 65 | 40% | 15 | 9% | 162 |
| 1970 | 77 | 50% | 54 | 35% | 23 | 15% | 154 |
| 1971 | 68 | 28% | 156 | 65% | 17 | 7% | 241 |
| 1972 | 111 | 51% | 87 | 40% | 21 | 10% | 219 |
| 1973 | 59 | 36% | 74 | 45% | 32 | 19% | 165 |
| 1974 | 33 | 24% | 72 | 53% | 31 | 23% | 136 |
| 1975 | 19 | 14% | 99 | 71% | 21 | 15% | 139 |
| 1976 | 13 | 12% | 74 | 70% | 18 | 17% | 105 |
| 1977 | 32 | 23% | 77 | 55% | 32 | 23% | 141 |
| 1978 | 5 | 5% | 80 | 73% | 24 | 22% | 109 |
| Total | 19353 | 77% | 3280 | 13% | 2407 | 10% | 25040 |
| Ave | 461 | 67% | 78 | 22% | 57 | 11% | 596 |
Sources, Annual reports, 1937-40 (Table 35); 1941-59 (Table D); 1960-68 (Table C(ii)); 1969-70 (Table 3(ii)); 1971 (Table 6); 1972-78 (Table 2)
Graph 5: National commitals: three sub-categories
(1) Needy
The great majority of those committed were from the category of needy children: as Cussen noted, in 1934 the figure was as high as 90 percent. Graph 5 and Table 3 illustrate that the needy category continued to account for an overwhelming majority of the total committals. Between 1937-64, the figure averaged 81 percent. Thereafter, during the 1964-78 period, it fell steadily to 5 percent in 1978, with an average throughout this period of 40 percent
Regional comparisons: comparison between county borough and national figures
Table 4: Needy committals
| Year | CB | National | CB/NAT% | Ave CB/Nat % |
|---|---|---|---|---|
| 1937 | 201 | 841 | 24% | |
| 1938 | 231 | 812 | 28% | |
| 1939 | 238 | 834 | 29% | |
| 1940 | 389 | 868 | 45% | |
| 1941 | 218 | 832 | 26% | |
| 1942 | 189 | 769 | 25% | |
| 1943 | 217 | 806 | 27% | |
| 1944 | 265 | 732 | 36% | |
| 1945 | 213 | 778 | 27% | |
| 1946 | 209 | 788 | 27% | 1937-46: 29% |
| 1947 | 261 | 762 | 34% | |
| 1948 | 240 | 809 | 30% | |
| 1949 | 198 | 653 | 30% | |
| 1950 | 170 | 718 | 24% | |
| 1951 | 171 | 655 | 26% | |
| 1952 | 207 | 607 | 34% | |
| 1953 | 140 | 511 | 27% | |
| 1954 | 125 | 462 | 27% | |
| 1955 | 156 | 462 | 34% | |
| 1956 | 141 | 488 | 29% | 1947-56: 30% |
| 1957 | 107 | 478 | 22% | |
| 1958 | 272 | 473 | 58% | |
| 1959 | 186 | 489 | 38% | |
| 1960 | 206 | 489 | 42% | |
| 1961 | 198 | 540 | 37% | |
| 1962 | 248 | 524 | 47% | |
| 1963 | 149 | 498 | 30% | |
| 1964 | 133 | 339 | 39% | |
| 1965 | 150 | 305 | 49% | |
| 1966 | 71 | 276 | 26% | 1957-66: 39% |
| 1967 | 20 | 168 | 12% | |
| 1968 | 9 | 118 | 8% | |
| 1969 | 3 | 82 | 4% | |
| 1970 | 2 | 77 | 3% | |
| 1971 | 1 | 68 | 1% | |
| 1972 | 3 | 111 | 3% | |
| 1973 | 3 | 59 | 5% | |
| 1974 | 0 | 33 | 0% | |
| 1975 | 0 | 19 | 0% | |
| 1976 | 2 | 13 | 15% | 1967-76: 6% |
| 1977 | 0 | 32 | 0% | |
| 1978 | 0 | 5 | 0% | |
| Total | 5942 | 19383 | 31% | |
| Ave | 141 | 462 | 31% |
Sources: Annual reports, Table D (National Figures); CICA survey (Dublin County Borough)
Table 4 shows that for the period 1937-56, the average committals, in the needy category, for the Dublin County Borough, were 204 or 29 percent of the national average of 697. Then during 1958-65, there was a significant increase in the number of committals from the Dublin CB, complemented by a levelling off of the national figures. The increase for Dublin CB committals is odd considering that, at this time, the prosperity level was improving. In any case, the result was that the Dublin CB proportion for 1958-65 increased to 42 percent of the national average. But from 1966 on, there was an even steeper reduction in the Dublin than the national figures.
Graph 6: Needy commitals
Graph 6 shows the population-adjusted committal rates for children in the needy category.
Provincial figures
How do the provincial figures compare with Dublin County Borough trends? The overall picture (taking the total figures for all three sub-categories) provided by Graph 3 shows that, during 1936-58, those committed per head of relevant population from the rural areas were less than half those from Dublin CB. The Cork, Limerick and Waterford County Boroughs aggregate falls in between the two extremes but closer to Dublin CB. In an attempt to ascertain the position in regard to each of the three sub-categories (information not given in the annual reports), a survey of the following District Court areas: Cork County Borough, Rural Galway, Rural Limerick, Limerick County Borough and County Carlow, was carried out.
However, the records at the National Archives are incomplete83 and it seemed to us, accordingly that it would not be helpful to publish all the figures we have collected.
The following tentative observation can be made. Within Cork County Borough, approximately 2.5 percent of the age cohort lived. During the period 1940-66 (the only period for which Cork County Borough figures were available) there was an annual average of 19 committals overall and 13 committals on needy grounds compared with a national average for the same period, of 817 and 664, respectively: in other words 2.3 percent and 2 percent, respectively. This is in line with the national trend, and thus rather below that for the county boroughs, though as noted at para 00, Cork County Borough was the lowest of the county boroughs. However, following the usual trend, the Cork figures were significantly reduced from 1958 onwards.
Turning to the rural areas, in County Limerick, which had approximately the same under 15 population as Cork CB from 1933-62, there was an average of seven in the needy category; 0.3 for school attendance and just 0.1 for offences.
There were very few committals in County Carlow. In most of the years, indeed, there were none in any of the three categories, though quite suddenly one finds in 1948 24 committals ‘in the needy category’, presumably because of a change of District Justice.
In short, in some of the provincial rates there may be an air of unreality because the concrete figures are so low. However, these figures are in line with what one would expect, namely in the rural areas, there seemed to have been relatively fewer in the needy category than in Dublin, and next to none in the other two categories.
(2) Offenders
The national figures for those committed because of an offence, having peaked in 1940 at 147, declined to 47 in 1956: see Table 3. After 1956 there was a slightly increasing trend for those committed because of an offence. During the period 1937-41, the average was 94 or 10 percent of the total committed. Then during the period 1942-55, the figures were 75 or 9 percent. Finally during the period, 1956-78 the figures increased to an average of 76. Because of the decline in total figures mentioned earlier, these increases meant that the numbers of children committed because of offences constituted an average of 33 percent of all committals, for the 1956-78 period.
The next point is to compare the national committals and Dublin County Borough committals for offences. As can be seen from Graph 7, throughout the 1940s, 1950s and 1960s the Dublin CB accounted for a majority of children committed to Industrial Schools. During 1937-78, 3200 were committed nationally for committing offences. Of this 1835, or 57 percent, came from Dublin CB, despite the fact that only approx 24 percent of the national age cohort lived in Dublin CB. A more precise version of this comparison is given in Graph 7 in which the annual figures are related to the under – 15 age populations of the Dublin CB and, of the nation.
Graph 7
Graph 7 shows that national committal rate in the offences group appears to be broadly constant (between 10 to 15 per 100,000 population per year). On the other hand, the Dublin County Borough rates appear to have a cyclical trend, with peaks around 1940 and the mid 1960’s.
Provincial figures
Of the provincial courts that were surveyed, only Cork CB sent or committed on the grounds of offences a number of children that was in any way proportionate to the number to be expected, in the light of the national figures. In Rural Limerick, Rural Galway and County Cavan, for the several of the years we surveyed, there were no committals for offences. In Limerick County Borough (admittedly only for the period 1945-53 and 1959-62), the total was six. For Cork County Borough, on the other hand, the total was 95 for the period 1940-66. These figures, should however, be treated with caution because of the great likelihood that a rural court would prefer to categorise the child as needy rather than an offender. However they do tend to confirm what is anyway not controversial, namely that fewer children per head of population, were committed for offences, in the rural areas.
Reformatories and Industrial Schools
The figures set out below are for Reformatories together with those for Industrial Schools (offender sub-category only) since those committed to Reformatories were all offenders.
Graph 8: Industrial Schools (offences) and Reformatories: national figures
Source: Annual Department reports
Taking the period 1939–51, an average of 114 young offenders were committed each year to Reformatories. During 1952-56, there was a reduced number of 82. Thereafter the numbers increased to an average, for the 1964-70 period, of 110.
The trajectory of Reformatory committals very approximately tracks that of the figures for those committed to Industrial Schools under the offences sub-category. The plot shows that each is cyclical; though the number of committals to Reformatories is higher. The numbers for Industrial Schools peak at around 1940 and 1970, while committal numbers to Reformatory School appear to peak around 1943 and also around 1960 and 1970. One should not compare the sizes of the groups sent to Reformatories and Industrial Schools (offences category) directly since they are drawn from largely different, though adjacent, elements of the population: roughly speaking the Reformatory residents were usually above 15 at the time of conviction and the Industrial School residents were usually below.84 However the similarity in trajectory noted earlier is to be expected since any increase in juvenile crime would naturally affect those in adjacent or overlapping age groups.85
As for geographic origin of residents in Reformatories, only figures for 196886 are available. These show that out of a population of boys (in Daingean) of 103, 46 were from Dublin County Corough or County. For girls (at St Josephs in Limerick and St Anne’s in Kilmacud) the corresponding figures were 11 out of 38. In other words, 44 percent of the boys and 29 percent of the girls respectively were from Dublin; whereas on the basis of the population the figures should have been 27 percent. A less substantial fraction – 28 percent and 13 percent of the boys and girls, respectively – came from Cork, Limerick or Waterford county boroughs or counties; in comparison, the general under-15 population for these county boroughs and counties was 19 percent.
(3) School attendance
The remaining category is school attendance offences (SAO). The following plot shows that here, too, there was a disproportionate number of committals from Dublin County Borough.
Graph 9: School attendance committals
Sources: Annual reports, Table D (National Figures); CICA survey (Dublin CB)
The figures for SAO declined from an average annual figure of 66 during 1937-69 to 24, during 1970-78. The proportion for those committed under this head, during 1937-69 averaged 9 percent of total committals. During 1970-78 because the total figures were declining so steeply during this period, the proportion of school attendance committals increased to 17 percent.
The regional feature, which jumps out of Graph 9, is that, as with offences, a disproportionate number of committals came from Dublin County Borough. National committal rates start around 15 per 100,000 per year in 1937 and show a slow decline over the years. By contrast Dublin CB figures start around 75 per 100,000 per year in 1937, which is about five times the national rate. The Dublin CB figures show a steady decline over the years to about 15 per 100000 per year in 1978, by which time, the figure is much closer to the national rate, but still higher. For the entire period, 1937-78, 76 percent of the committals were from the Dublin Metropolitan Court, despite the fact that to take an average over the period, 24 percent of the age cohort lived within its jurisdiction.
This conclusion is confirmed from the opposite direction, by our findings from the limited number of provincial courts whose figures we have surveyed: for instance, for the period 1933–69 there were only 11 SA committals in rural Limerick.
Note on sources and methodology
In the first place, the figures and information in the Department of Education annual reports and also the Kennedy Report have been drawn on. The information available from these sources is limited. Some interviews were conducted with retired District Court Justices or clerks who held office in the 1970s or earlier; but again there are not all that many such interviewees still available.
A comprehensive survey of the minute books of the Dublin Metropolitan Court,87 which are still to be found in the Court House was made. However, the facts given for each committal are extremely bare; usually only the name and address of the child and the statutory provision under which they were committed.
At some points in the present section, figures taken from the CICA survey on Dublin were compared with the national figures taken from the Department of Education annual reports. This cannot be an exact comparison because the under-mentioned differences between the two sets of figures needs to be taken into account. However, once these possibilities are borne in mind, it is useful to publish these figures since the errors are likely to be small scale; and the figures do illustrate trends over time.
(1)The CICA figures were based on the Dublin Metropolitan Police District; whereas the population figures, taken at each census, were based on the Dublin County Borough. The difficulty is that while there was a very large overlap between the two in terms of the territory and population embraced, some areas of the DMD were outside the corporation borders and (to a much less extent) vice versa. Moreover while there was no change in the physical boundaries of the two, until 198288, there was significant population movement. The Central Statistics Office have advised that, for instance in 1946, the net difference was that the general population (the under-15 age cohort reflects this) of the DMD was larger than the CB by about 10 percent: 550,000 in DMD and 506,000 in Dublin CB,. Now Dun Laoghaire would account for 48,000, but there are other smaller areas which would affect the issue.
The suggestion simply to increase by 10 percent the population out of which came the children sent to the schools is too simple, because the socio-economic groups living in the areas outside the County Borough but in the DMD (such as Dun Laoghaire; population = 48,000) would be much higher. Consequently, we assume that disproportionately fewer of the offspring would have been committed to the schools: it was not possible because of resources to check the address of each child sent from the DMD area to an Industrial School. However, the addresses of those committed came overwhelmingly from inner city addresses.
In the light of this, the correct adjustment would be to keep population figure at that of the County Borough, but to make a small adjustment (much less than 10 percent) in the numbers of children committed. Without a way of knowing how much the adjustment would be, the figures were left as they are, at the inevitable loss of making the figures for Dublin MD committals very slightly greater than they ought to be.
(2)The Dublin County Borough figures were measured at a different stage of the cycle from the national figures. Specifically, they were collected from the minute books compiled by District Court clerks immediately after the case. By contrast, the annual report figures were taken from returns made to the Department, by each school at the end of the year, that is every 30th June or, later, 31st July.
During this ‘gap’, there would be some danger of leakage in the sense that a child could be the subject of a committal order, yet no longer be in school at the time when the annual return was taken. One way in which this might happen would be if there were a successful Circuit Court appeal against committal. The figures used were collected from the District Court record books and the Circuit Courts records were not available. Thus, the figures do not allow for the fact that there may have been a successful appeal to the Circuit Court so that at the end of the day, the juvenile offender against whom a committal order was made did not in fact go to a school. Such an appeal would be more likely in the case of a child or young person committed for an offence or SAO and least likely in the case where a child was committed for being ‘needy’. An appeal would probably be less unlikely in Dublin than the provinces and definitely more likely later than earlier in our period. However even during the later (1960s) period this was a time when lawyers and legal knowledge was slight. There is no evidence to suggest that there were sufficient successful appeals to invalidate our broad conclusion.89
A second way in which a child, the subject of a committal order, might not be in the school by the time of the annual return would be if the Minister had exercised his power of early discharge. Again, there would be only a small number in this category.
Appendix 1: Period of committal
(I) Average periods of committal in Dublin Metropolitan District Court, 1934-75
The figures in Table B1 are for the Dublin Metropolitan District only.
Table B1
| Year | Needy | Sa | Off |
|---|---|---|---|
| 1934 | 6.8 | 3.4 | 3.1 |
| 1935 | 7.8 | 1.6 | 3.1 |
| 1936 | 8.3 | 1.9 | 3.9 |
| 1937 | 8.4 | 3.8 | 4.6 |
| 1938 | 7.1 | 4.3 | 4.2 |
| 1939 | 8.3 | 4.5 | 4.2 |
| 1940 | 8.2 | 4.5 | 4 |
| 1941 | 8.9 | 3.9 | 4.3 |
| 1942 | 8 | 4.3 | 4.3 |
| 1943 | 8.3 | 4.4 | 3.2 |
| 1944 | 8 | 4.5 | 4 |
| 1945 | 8.4 | 4.2 | 4.2 |
| 1946 | 8.4 | 4.6 | 3.7 |
| 1947 | 9.5 | 4 | 3.5 |
| 1948 | 9.2 | 4.5 | 4.8 |
| 1949 | 9.8 | 3.9 | 3.5 |
| 1950 | 9.4 | 4.8 | 3.3 |
| 1951 | 8.1 | 5 | 3.7 |
| 1952 | 7.7 | 5.2 | 4 |
| 1953 | 8 | 5.3 | 3.8 |
| 1954 | 8.4 | 4.5 | 3.2 |
| 1955 | 6.8 | 4.2 | 3 |
| 1956 | 6 | 6.3 | 4.3 |
| 1957 | 5.7 | 4.5 | 2.4 |
| 1958 | 5.3 | 4.2 | 3.7 |
| 1959 | 5.7 | 4.7 | 3.5 |
| 1960 | 3.2 | 3.5 | 3.3 |
| 1961 | 6.8 | 3 | 3 |
| 1962 | 5.5 | 3.7 | 3 |
| 1963 | 6.5 | 2 | 2.9 |
| 1964 | 4.2 | 2 | 1.5 |
| 1965 | 5.5 | 1.1 | 1.5 |
| 1966 | 4 | 1.7 | 1.5 |
| 1967 | 4.8 | 2.5 | 1.8 |
| 1968 | 3.6 | 1.8 | 1.3 |
| 1969 | 1 | 2.1 | 1.4 |
| 1970 | 3.5 | 1.9 | 1.7 |
| 1971 | 3 | 2.5 | 2 |
| 1972 | 1 | 1.9 | 2.5 |
| 1973 | N/A | 1 | 1 |
| 1974 | N/A | 1 | 1.5 |
| 1975 | 1 | 1 | 1.5 |
| AVE | 6 | 3 | 3 |
The table shows that, since the age of those who were committed for the offences category was the highest, the average period for which they were committed was shorter. At the other extreme. In the needy category some of those committed were mere infants and the average age, at the time of committal, was much lower than for offences. The ages of the children committed for non-school attendance fell between those for the other categories. At a certain point, there was a watershed – decline in the period for which the children were committed. The date of this decline varied according to the different categories. The date was 1955 (in the case of the needy category); 1964 (offences); and 1960 (school attendance). In the needy category, there appears to be an increase in sentence in 1970 but the 1970–75 figures are less significant,because the actual number of cases were so very few.
(II) National figures, 1951-60
These figures were compiled by a survey undertaken in December 2005 – January 2006, by Mr Jimmy Maloney a HEO in the Department of Education. The statistical information was drawn primarily from the 4,102 entries contained in the Departmental journal entitled ‘Applications for Early Discharge 1951-60 – DJ11’.90 The primary purpose of the survey was to examine the operation of the Minister’s power of early discharge. However this survey also collected the dates of committal for each resident and this data has been used to deduce the period for which these children were committed. Necessarily, many of these particular children were in fact released early by the Minister; but here we focus on the earlier stage of computing the period for which the child was initially committed not that which was actually served. The use of these figures is predicated on the assumption that those who applied for early discharge represented a fair sample of the entire population.
Table B2: Industrial Schools – average period of committal
| Year | Needy | SA | Offences |
|---|---|---|---|
| 1951 | 8.3 | 4.5 | 4.1 |
| 1952 | 8.7 | 4.3 | 4.5 |
| 1953 | 9.2 | 4.3 | 3.9 |
| 1954 | 8.9 | 4.4 | 3.6 |
| 1955 | 9.2 | 4.6 | 4.3 |
| 1956 | 9.5 | 3.6 | 4.3 |
| 1957 | 9.3 | 4.6 | 4.3 |
| 1958 | 9.1 | 4.7 | 4.4 |
| 1959 | 8.3 | 3.6 | 4.2 |
| 1960 | 7.6 | 4.2 | 3.8 |
| Total | 88.1 | 42.8 | 41.4 |
| Average | 8.8 | 4.2 | 4.1 |
(The average figures are weighted by reference to the fact that the great majority of the committals was in the needy category)
(III) National figures in 1940s
A similar though not identical survey was carried out by Mr Maloney (of the Department of Education) of the school populations in 1940s. Specifically, he surveyed the figures for 19 percent of the Industrial School residents and 25 percent of Reformatory School residents, as of 31st July 1945 (the date for which the Department’s annual report was compiled). This survey then was drawn from the entire population as of this date. In addition the unit carried out an analysis of all residents admitted to Industrial and Reformatory Schools who were committed by a court order made during the period August 1942 – July 1943, August 1946 – July 1947 and August 1950 – July 1951. The average age results for all four of these analyses are detailed in Table B3.
Table B3: Average period of committal
| Overall average period |
Needy | SA | Offences | |
|---|---|---|---|---|
| All admissions between 1st Aug 1942 & 31st July 1943 | 7 | 7.8 | 4.3 | 3.5 |
| 19% sample of children in residence on 31st July 1945 | 7.8 | 8.3 | 4.5 | 3.8 |
| All admissions between 1st Aug 1946 & 31st July 1947 | 7.8 | 8.4 | 4 | 3.3 |
| All admissions between 1st Aug 1950 & 31st July 1951 | 8.4 | 9.1 | 4.8 | 3.7 |
| Average | 7.75 | 8.4 | 4.43 | 3.6 |
Appendix 3: Figures on early release
Unless the contrary is stated, the figures in this Part are drawn from information compiled for a survey, undertaken for CICA in December 2005 – January 2006, by Mr Jimmy Maloney of the Department of Education. The statistical information was primarily from the 4,102 entries contained in the departmental journal entitled ‘Applications for Discharge 1951–60 – DJ11’. (The grounds for committal statistical information and the age profile statistical information is also sourced from the Department’s electronic access database of former residents which provides, where available, details of the grounds by which a child was committed to a school, dates of birth and dates of committal of the 4,102 residents detailed in the journal DJ11.) The Department of Education has also supplied figures for those applications which were withdrawn and for which there was no record of decision. But we have thought it best to ignore these relatively small categories and not to count them among the figures for either application or detention.
Table C1: Length of time by which the committal period to Industrial Schools was reduced
| Year | Total schools population | Number applying | Number successful | Success rate |
|---|---|---|---|---|
| 1951 | 6195 | 259 | 145 | 56% |
| 1952 | 6044 | 322 | 170 | 53% |
| 1953 | 5809 | 386 | 219 | 57% |
| 1954 | 5513 | 366 | 234 | 64% |
| 1955 | 5289 | 332 | 233 | 70% |
| 1956 | 5028 | 336 | 274 | 82% |
| 1957 | 4781 | 338 | 299 | 88% |
| 1958 | 4734 | 315 | 236 | 75% |
| 1959 | 4452 | 344 | 289 | 84% |
| 1960 | 4341 | 180 | 158 | 88% |
| Total | 51996 | 3178 | 2257 | 71% |
| Ave | 5200 | 317.8 | 225.7 | 71.7 |
Note: These figures do not distinguish according to the ground of committal of the residents who applied for early discharge.
(From another source, we know that for the earlier period 1943-50, the number of applications averaged 439 which was an equivalent of 7 percent of the then population.)
Table C1, which gives a single figure for all categories shows that there were a significant number of successful applications (the breakdown by category is given at Table C2) an average of 226. This represented 72 percent of those who applied and was the equivalent of 4.3 percent of the entire population. One should also relate the numbers of applicants to the school population for that year; though when this is done, one can see that the percentage of application increased fairly steadily through the 1950s
Of the total of 3,178 applications 2,257 were approved and 921 refused. Applications were at a peak in 1957. This feature is brought out by the column showing the increasing fraction of successful applications compared to the schools population. The shows the full impact of the Doyle judgement in December 1955 (regarding early discharge of residents committed for SAO. also apparent in terms of the numbers approved, during 1957, when there were 338 applications of which 299 were approved with just 39 refusals).
Throughout the 1950s, the number of applications approved increased despite the fact that the Industrial School population was falling steadily. This was presumably in line with the general improvement in economic and social conditions in the country over the course of the decade. There were, however, notable exceptions. Figures not presented here but as supplied by Mr Maloney show Artane and Letterfrack for boys and Goldenbridge for girls standing out, in terms of the high percentage of refusals. This is perhaps because of the influence of the Resident Manager’s recommendation on the Department’s decision.
The following tables show the figures for early discharge related to each particular ground for entry to the schools.
Table C2: Early discharge by reference to individual categories
| Industrial Schools | ||||||||
|---|---|---|---|---|---|---|---|---|
| School attendance | Offences | |||||||
| Year | Approved | Detained | Ratio approved | Year | Approved | Detained | Ratio approved | |
| 1951 | 11 | 9 | 55% | 1951 | 11 | 13 | 46% | |
| 1952 | 5 | 15 | 25% | 1952 | 6 | 25 | 19% | |
| 1953 | 11 | 13 | 46% | 1953 | 8 | 14 | 36% | |
| 1954 | 13 | 15 | 46% | 1954 | 15 | 20 | 43% | |
| 1955 | 17 | 9 | 65% | 1955 | 14 | 15 | 48% | |
| 1956 | 19 | 4 | 83% | 1956 | 15 | 9 | 63% | |
| 1957 | 26 | 3 | 90% | 1957 | 19 | 9 | 68% | |
| 1958 | 21 | 8 | 72% | 1958 | 20 | 17 | 54% | |
| 1959 | 30 | 6 | 83% | 1959 | 26 | 21 | 55% | |
| 1960 | 11 | 3 | 79% | 1960 | 9 | 8 | 53% | |
| Total | 164 | 85 | 66% | Total | 143 | 151 | 49% | |
| Needy | No Grounds stated | |||||||
| Year | Approved | Detained | Ratio approved | Year | Approved | Detained | Ratio approved | |
| 1951 | 117 | 79 | 60% | 1951 | 6 | 13 | 32% | |
| 1952 | 140 | 105 | 57% | 1952 | 19 | 7 | 73% | |
| 1953 | 177 | 131 | 57% | 1953 | 23 | 9 | 72% | |
| 1954 | 192 | 87 | 69% | 1954 | 14 | 10 | 58% | |
| 1955 | 183 | 73 | 71% | 1955 | 19 | 2 | 90% | |
| 1956 | 230 | 43 | 84% | 1956 | 10 | 2 | 83% | |
| 1957 | 226 | 25 | 90% | 1957 | 28 | 2 | 93% | |
| 1958 | 171 | 50 | 77% | 1958 | 24 | 4 | 86% | |
| 1959 | 207 | 26 | 89% | 1959 | 26 | 2 | 93% | |
| 1960 | 119 | 11 | 92% | 1960 | 19 | 0 | 100% | |
| Total | 1762 | 630 | 74% | Total | 188 | 51 | 79% | |
Sources: Records from DJ11, commencing in July 1951 and ending July 1960
These tables show that, even when related to the population in each category of entry, there were more applications on the needy ground than either of the other two categories. Moreover, the success rate was also higher on the needy ground. This is to be expected given the fact that a change in family circumstances would be likely to have more impact.
Average reduction in committal period: reduction in length of sentence
For those who were successful, by how much did early discharge reduce their stay in an Industrial School?
| Period by which the committal period was reduced. | ||||
|---|---|---|---|---|
| Year | All categories | SA | Offences | Needy |
| 1951 | 5 | 2.4 | 1.8 | 5.6 |
| 1952 | 3.9 | 1.6 | 1.3 | 4.1 |
| 1953 | 4.6 | 1.7 | 1 | 4.9 |
| 1954 | 4.8 | 1.3 | 1.5 | 5.3 |
| 1955 | 5 | 1.8 | 1.9 | 5.5 |
| 1956 | 5 | 1.6 | 1.9 | 5.5 |
| 1957 | 5.5 | 1.8 | 1.3 | 6.1 |
| 1958 | 5.3 | 1.6 | 1.4 | 6.2 |
| 1959 | 4.9 | 1.6 | 0.9 | 5.8 |
| 1960 | 5.3 | 1.5 | 1.4 | 6 |
| Total | 49.3 | 16.9 | 14.4 | 55 |
| 4.9 | 1.6 | 1.4 | 5.5 | |
The table shows that for those applicants who were successful, the periods by which the committal period was reduced averaged nearly five years (this being an average across the sub-categories SA, offences and needy, which is weighted to reflect the fact that the majority of successful applications were from the needy category91).
One may see these figures in the perspective of two others. First, the average period for which children were committed during the 1950s was about seven years (depending on the category); secondly, only 4.3 percent of the population was successful in securing this reduction.
Reformatories
The above statistics concern Industrial Schools. The position regarding Reformatories was very different. Not only was their population much smaller. In addition, young offenders were committed by the courts for a relatively short period, compared to other categories of offender so the vast majority of applications were turned down. There were relatively few applications, and the success rate, for Reformatories at an average of 24 percent was much lower than for Industrial Schools.
| Year | Approved | Detained | Ratio approved |
|---|---|---|---|
| 1951 | 4 | 19 | 17% |
| 1952 | 3 | 26 | 10% |
| 1953 | 7 | 22 | 24% |
| 1954 | 6 | 33 | 15% |
| 1955 | 10 | 23 | 30% |
| 1956 | 6 | 27 | 18% |
| 1957 | 17 | 32 | 35% |
| 1958 | 13 | 34 | 28% |
| 1959 | 13 | 36 | 27% |
| 1960 | 7 | 23 | 23% |
| Total | 86 | 275 | 24% |
Numerical tables and comments
1 Section 31 of the Children Act 1908 (as amended by s 29 of the Children Act) gives these meaning: ‘child’ (under the age of 15, originally 14); a ‘young person’ (between the ages of 15 and 17, originally 14 and 16). The umbrella term ‘young offenders’ comprehends any offenders between the ages of seven and 21 years.
2 Similarly, after 1970 to avoid the stigma of committal proceedings, the tendency has been to have the child referred to the home wherever possible by the health board, under the provisions of s 55 of the Health Act 1953.
3 District Justice Sean Forde commented in 1930 that the county councils did not live up to their responsibility in regard to attendance in court: ‘This charge [of neglect and cruelty against parents] is a very serious one and I am adjourning it. I hope that the county council will be represented on the next occasion. In only one application of this kind in the past seven years has the county council appeared.’ The Department of Health inspector on boarded-out children also accused the county councils of neglecting their responsibility; even when they were present in court, they rarely opposed requests for committal: ‘This appears to be an extremely casual manner to treat the question of disposal of whether a child’s interests will best be secured by committal to an institution, by boarding-out if the family of which the child is a unit cannot be kept together by means of home assistance.’: Connacht Tribune, 4th January 1930, quoted in Department of Local Government and Public Health, Annual Report 1935-36, p 390.
On the other hand, a survey of ISPCC records (O’Cinneide and Maguire, ‘Findings from the ISPCC Records’ Sisters of Mercy Industrial Schools in Context, Report II, p 27) shows the ISPCC: ‘Interacting with a variety of individuals and agencies, including parish priests, local branches of the Society of St Vincent de Paul, and local authorities, to secure the resources necessary for parents to keep their children rather than have them committed.’
4 Section 58(4) also stated that, as an alternative to committal, the out-of-control child might be placed under the supervision of a probation officer. Also omitted from the text, as being seldom used, is sub s (5) by which:
Where the guardians of a poor law union or the managers of a district poor law school satisfy a petty sessional court that any child maintained in a workhouse or district poor law school is refractory or is the child of parents either of whom has been convicted of an offence punishable with penal servitude or imprisonment, and that it is desirable that the child be sent to an industrial school under this Part of this Act, the court may if satisfied that it is expedient so to deal with the child, order him to be sent to a certified industrial school.
[This was repealed by Child Care Act 1991].
5 However Kennedy, at (paras 10.5-6) suggested a more radical extension which was never implemented:
There could be numbers of recommended neglected children and young persons never brought before the Court because their cases do not fall within the limited provisions of Section 58…
This section should be amended to give the courts the widest possible jurisdiction to deal with a child or young person up to the age of 17 years who:
a) is not receiving such care, protection or guidance as a good parent might reasonably be expected to give, or
b) who is beyond the control of his parent or guardian and the lack of care, protection or guidance is likely to cause him unnecessary suffering, seriously to affect his health or physical development, or,
c) if he is falling into bad associations or is exposed to moral danger.
This would ensure that the complainant would no longer be faced with proving that the parent or guardian is unfit or unable to exercise, or is not exercising proper guardianship, but only with the tasks of showing that the child or young person is in fact not receiving such care.
6 The full wording of s 10 of the 1941 Act was as follows:
Provided also that the Court shall not make an order that a child be sent to a certified industrial school on the grounds stated in paragraph (h) unless –
the child’s parents consent or his surviving parent or, in the case of an illegitimate child, his mother consents to such order being made, or
the Court is satisfied that owing to mental incapacity or desertion on the part of the child’s parents or his surviving parent or, in the case of an illegitimate child, his mother, the consent of such parents or parent may be dispensed with, or
one of the child’s parents consents to such order being made and the Court being satisfied that, owing to mental incapacity or desertion on the part of the other parent or to the fact that the other parent is undergoing imprisonment or penal servitude, the consent of that parent may be dispensed with.
7 Commenting on the significances of the new legislation, the Department of Education Annual Report for 1929-30, p 105 stated that:
in 1929-30, there were 377 (out of a total of 996) committals under the 1929 Act. However this represents an increase of only 53 on the previous year’s figures under the narrower heads in the 1908 Act (and there was anyway a rising trend’). So ‘it is but natural to assume that the majority of committals under that Act would have been made under the Principal Act…even had not the more recent Act been in existence.
8 Perhaps the circumstances in which Mr Doyle consented to the making of the order of detention were significant. He was not at that time professionally represented. He was under the impression that such detention was not for a fixed period, but that he could obtain the child’s discharge at any time on making application therefore. This impression was contributed to by a remark made by the District Justice advising Mr Doyle ‘not to leave the child in the School too long.’: [1956] IR at 218. O’Mahoney, ‘Legal Aspects of Residential Child Care’ (1971) VI Irish Jurist 217.
9 Desmond Doyle, who had moved to England after his daughter was committed, soon returned to Ireland found a job and set about having his daughter released from St Joseph’s Industrial School in Whitehall in Dublin. The Minister refused the application. An internal Departmental memo stated that the sources of information on which the Department based its refusal of the application were as follows:
• Garda Siochana report that recommended the refusal of the application ‘in view of the limited accommodation in the house and the absence of a responsible woman on the premises’.
• The NSPCC report which recommended refusal on the grounds that there was a danger that the housekeeper employed by Mr Doyle (who was to look after the little girls) might find better employment and leave her position.
• A parental money collector reported that he failed to make contact with the housekeeper in his efforts to make discreet enquiries as to the nature of the relationship between herself and Mr Doyle.
10 SD vol 25, col 922, 22nd April 1941.
11 These formal shifts in classification were faithfully observed in the Education annual reports. The statutory categories for committal to Industrial Schools were naturally followed by the court and its records and, likewise until 1959-60, the Department annual reports gave the figures for those committed under every head of the statutory catalogue. There were in fact eight categories drawn from s 58(2), (4); plus three categories of ‘charged with an offence punishable in the case of an adult with penal servitude’ (division into three was made according to whether the child was under 12 and 14 or over 14 and under 15); plus non-school attendance. Thereafter there were some minor reductions in the Education reports but the big change came in 1959-60, when there were only four categories: destitute; uncontrollable; offender; non-school attendance: Barnes, Irish Industrial Schools, 1868-1908 (Irish Academic Press, 1989).
12 Barnes, Irish Industrial Schools, 1868-1908 (Irish Academic Press, 1989), p 62 states:
This industrial school legislation proved difficult to implement and in the early years of its operation many errors were made in the committal of children, resulting either in dismissals from schools or in the necessity of repeating the committal process. In some cases the error was slight as when, for example, a magistrate failed to complete the necessary order form correctly. Invalid order forms were a nuisance for the administration, and the Inspector of Schools, Lentaigne was driven to complain bitterly’ … these invalid orders are so frequent that I believe a circular to magistrates is necessary – magistrates especially in the West of Ireland are so ignorant of the statute that frequent blunders are committed’. In 1873 a circular to magistrates at petty sessions was drawn up giving a clear summary of the grounds upon which committal could be made and indicating how the order form should be filled in. Each subsequent year copies of this circular were sent to magistrates throughout the country. Despite these efforts illegal committals due to simple errors remained a feature of the industrial schools throughout the Nineteenth Century.’ We have discovered no similar errors in post-Independence committals. This may be because District Justices, in contrast to Magistrates were legally qualified.
13 Kennedy, Table 25 shows out of a 1969 population of 105 boys at (Daingean) Reformatory, 6 at 13+ years and 11 at 14+ with the remainder aged 15+. (For girls the equivalent figures were: a total of 38 with three and five girls aged 13+ or 14+, with the remainder aged 15+.) The 1908 Act, s.58(3) as amended by the 1941 Act, s 10(2) states:
Where a child, apparently of the age of twelve or thirteen [or fourteen] years, who has not previously been convicted, is charged before a petty sessional court with an offence punishable in the case of an adult by penal servitude or a less punishment, and the court is satisfied that the child should be sent to a certified school but, having regard to the special circumstances of the case, should not be sent to a certified reformatory school, and is also satisfied that the character and antecedents of the child are such that he will not exercise an evil influence over the other children in a certified Industrial School, the court may order the child to be sent to a certified Industrial School, having previously ascertained that the mangers are willing to receive the child: Provided that the [Minister for Education] may, on the application of the managers of the Industrial School, by order, transfer the child to a certified reformatory school.
Before the 1941 Act the unamended 1908 Act referred to children of the age of ‘twelve or thirteen’ only.
14 IPA, 2005, Table 5.3 The most numerous offences for which juveniles were sent to Reformatories were larceny; subsequently house-breaking overtook larceny in the share of the committals.
15 What follows is a paraphrase of s 107 of the 1908 Act where the available sanctions are summarised. Section 107 states:
Where a child or young person charged with any offence is tried by any court, and the court is satisfied of his guilt, the court shall take into consideration the manner in which, under the provisions of this or any other Act enabling the court to deal with the case, the case should be dealt with, namely, whether –
by dismissing the charge; or
by discharging the offender on his entering into a recongisance; or
by so discharging the offender and placing him under the supervision of a probation officer; or
by committing the offender to the care of a relative or other fit person; or
by sending the offender to an industrial school; or
by sending the offender to a reformatory school; or
by ordering the offender to be whipped; or
by ordering the offender to pay a fine, damages, or costs; or
by ordering the parent or guardian of the offender to pay a fine, damages, or costs; or
by ordering the parent or guardian of the offender to give security for his good behaviour.
16 Summary Jurisdiction over Children (lreland) Act 1884, Children Act 1908, ss 128(1), 133(7) (under 14s); Larceny Act 1916, Offences Against the Person Act, 188? (under 16s).
There are involved arguments (founded on possible inadvertence by the legislature) to the effect that it remained lawful for a court to order the whipping of male children, though not probably young persons. But the fact remains that whipping was not ordered, at any rate after independence, and there were no arrangements for carrying it out.
17 1908 Act, s 106 states:
Where a child or young person is convicted of an offence punishable, in the case of an adult, with penal servitude or imprisonment, or would, if he were an adult, be liable to be imprisoned in default of payment of any fine, damages, or costs, and the court considers that none of the other methods in which the case may legally be dealt with is suitable, the court may, in lieu of sentencing him to imprisonment or committing him to prison, order that he be committed to custody in a place of detention provided under this Part of this Act and named in the order for such term as may be specified in the order, not exceeding the term for which he might, but this Part of this Act, be sentenced to imprisonment or committed to prison, not in any case exceeding one month.
18 In addition there was an Honorary Probation Officer, a Major in the Salvation Army, who had responsibility for 10 Protestant probationers, throughout the State: see The Irish Times, 2nd February 1950 ‘Child Delinquency – I’ Report on the Probation and Welfare Service for 1980.
19 The Protection and Welfare of the Young and the Treatment of Young Offenders (Cmd 187) (Belfast, HMSO, 1938), paras 95-104; Report on Social Services Committee (Cmd 1601) (HMSO,) para 53.
20 At para 10.10.
21 In the mid-1970s, health boards began to take children into care following orders made under this power, though these were of doubtful legality. By this time, there were very few cases of destitution but there remained a relatively large number of cases of lack of guardianship. These were dealt with not by committal but by making a fit person order in which the fit person was a relation, or neighbour following a change brought in by the Health Act 1970?? But it was not until emergency legislation – The Children Act 1989 – that these orders were (retrospectively) legally sanctioned by designating the health board as ‘a fit person’ for the purposes of such applications. The 1989 Act was enacted because it was held in The State (D and D) v G 1990 IRLM 136 that health boards were not ‘a fit person’ within the meaning of the 1908 Act.
22 For instance, in the case of Seamus Dalton (hearing 23rd June 2005) in March 1962, aged 10, he was committed to Letterfrack for six years, for stealing a purse. The Brothers regarded this as an ‘extraordinary’ length of time. The cause seems to have been that the Gardai considered that, (possibly because his mother had received a suspended sentence for the same offence), he should be sent away for a long time. And, in 1966, when an application was made to the Minister for his release, the Gardai still recommended against it; whilst Letterfrack advised (in September 1966) that he should be released. He was not released until July 1967, an unusually long time after the school’s recommendation.
23 In 1964, some 2,800 children in the age group between 7 and 17 (including 195 girls) were found guilty of indictable offences. This was the lowest total in six year and undoubtedly reflected the siphoning off of young offenders by the junior liaison officers.
Since they began operating, in 1963 up to 1969, a total of 5,000 juveniles were cautioned and supervised by the Gardai. The comparison between a probation officer and the JLO was that the JLO made an impact at a significantly earlier stage in the ‘delinquent machine.’: see P Shanley, ‘The Formal Cautioning of Juvenile Offenders’ (1970) V Irish Jurist, 267.
There were preconditions for entry to the scheme: the offence had to be minor; the parents had to allow the JLO to make visits to their house; the juvenile had to submit to a talking-to from the superintendent for the district. The JLO himself was a comparatively junior officer (with no authority to restrain a fellow garda who had arrested a young offender from bringing him before the court.
24 Annual figures for the JLO for 1968-2003 are given in O’Donnell, O’Sullivan and Healy (eds), Crime and Punishment in Ireland 1922 to 2003: A statistical Sourcebook (IPA, 2005), Table 5.3 and 4.
25 See Fahey, ‘State, Family and Compulsory Schooling in Ireland’ Economic and Social Review, Vol 23, No 4, July 1992, p 369; D H Akenson, The Irish Education Experiment (London, Routledge and Kegan Paul, 1970), pp 344-9. The Education (Ireland) Act 1892 first made school attendance compulsory; though only in a number of urban boroughs and about 40 rural districts.
26 Section 17 of the 1926 Act states:
(1) Whenever a parent fails or neglects to cause his child to whom this Act applies to attend school in accordance with this Act and, so far as is known to the enforcing authority of the school attendance area in which the child resides, there is no reasonable excuse for such failure or neglect, such enforcing authority shall serve on such parent a warning in the prescribed form –
requiring him within one week after such service either to cause his child named in the warning to attend school in accordance with this Act or to give to the enforcing authority a reasonable excuse for not so doing, and
informing him that in the event of his failing to comply with the warning, proceedings will be instituted against him under this Act in the District Court, and
informing him that if within three months after such proceedings he again fails to comply with the Act, further proceedings may be instituted against him without previous warning.
(2) If a parent does not comply with a warning duly served on him under this section, he shall, unless he satisfies the Court that he has used all reasonable efforts to cause the child to attend school in accordance with the Act, be guilty of an offence under this section and shall be liable in the case of a first offence to a fine not exceeding twenty shillings and in the case of a second or subsequent offence (whether in relation to the same or another child) to a fine not exceeding forty shillings.
(3) Whenever a parent within three months after being convicted of an offence under this section, fails without reasonable excuse to cause his child in respect of whom he was so convicted to attend school in accordance with this Act, such parent shall, unless the child has ceased to be a child to whom this Act applies, be guilty of an offence under this section (which shall for the purposes of this section be deemed to be a second offence under this section) and shall be liable on summary conviction thereof to a fine not exceeding forty shillings.
(4) If in any proceedings against a parent under this section the parent satisfies the court that he has used all reasonable efforts to cause the child to whom the proceedings relate to attend school in accordance with this Act or the parent is convicted of a second or subsequent offence under this section in respect of the same child, the court if it thinks fit may: (a) order the child to be sent to a certified industrial school, in which case the provisions of Part IV of the Children Act 1908 so far as applicable shall apply as if the order had been made under that Part of that Act, or (b) in accordance with the provisions of Part II of the said Children Act 1908 order the committal of the child to the care of a relative or other fit person named by the court, and in such case the provisions of that Part of that Act shall, so far as applicable, apply as if the order were an order made there under.
The court minute books in relation to committals to Industrial Schools always display the dates on which the parent has been convicted of the requisite two offences.
27 The School Attendance Act 1926 (Extension of Application) Order 1972, SI 105 of 1972 raised the school leaving age from 14 to 15.
28 There was an alternative possibility: if in the first proceedings ‘the parent satisfies the court that he has used all reasonable efforts to cause the child to attend school’, then by s 17(4), the child may be sent away, even though there is no second conviction. In fact, our survey of the Dublin Metropolitan Court records show that this possibility occurred very seldom.
29 A lot of the information in the previous three paragraphs is taken from Fahey, State, Family and Compulsory Schooling in Ireland at 379-81.
30 The annual reports for Dublin School Attendance Committee record that in 1965-66, 40 children were committed with 10 appeals, 5 of which were allowed; 1966-67: 41, 7 appealed, all allowed; 1967-68: 25 appealed, 8 allowed,1. 1965-66 was the first year for which there was any mention of appeals. It seems reasonable to infer that this was the first year when any appeals were taken to the Circuit Court against committal by the District Court.
31 DD, 17th February 1942, cols 2533-4.
32 Compiled from City of Dublin School Attendance Committee Annual Reports for 1940-41 to 1967-68, (though with 1943-44, 1945-46, 1948-49, 1952-53, 1961-62 missing) national figures from Department of Education. And from Fahey op cit, which states:
National school attendance rates remained in the range 83-85 per cent from early 1930 through to the mid-1950s. In the second half of the 1950s it began to edge towards 87-88 per cent and it was only in the mid 1960s that it broke the 90 per cent barrier.
33 Source: ‘Return of Prosecutions under the Education and School Attendance Acts – by Counties’, available in National Archives.
34 CICA received a letter from a retired Gardai superintendent who at the start of his career in the 1950s acted as a SAO in County Dublin and County Clare. He states that over this five-year period, he did not once apply for a committal order. He continues:
I would deal informally with the parents, usually the mother, of the offender, without resorting to summoning. Where this was not effective I would have a parent and child summons issued directing both defendants to attend at a special sitting of the District Court known as a Children’s Court to which members of the general public would not be admitted. Resultant fines would be levied on the parent. In the case of truancy or mitching I always searched out the child no matter if this involved crossing District or Divisional boundaries. When located I either walked the child or conveyed him (usually a male) on my bicycle (my only transport was a bicycle), to his home or back to school. If a District car were available I would request its use. It was not unknown for School Attendance Officers to visit the home of an absentee and alert whatever social service might be available, if conditions were bad. My predecessor, Garda …had a reputation for strictness but I found that he had arranged for weekly supply of bare essentials like tea, sugar bread and milk where a lone or deserted parent was destitute or simply ineffectual. He later became a Chief Superintendent and is deceased. He had enjoined me not to mention my discovery to anyone during his lifetime.
35 Commissioners Minute 20.33/S/40R of 18/10/40. The response is Document 2627/40.R.For a brief protest at the harshness of a committal in these circumstances, DD, vol 14, col 8321 (12th February 1926).
36 This was the view expressed for instance at the time of the (original) Irish Industrial Act, 1868 (modelled on earlier legislation for England). Presbyterian MPs from North Ireland pointed out that it was ‘a considerable infringement of personal liberty’ to take up children merely for vagrancy and send them to prison for a long time – ‘although the prison be called an industrial school’: Hansard Debates (3rd series) 191, 1867–68, 221-22.
37 Eg Cussen Committee, para 49-52; commented unfavourably on the fact that children’s cases were heard within the precincts of the ordinary courts.
38 The more radical terms of reference of the abortive Commission of Inquiry of 1929 (Misc/56) included:
Committals:
The method of Committal and the question of substituting civil for criminal procedure;
The grounds of committal;
The number and character of committals; and
The use of probation as an alternative.
39 Cussen, para 51 and Deputy T O’Connell and Hayes in debate in the Children (Amendment) Bill 1941: DD, vol 76, col 543.
As one of many case-studies on this topic, consider Mary who was committed to an Industrial School on 13th April 1935 by order of the District Court pursuant to the Children Act 1908. The reason given was that she was destitute. The District Court directed that she remain within the Industrial School system until she reached the age of 16. Since her age at the time the order was made was 23 months, she spent 14 years of her life in Industrial Schools. In relation to the manner in which she was placed within the Industrial School system her major complaint is that in so doing the State criminalised her. She is of the view that she was charged, tried and convicted by a criminal court, which sentenced her to 14 years in prison (she was aged 23 months at the time of her committal). The words she uses in her various letters are that she was ‘charged,’ with being destitute, ‘found guilty’ and ‘sentenced to 14 years in one of Ireland’s penal institutions’. She has consulted the court records and they have reinforced her in this view. The Department of Justice, Equality and Law Reform has stated that she was not convicted of any offence and furthermore that she could not have been in view of her age and the fact that she was involved in care proceedings.
At this point, one might comment that the selection by someone in the courts, system, of criminal (rather than say civil forms) suggested that even officials were not clear about the difference between committal orders and criminal proceedings. They did admit however that the court forms used at the time might have contributed to her view that she was involved in to criminal rather than care proceedings. The Department also pointed out that s 35 of the Residential Institutions Redress Act 2002 removes any doubt that a person who was detained in an Industrial School pursuant to the Children Act 1908, other than a person who was so detained as a consequence of a conviction for an offence, shall not be subject to any disqualification or any other restriction that is a consequence of a conviction. Ms Henderson is not persuaded by this provision and wants her criminal record expunged. She is also dissatisfied by the fact that no evidence survives to support the courts’ view that she was destitute. She feels that she was ‘stigmatised as a criminal as surely as if [she] had been sentenced to a term of imprisonment in Mountjoy Prison,’ and points out that as a result she has been deprived of employment opportunities in many spheres.
Finally she points out that the State made no effort to keep her family together in that it deliberately withheld correspondence from her family while in school and also in so far as it did not tell her how many siblings she had.
40 Dennis O’Sullivan, ‘An Irish Industrial School viewed as a socialising agent with particular reference to its social organisation’ (UCG PhD, 1976) (study of Letterfrack, based on interviews with 40 of the residents).
41 Interviewees also stated (Dennis O’Sullivan, PhD, 157):
The judge tried me and said I wasn’t able to read and didn’t know anything. So she sent me down here and thought I’d be getting a better education and get more things learned.
I was sent down here by Justice Kennedy – She said I was giving my mother a lot of trouble and she wasn’t well and in hospital with her nerves. She said it would do me good and would teach me a lesson.
42 At para 53. Yet when this proposal was brought up in the Dail by the opposition deputy, James Dillon, it was rejected at the report Stage of the 1941 Bill (DD, vol 81, col 2219 (19th February 1941)), by the Minister for Education on the basis that such ‘psychological disease’ did not exist in Dublin:
43 While their main task is supervision, probation officer are officers of the court and they could also be and, in the Dublin Metropolitian District Court were asked, in advance of sentence, to supply authoritative information on an offender’s background. However, there were until the 1970s (para 00) no probation officers outside the Dublin MDC and even there, they were hard pressed with their other duties. Thus the probation officers did not meet the need. In the 1970s, something like the recommendations of the Cussen Committee were adopted: in that where a School Attendance Officer considered that he ought to go to Court to seek a committal order he had first to have the child assessed (psychologically, medically and educationally) over a three week period at St Michael’s assessment unit in Finglas. During the final week the assessments would be reviewed at a case conference by agencies – for instance the ISPCC, health board, as well as SAO – who knew the child and his family. It would then be the case conference’s decision – which might be not to seek committal but, for instance, to seek a fit person order or to move the child to another external school or to shift the child to a special class, within the same school – which would be implemented.
44 Section 111, as amended by Children (Amendment) Act 1941, s 26.
The Dublin MDC was held at Dublin Castle from its establishment in the late 1930s to the early 1980’s when it moved to the Four Courts (Morgan Place entrance) for approximately one year and then onto Smithfield in 1986. It moved from its original building to the building next door in 1987, where it is at present.
45 After a survey of the regional and national newspapers M Maguire states that outside Dublin both categories of newspaper did publish names and/or addresses of children who came before courts: ‘Briefing paper: Newspaper Research on former residents of Mercy Industrial Schools’; Sisters of Mercy Industrial Schools in context, 1.
46 Application is generally made by summons specifying the ground on which the order is sought and naming the child and parent or guardians as defendant. However a Justice may hear an application in a case where it is inexpedient or impracticable to take out a summons: James V Woods, District Court Guide (1977) , vol 1, pp 186-90; Summary Jurisdiction Rules 1909, r 16.
47 The introduction of legal aid in criminal cases in 1964 (by the Criminal Justice (Legal Aid) Act 1962) was slow to catch on perhaps because some people’s pride would be wounded if they had to disclose that their means were sufficiently low to qualify for legal aid. Next to no children were represented under the Legal Aid Scheme, at least until 1971. Its impact is shown by the following figures:
| Applications | Granted | ||
| 1967 | 14 | 1 | |
| 1968 | 18 | 4 | |
| 1969 | 6 | 2 | |
| 1970 | 9 | 1 | |
| 1971(up to 13th May) | 40 | 13 |
[Figures from M Robinson’s speech in debate in Kennedy Report: SD, vol 76, col 109 (15th November 1973); DD, vol 254, cols 1968-69 (17th June 1971)]
48 Section 98(1) of the 1908 Act provides that:
The parent or guardian may in any case and shall if he can be found and resides within a reasonable distance, and the person so charged or brought before the court is a child, be required to attend at the court before which the case is heard at all stages of the proceedings unless the court is satisfied that it would be unreasonable to require his attendance.
It is the parent ‘having actual control’ of the child or young person who is required to attend: s 98 (4). When a child or young person is arrested it was the duty of the garda in charge of the Garda station to which he was brought, to warn the parents to attend the court when the child or young person appears: s 98(2)
49 The legislation stated ‘that no order for the detention of a child in an Industrial School shall be made unless the [health board] for the region in which the child resides has been given an opportunity to be heard’: Children Act 1908, s 74, as amended by Children Act 1941, s 40. This was because the health authority had to contribute to the capitation grant. However, the health authority was not usually represented.
50 J O’Connor BL, ‘A paper on Juvenile Delinquency’ read to Tuairim, 6th March 1959), p 25:
There is an almost complete lack of co-operation between Probation Officers, School Attendance Officers and other such persons on the one hand, and youth organisations on the other. In four years from 1950 to 1954, over 1,000 boys regularly attended the Civics Institute Playground at Cabra, and they came into close contact with the playleaders, who developed an intimate knowledge of their background. Some of these boys came before the Children’s’ Court for a variety of reasons, yet at no time during that period was the co-operation of the playground staff sought by the Probation or School Attendance Officers.
51 For protest against refusal by Managers to accept children, see for example District Justice McCarthy (at p 51):
On frequent occasions the Managers of these Institutions – particularly in the case of the Girls Reformatory School – have refused admittance to a child on the ground that they did not consider him or her a fit subject for treatment in their Institutions. Within the past 12 months the Sisters in charge of the Reformatory School at Limerick have refused to accept girls for no other reason than that they were likely, as they thought, to prove troublesome – and this, although, they had little or no knowledge of the circumstances surrounding the girls’ delinquencies, and had not the advantage, shared by the Court and its advisers, of contact with the girls and their relations, sometimes over a period of weeks…
On a Manager’s discretion to refuse admission to a child.
52 When children were committed in the Dublin Children’s Court to schools outside Dublin it was sometimes necessary to keep them overnight in a ‘safe place’, also called a ‘place of detention’. The Industrial School at High Park served as a place of detention for girls, whilst boys were held at Summerhill, later Marlborough House.
53 Kennedy, para 10.14.
54 Lunney, MA 1995, p 87 writes:
Invalid court committal orders were so frequent by 1871, particularly in the West of Ireland that a circular was issued from the Chief Secretary’s Office to the Magistrates of Ireland informing them that such ‘blunders’ were a great injustice to the managers of the Industrial Schools who were put to much trouble and expense. There was no recompense to the schools for the period of detention served under these invalid committal orders since retrospective payments were not made. Dr John Lentaigne [the earliest Inspector of Schools: para 00] tried in vain to have this matter rectified so that a child would not have to be discharged pending the provision of a correct court order. Secretary Thomas Burke insisted that such children ought to be discharged, and if at a later date they were considered suitable subjects for an Industrial School a new committal order had to be issued, repeating the procedure of bringing them before the justices in Petty Sessions. The sisters in these schools were reluctant to discharge such children for the intervening period, preferring to keep them unofficially at their own expense.
What jumps out of this passage is the absence of any suggestion that if the committal order was invalid, the detention was unlawful and could theoretically have resulted in a habeas corpus order and/or damages for false imprisonment.
At the stage of exit, too, difficulties might arise. For instance, in one nineteenth century case, through a mistake, the order specified committal only until the age of 13. The Chief Secretary refused to allow the manager to retain her any longer. In the converse case, where the committal order set a date later than the 16th birthday, the Chief Secretary directed her release at her 16th birthday. In each case, a longer detention would have been unlawful. Both cases from Lunney TCD MA, 88.
55 Cussen (1934-37), Little (1937-40), McCarthy (1941-57), O’Riain (1957-62), O’Hagan (1963), Carr (1964-66), Mixed (Carr, O’hUadhaigh, Kennedy) (1967-68); Kennedy (1968-83).
56 Note of interview given by Minister to Fr Ryan, Superior General of Oblate Order, and Fr Reidy, Headmaster of Daingean (noted by TOR on 16th March 1950: DEDANO – 276-018/1) Fr Ryan stated that the chances of a boy’s reform are in inverse ratio to the number of chances given to the boy by the District Justice:
For the District Justice to give too many chances causes lack of respect for the law and also every new offence contributes to habit. Some boys are now under the impression that they have a right to be let off three times under the First Offenders Act. (sic)
The Department’s comment on this is contained in a memo from MO’S to Mr Hackett of 29th April 1950 (DEDA No 276-020/1):
There is something to be said for Fr Ryan’s point of view on the number of chances given to boys by the District Justice but that is a matter about which we will have to be very careful, if any action is taken. A District Justice would probably resent even a suggestion from a Department: he might consider it undue interference in his work.
57 Memo of Report of Department of Education of August 1971 states:
In this connection a further point arises for mention from our discussion with Fr. Kennedy of Clonmel. He is altogether opposed to committals to the school for short periods i.e. 3 to 9 months or one year and he has now let it be known to the courts that Clonmel is not available except for children committed, in general, up to 16 years. He said that, in his view, the course of training in the school cannot achieve its purpose unless the boy remains for a sufficiently long period to benefit from it. Furthermore, the departure of boys who have spent shorter periods than the normal in the school has an unsettling effect on the other boys.
58 District Justice McCarthy presided over the Dublin Children’s Court between 1941 and 1957. See also Raftery and O’Sullivan, Suffer the Little Children, pp 195-7 for an account of a suggestion by Gerry Boland, Minister for Justice, that a committee be established the real purpose of which would be to establish that DJ McCarthy was too lenient.
59 Originally (under the 1908 Act) this was three to five years. However the 1941 Act reduced this period from two to four years. It also raised the upper limit of committal to a reformatory from 16 to 17 and reduced period of detention after which managers could release on licence from 18 to six months.
60 In The Irish Press 27th June 1967, Joseph O’Malley gives the eventual average length of stay in Daingean Reformatory as about 15 months.
61 The 1908 Act, s 65(b) states:
The detention order shall specify the time for which the youthful offender or child is to be detained…being… in the case of a child sent to an industrial school, such time as to the court may seem proper for the teaching and training of the child, but not in any case extending beyond the time when the child will, in the opinion of court, attain the age of sixteen years.
One legal argument that has been suggested is that the phrase ‘such time as … may seem proper for the teaching and training of the child’ assumes that the child will remain on in school in order to take the leaving certificate examination. To do this, it was necessary to stay in school until at least the 16th birthday. In the result, the order committing the child to the Industrial School would have to acquire to remain there until the 16th birthday. But this reasoning proceeds from a somewhat unlikely assumption, namely that a child who in most cases would have shown no academic aptitude (especially the SAO entrants) was going to be one of the, what until the late 1960s and the coming of free secondary education was a considerable minority, namely students attempting the Leaving Certificate. This unlikely eventuality was made to bear the weight of a considerable deprivation of liberty. For a view that a District Judge could not commit for less than two years, see DD, vol 164 (31st October 1957) (J Lynch). But see also DD, vol 88, col 2535 (10th October 1937): Minister for Education, Tom Derrig, spells it out that the District Justice does have discretion.
62 Kennedy (1970) at para 10.18 writes:
The period for which a child may be legally detained in an Industrial School under the School Attendance Act, 1926, appears to be the same as under Section 65(b) of the Children Act 1908, but, in practice, the Courts appear to hold that detention may not extend beyond the date when the child will, in the opinion of the Court, attain the age of 14 years.
63 DD vol 166, col 779 (25th March 1958).
64 A child could not be kept in an Industrial School beyond 16 unless the Minister for Education, with the consent of their parents or guardians, directed that he stay on for one further year only for the purpose of completing his education or training. See s 65(b) of the 1908 Act as extended by s 12 of the 1941 Act, and for St Anne’s Reformatory see s 6 of the Children (Amendment) Act 1949.
65 1908 Act, s 69(1) as amended by s 29 of 1941 Act states: ‘The [Minister] may at any time order a youthful offender or a child to be discharged from a certified school, either absolutely or on such conditions as the [Minister] approves….’ The Children (Amendment) Act 1957, s 5, which superseded the 1908 Act, in the case of children committed under s 58 of 1908 Act stated:
‘(1) Where
(a) a child has been committed to an industrial school under section 58 of the Principal Act and,
(b) an application is made to the Minister for Education by a parent or guardian for the release of the child, and
(c) the minister is satisfied that the circumstances which led to the making of the committal order have ceased and are not likely to recur if the child is released, and that the parent or guardian is able to support the child, the Minister shall order the discharge of the child.
(2) The Minister may, if he so thinks proper, refer the application to the court.
(3) If the Minister refuses the application, the parent or guardian may refer it to court.
(4) The Court if satisfied in regard to the matters referred to in paragraph ( c) of subsection (1), shall have jurisdiction to order the discharge of the child.
(5) A reference to the court under this section shall be made to the District Court in the District in which the committal order was made or, if the applicant resides in another District, in that District.
(6) The order for the discharge of the child, whether made by the Minister or the court, shall operate to revoke the detention order.
(7) (a) Where the District Court or, on appeal, the Circuit Court, orders the discharge of a child, the court may award costs and expenses to the successful applicant.
We came across no instance of recourse to a court, under sub-ss (2)-(7) and so this possibly is not mentioned in the text.
This provision was introduced in response to the Doyle case discussed at Appendix, par (iii).
66 The general obligation on parents in accordance with the SA Act 1926 was to arrange for the elementary education of their children, between the ages of 6 and 14 years. Outside this range, the Department believed (as a result of Doyle) that the parents rights under Art 42 of the Constitution, which makes the family the primary educator of the child meant that their preference to send the child to school or not must be supreme and the State could not interfere. Accordingly s 17(4) of the SA Act, 1926 in so far as it empowered the courts to commit a child to an Industrial School for a period extending beyond the child’s 14th birthday was repugnant to the Constitution.
The Department’s view was challenged by Dublin CB District Justice O’Riain (Children’s Court Justice during 1957-62) who made vigorous representations to the Department (note of 9th September 1960) to the effect that almost all of those committed were over 10 years of age, chronic non or bad school attenders and hence well-nigh illiterate or wholly so and therefore sorely in need of at least a few years education. He felt strongly therefore that the Minister should exercise the powers he believed him to possess to retain those children committed under SA Act until the expiry of the period fixed by the courts, even if this was 16. He sought to sustain this view legally, by invoking ss 58, 65 and 133(20) of the 1908 Act.
Following these representations, the Department referred the issue to the Attorney General who in effect upheld the Department’s view. The gist of his opinion was that:
Throughout both the Doyle Judgments, therefore, there is a common thread. Legislation authorising the State to take the place of the parent cannot be regarded as appropriate within the terms of Article 42(5) unless there is provision by which the State’s intervention is limited in time to the duration of the parental need or the parental default.
The, second stage in the reasoning was that once the child passed their 14th birthday, a parent could not be in default just because, under the 1926 Act, the general obligation (irrespective of anything to do with the Industrial Schools) was to ensure only that the child attended school up to the age of 14. The conclusion was that the State cannot interfere further, after that age has been reached, with the natural, primary and fundamental unit group of the family or with the unalienable and imprescriptible rights of the parents.
Rather significantly, though, the Department took the view that if no request was made by the parents, the young person did not have to be released: Memorandum from Mr Justice O’Riain, 13th September 1960; Attorney General’s Opinion of 23rd September 1960, 2780/60.
67 As public representatives, TDs often contacted the Department or the Minister of the day, supporting the parent applications or requesting that a particular case be investigated. However, as will be seen from the various examples to be cited, there is no particular evidence to suggest that such representations had any real influence on the decision or that cases supported by TDs were treated more favourably than others. Two individual applications by parents to have their children released from St Patrick’s Industrial School for Boys in Kilkenny illustrates the point. An application by the parents of David Purcell supported by Sean Tracey TD was refused. The ISPCC was against the release of the boy on the grounds that the financial position of his parents was insufficient. In contrast, the politically unsupported application of the parents of Gerard Myles Conlan was granted due to the favourable reports received from both the ISPCC and the school.
68 Sometimes it was also necessary to write to British children’s social workers for a view as to the condition of parents residing in Britain who wished to recover children.
69 Departmental memo of 15th and 21st June 1944 stated:
It is a legal obligation imposed on the Minister to release such children when their parents are able to support them and apply for their release; moreover; even when such an application, is not received, the Minister consider that maintenance at the public expense of children whose parents are able to support them, is an abuse of the industrial schools system.
In anticipation of a meeting with the Association of Managers Department, memo of 18th November 1964 stated that ‘three sore points will certainly come up: (i) Lack of committals; (ii) Short term committal; (iii) Discharges.’
70 At DD, vol 164 (31st October1957).
71 See to same effect a letter from Artane Residential Manager to (Inspector) J McLoughlin of 29th March 1943. One telling case concerned Carriglea Park School in County Dublin. In 1943, when both of the senior boys schools in County Dublin were consistently full to capacity, the Minister wrote to the Manager. He proposed that, where the boys had been committed under the School Attendance Act, they should be released at the age of 14 years on the ground that they would, if they had not been committed to a school, in all probability have ceased education at that age. The Carriglea Park Manager’s response was:
To give a précis of the record of each boy committed under the 1926 Act whose period of detention was due to end in 1943, 1944 and 1945 setting out the reasons why these boys were either suitable (1 case) or not suitable (6 cases) for discharge. The reason given was generally backwardness or the unsuitability of family circumstances. The Departmental record continues: ‘Those boys whose periods of detention were drawing to a close because they were due to leave in 1943, fare better. 10 out of the 22 boys in this group were deemed suitable for early release.’
In 1955, Fr Reidy of Daingean, and therefore chairman of the Association of Resident Manager’s received large headlines in the Evening Herald for his statement to Justice McCarthy’s Children’s Court in Dublin that boys were being released from the Reformatory through political influence (from File G:001E 13th September 1955).
72 Appendix E, Table 8.
73 O’Cinneide and Maguire, ‘Childcare in Ireland: State Policy and Administration 1920s to 1960s; The Sisters of Mercy ‘Industrial Schools in context’, pp 53-54.
74 Section 56(2) of the 1953 Act states that
Where a health authority have sent a child to a school approved of by the Minister, the authority –
May at any time, with the consent of the Minister, remove the child from the school, and
Shall remove the child from the school if and when required so to do by the Minister or by the managers of the school, or upon the school ceasing to be approved of by the Minister.
75 Section 55 (1) stated:
A health authority may provide, in accordance with regulations, for the assistance of a child to whom this subsection applies in any of the following ways (whether in or outside their functional area), that is to say, by boarding the child out, or by sending him to a school approved of by the Minister, under Sect 55 (8) of the Health Act 1953, or, where the child is not less than fourteen years of age, by arranging for his employment or by placing him in any suitable trade, calling, or business.
(2) Subsection (1) of this section applies to any child who is eligible for institutional assistance under section 54 of this Act and who is –(a) a legitimate child whose father and mother are dead or who is deserted by his father and mother or (where one of them s dead) by the survivor, or an illegitimate child whose mother is dead or who is deserted by his mother.
(3) A health authority may, with the approval of the Minister, assist any person eligible for general assistance within the meaning of the Public Assistance Act, 1939, by doing, with the consent of such person and in accordance with regulations, any of the following things in respect of any child whom such person is liable under the Public Assistance Act, 1939 to maintain, that is to say, boarding the child out, or sending him to a school approved of by the Minister or, where the child is not less than fourteen years of age, placing him in any suitable trade, calling, or business.
Section 55 was repealed by the Child Care Act 1991. Section 4(4) of the Children Act 1989, which provided that where a child or young person was dealt with under s 55 (1)(a) (ie placed in foster care) he should be deemed to be boarded out under s 55. The Act of 1989 seems to have been a response to a decision of the Supreme Court in The State (D and D) v Groarke [1990] 1 IR 305, which held that a health board has no statutory authority to act as a ‘fit person’ under the Act of 1908.
76 These had various relationships with general local authorities. For instance, in County Cork, there existed the South Cork Board of Public Assistance, the North Cork and West Cork Boards; whereas Cork Corporation administered services within its own area. In 1961 the Cork Health Authority was established and took over the health and social services functions from the local authorities for both Cork City and County. In Kerry, the country council administered each function until 1970. Then throughout the State eight health boards were established taking responsibility for both health and social services for children.
77 ‘There are over 80 children at present in the Children’s Home, Tuam. This is an increase of 33 1/3 per cent over last year’s figures. The maintenance of this large number of children in the Home is a considerable drain on the resources of the country and steps should be taken to reduce it by boarding out at an earlier age. This will not only cost less but will be better for the children. When the agreement between the Health Board and the Children’s Home is due for renewal, the age for boarding out should be fixed at not later than 3 years of age. F23, 506/40 (ab) 28 October, 1940.’
78 At para 27.
79 ‘Childcare in Ireland: State Policy and Administration 1920s to 1960s’ The Sisters of Mercy Industrial Schools in context, p 53.
80 Note: after the post-Kennedy reorganisation of 1970 Letterfrack, Clonmel and St Laurence’s, Finglas were included, with Daingean, St Joseph’s and Kilmacud, as ‘special schools’; and distinguished from other former Industrial Schools (which were shifted from the aegis of the Department of Education to Health. This was because these ‘Special Schools’ received all offenders. However despite this shift, in order to be consistent we have, throughout, treated all the residents in Letterfrack, Clonmel and St Laurence’s as Industrial School residents.
81 The annual report Table O gives a regional breakdown for population (so too does Table 26 of Kennedy, which even refers to Great Britain).
82 This represents an average over the five years in which a census was taken (1936 22%, 1946 24%, 1951 23%, 1961 26%).
83 While the extant court records are supposed, by now, to have reached the National Archives we found that quite a few of the annual minute books (for different court areas or districts) were missing from the Archives. Furthermore it was difficult to calculate the varying age cohorts from which those committed would be drawn, in view of the fact that this fluctuated depending on which record books were missing for which year. Again, with frequently sparse populations, the raw figures are so low it would be difficult to see anything in the way of a trend. While the Cork Borough material covered the 1940-66 period, four books were unavailable/missing and as a result we have no figures for the years 1953,1954, 1955 and 1957. The Rural Galway material covers the entire period 1933-69 but only in respect of five Court Areas.
Of the 10 district areas examined from the Rural Limerick area only five of them has books covering the entire period 1933-69 and, as such, the analysis of the Rural Limerick figures should not extend beyond 1960.
84 In practice there was only slight overlap between the categories of offender who could be committed to a Reformatory or Industrial School, in view of the fact that by law it was not open to courts to send an offender above 14 to an Industrial School. And in practice, save for the most hardened offender, those aged 15 or below were invariably sent to an Industrial School. Moreover at the upper level an offender could be sent to a Reformatory up to the age of 17. Nevertheless, the trends were likely to be similar.
85 To take another comparison, one might also expect juvenile crime to be moving in the same direction and at the same pace as adult crime. However the salient feature of adult crime figures for indictable offences show that a crime wave did not really start until the second half of the 1960s, moving from 15,000 to 30,000 between 1960-70. This increase is to some extent reflected in both the Industrial School (offences) and Reformatory committal figures
86 Kennedy Report, Table 26, which aggregates the county and county borough figures.
87 Most of this work was done with great care by Ms Kate Earley, solicitor.
88 Compare map establishing the jurisdiction of the Police District in SI No 279 of 1945 with SI Nos 5 and 6 of 1971 and SI No 300 of 1982.
89 According to a solicitor who started a criminal practice in 1959, there was, starting in the 1960s, a possibility of appeals but only from criminal offences and truancy. Also, in criminal cases there was a culture of being legally represented with, free legal aid, a fee of 3 or 4 guineas; by a very inexperienced lawyer. Even if unrepresented, parents would ask the District Court clerk, and would be informed of the possibility of appeal to Circuit Court. A reasonable number would appeal and perhaps the success rate might be of the order of a half. These appeals were taken seriously by the Circuit Court as a period of two years’ committal was regarded as serious. The Circuit Court would often have made numerous adjournments and, then if the circumstances had changed or no further crimes committed, the order might be changed to the Probation Act. But this would only affect the figures for the 1960s.
90 The grounds for committal statistical information and the age profile statistical information is also sourced from the Department’s electronic access database of former residents, which provides, where available, details of the grounds by which a child was committed to a school, dates of birth and dates of committal of the 4,102 residents detailed in the journal DJ11.
91 We have also figures for the unsuccessful ones and these show that those residents whose applications for early discharge was approved, had, on average, a few months longer in their committal periods than the unsuccessful applicants. Thus it cannot be contended that the Minister preferred to release applicants who were closer to the end of their committal period.
Chapter 3
The psychological adjustment of adult survivors of institutional abuse in Ireland Report submitted to the Commission to Inquire into Child Abuse1
Executive summary
3.01The present report describes a research project which was commissioned by the Commission to Inquire into Child Abuse (hereafter referred to as CICA).
3.02In 2005 and 2006, 247 adult survivors of institutional abuse in industrial and reformatory schools recruited through CICA were interviewed. Other witnesses to the Commission who reported institutional abuse in other institutions and out-of-home care settings were not included in this study. There were approximately equal numbers of men and women who were about 60 years of age, and who had entered institutions run by nuns or religious brothers due to family adversity or petty criminality.
3.03Participants had spent, on average, about 5 years living with their families before entering institutions and about 10 years living in institutions. More than 90% had experienced institutional physical and emotional child abuse and about half, institutional child sexual abuse. Just over a third of those who had memories of having lived with their families reported family-based child abuse or neglect.
3.04All participants had experienced one or more significant life problems with mental health problems, unemployment and substance use being the most common. More than four fifths of participants had an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships.
3.05About four fifths of participants at some point in their life had had a psychological disorder including anxiety, mood, substance use and personality disorders. The overall rates of psychological disorders among survivors of institutional living, for most disorders, were double those found in normal community populations in Europe and North America.
3.06Participants with multiple co-morbid psychological disorders had experienced more institutional abuse and showed poorer adult psychological adjustment than those with fewer disorders. Those with no diagnoses were the best adjusted as adults. Subgroups selected by specific diagnosis showed an intermediate level of adult psychological adjustment between these extremes.
3.07In the analysis of groups of participants who had spent different amounts of time in institutions and entered under different circumstances, the most poorly adjusted as adults were not those who had spent longest living in institutions (more than 12 years), but rather, those who had spent less time in institutions (under 11 years), entered institutions through the courts and reported institutional sexual abuse, in addition to physical abuse within their families.
3.08The psychological processes of traumatization and re-enactment of abuse on self and others were associated with multiple difficulties in adult life and a history of institutional abuse, but not family-based child abuse.
3.09Having spent more time living within a family context in childhood and using positive coping strategies such as planning, developing skills and developing a social support network in adulthood were associated with a good quality of life.
3.10This study had three main limitations: (1) there was a high exclusion rate and a low response rate; (2) there was no control group; and (3) the study used a crossectional, not a longitudinal design. There were also three strengths: (1) it was the largest study of its kind conducted to date; (2) an extensive reliable and valid interview protocol was used; (3) interviews were conducted by qualified psychologists. These strengths and weaknesses allow confidence to be placed in the associations found between indices of childhood institutional abuse and adult adjustment. However, they limit the strength with which causal statements may be made about institutional abuse and adult adjustment. They also limit the confidence with which statements may be made about the generalizability of the findings. Our informed judgement, in which we have a moderate degree of confidence, is that the abusive experiences caused the adult adjustment problems. But of course, we are cautious about making a definitive statement in this regard.
3.11The first recommendation is that legislation, policies, practices and procedures be regularly reviewed and revised to maximize protection of children and adolescents in institutional care in Ireland from all forms of abuse and neglect.
3.12The second recommendation is that evidence-based psychological treatment continue to be made available to adult survivors of Irish institutional abuse.
3.13The third recommendation is that staff at centres which provide psychological treatment for adult survivors of Irish institutional abuse have regular continuing professional education and training to keep them abreast of developments in the field of evidence-based treatment of survivors of childhood trauma.
3.14The fourth recommendation is that research be conducted to evaluate the effectiveness of psychological treatment for adult survivors of institutional abuse.
Acknowledgments
3.15This project involved the co-operation of a large number of people. Thanks to all who contributed. Some deserve special mention.
3.16Thanks to Christine Buckley at Aisling in Dublin for her advice and support. Thanks to colleagues at interview venues in Ireland and the UK for generously offering their premises as interview sites: Mr. Philip Moore, Director of Counselling, Harbour Counselling Service, Penrose Quay, Cork; Mr. Noel Barry, Right of Place, Lower Glanmire Road, Cork; the London-Irish Centre, Camden Square, London; Professor Peter McGeorge, School of Psychology, University of Aberdeen, Scotland; Professor Penny Renwick, Director of School of Health, Psychology and Social Care, Manchester Metropolitan University, UK; Professor David Shanks Department of Psychology, UCL, London, UK.
3.17Thanks to directors of counselling services in Ireland and the UK for provision of support for participants requiring counselling: Ms. Isolde Blau, Director of Counselling, Laragh Counselling Service, Dublin; Ms. Rachel Mooney, Director of Counselling, AVOCA Counselling Service, Dublin; Ms. Marion Rackard, Director of Counselling, Alba Counselling Service, Newbridge, Co. Kildare; Ms. Theresa Flacke, Director of Counselling, Woodquay Centre Counselling Service, Galway; Ms. Noreen Harrington, Director of Counselling, Limerick; Mr. Philip Moore, Director of Counselling, Harbour Counselling Service, Cork; Ms. Fiona Ward, Director of Counselling, Rian Counselling Service, Meath. Mr. Gerard O’Neill, Director of Counselling, COMHAR, Adult Counselling Service, Waterford; Mr. Tom McGrath, Director of Counselling, Sligo; and ICAP Immigrant Counselling and Psychotherapy, London and Birmingham.
3.18Thanks to the interviewing team for the ethical and sensitive way in which they conducted demanding interviews: Carmel Howard, HDipPsych; Susan Gavin, BA; Philomena Crotty, HDipPsych; Anne Donnelan, HDipPsych; Tara Davis, MLitt; Aongus McGrane, HDipPsych; Mimi Tatlow, HDipPsych; Dervalla Mannion, HDipPsych; Barbara Hernon, BA; Maria Mannion, HDipPsych; Su Yin Yap, BA; Eimear McMahon, HDipPsych; Aoife McCann, HDipPsych; Evita O’Malley, HDipPsych; Mairead Dowling, HDipPsych; Marie McGrath, BA; Mary Keating, BA; Eoin O’Connell, MLitt; Faye Scanlan, BA; Lynsey O’Keeffe, BA; Elaine Smith, PhD; Lucy Smith, MA; Brid O’Donoghue, BA; and Julie Grace, BA.
3.19Thanks to the interview co-odinating team for careful scheduling of all interviews in Ireland and the UK: Megan White, BA and Kevin Tierney, BA. Thanks to the data analysis team Roisín Flanagan, MSc; Mark Fitzpatrick, MSc; Edel Flanagan, MSc; and also to Dr Mark Shevlin and Dr Barbara Dooley for their expert input on data analysis. Thanks to Dr Jonathon Egan for liaison with the national Counselling Centre network and to Margaret Daly, MPsychSc for providing interviewer support.
3.20Special thanks to Muriel Keegan, MA, for project co-ordination and administration.
3.21Thanks to colleagues at CICA especially Fred Lowe for their support throughout the project.
3.22Finally our gratitude goes to all 247 participants who contributed generously to the project and without whose co-operation it could not have been conducted.
Alan Carr
June 2006
Acknowledgment to participants from the interviewing team
3.23We, the interviewers, would like to thank the many courageous individuals who took part in this study.
3.24We were deeply moved, inspired and humbled by our contact with you.
3.25We recognise the personal cost to so many of you in taking part in this project. In coming forward to tell your stories, you knew you ran the risk of re-awakening emotional pain. However your desire that your experiences be heard and recorded was stronger. We acknowledge the generosity in your decision to take part in this project so that future generations of children might be protected from the horrors you had endured.
3.26Although we spent only a few hours with you, meeting with you and listening to your stories was a moving and enriching experience for all of us. We felt privileged and honoured that you trusted us with such intensely personal and private experiences. You told us of the isolation and loneliness you experienced as young children, of the hardships you endured, of abuse and violence – often sadistic and brutal- at emotional, psychological, physical and spiritual levels.
3.27At times it was heartbreaking to listen to the stories you told. We grieved for your childhoods and we grieved that, for many of you, the legacy of your early experiences continue to affect your relationships, your work and your social lives.
3.28But more than anything we were moved and inspired by the power of the human spirit you demonstrated in the face of the terrible adversities you suffered. Alongside your pain, anger and sadness was an inner strength and resilience that clearly sustained you and that allowed many of you to move on beyond your suffering.
3.29We offer you our gratitude, respect and admiration.
The Interviewing Team
June 2006
Part 1 Introduction
Summary of Part 1
3.30A number of tentative conclusions may be drawn from the cursory literature review in Part 1. Negative childhood experiences may lead to significant adult adjustment problems. These include psychological and personality disorders, relationship and parenting problems, occupational and health difficulties, self-harm and an impoverished quality of life. The negative effects of such early adversity is probably strongly related to the variety, severity, frequency, and duration of negative experiences. The long-term outcomes of negative childhood experiences may be mediated by critical psychological processes including traumatization, betrayal, disrespect for authority, stigmatization, powerlessness, avoidance of reminders of trauma and re-enactment of negative experiences on self or others. If the negative childhood experiences occur within the context of a religious institution, religious disengagement may also occur. The negative effects of adversity may be attenuated by the use of functional coping strategies such as developing social support, mastering skills, and effectively planning escape from adversity. In contrast, the adverse effects of negative experiences may be exacerbated by the use of dysfunctional coping strategies such as overcompliance, excessive opposition, or substance abuse.
Opening comments
3.31This report presents the results of a research study which investigated the adult adjustment of people who had negative childhood experiences while living in institutions in Ireland. A key aim of the study was to profile subgroups of adult survivors of institutional child abuse on historical and psychological variables with a view to detecting associations between recollections of institutional living and current adjustment.
3.32In Part 2 the methodology used in the study is described. The overall characteristics of the sample are presented in Part 3. In Part 4 profiles of subgroups of participants with different histories of institutional living and institutional abuse are presented. Part 5 contains a description of profiles of participants with different patterns of psychological disorders. In Part 6 the focus is on psychological processes associated with institutional abuse and related coping strategies. Conclusions and recommendations are given in Part 7. In this, the first Part, a summary of relevant national and international literature in the field is given.
What is known about the long term impact of child abuse and institutional living?
3.33Within an Irish context no major studies of the effects of living in an institution in childhood on adult adjustment have been conducted. Only one major study of the characteristics of children and adolescents living in institutions in Ireland in the 60s has been completed. In Appendix F of Justice Eileen Kennedy’s (1970) Reformatory and Industrial School System’s Report, Professor Fechín O’Doherty concluded from a survey of over 300 participants aged 6-15 years that rates of learning difficulties and intellectual disability were higher in reformatories and industrial schools than in the normal population.
3.34A number of areas of the international and national scientific literature are relevant to the research project described in the present report. These include the
- Long-term effects of child abuse
- Differential effects of the extent of abuse
- Effects of institutional rearing
- Processes mediating the long-term effects of child abuse
- Clerical abuse
- Functional and dysfunctional coping strategies.
What follows is a summary of key findings in each of these areas.
Long-term effect of child abuse
3.35The international research literature on the long-term effects of child abuse and neglect indicates that it affects functioning in a wide range of areas (Berliner & Elliott, 2002; Carr, 2006a; Carr & O’Reilly, 2004; Kolko, 2002; NCCANI & NAIC, 2004; Wekerle & Wolfe, 2003). These include:
- Psychological adjustment – as indexed by the presence of psychological disorders notably anxiety disorders (including PTSD), depression, and alcohol and substance abuse (e.g. McMillan et al., 2001; Wolfe et al, 2006)
- Personality functioning – as indexed by the presence of antisocial, borderline and other personality disorders. People with antisocial personality disorder typically have been involved in criminality (e.g. Battle et al., 2004; Bierer et al., 2003)
- Self-harming – as indexed by self-injury and parasuicidal behaviour (e.g. Brodsky et al., 2001). People with borderline personality disorder typically have a history of self-harm (e.g. Soloff et al., 2002)
- Intimate relationships – as indexed by problems with marital or co-habiting relationships, sexuality and domestic violence (e.g., Colman & Widom, 2004; Davis & Petretic-Jackson, 2000; White & Widom, 2003)
- Parenting relationships – as indexed by inability to adequately parent, having children in care, and victimization of children (e.g., DiLillo & Damashek, 2003; Newcomb & Locke, 2001; Quinton & Rutter, 1988)
- Educational and occupational functioning – as indexed by low educational and occupational performance (e.g., Perez & Wodom, 1994)
- Health – as indexed by a history of frequent illness, health service usage and risky health behaviour (Kendall-Tackett, 2002).
3.36The Sexual Abuse and Violence in Ireland (SAVI) report on a nationally representative survey of over 3,000 adults in 2002 confirmed that in Ireland, for a sizeable minority of survivors, child sexual abuse leads to significant mental health problems including post-traumatic stress disorder (McGee, Garavan, deBarra, Byrne, and Conroy, 2002).
Differential effects of the extent of abuse
3.37Attempts to identify the unique effects of different types of maltreatment (physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) have not yielded a clear pattern. In contrast the investigation of the effects of the extent of abuse clearly indicates that the variety, severity, frequency, and duration of abuse affects adjustment (Berliner & Elliott, 2002; Carr, 2006a; Kolko, 2002; NCCANI & NAIC, 2004; Wekerle & Wolfe, 2003). Poorer adjustment is associated with
- Multiple forms of abuse and neglect
- Severe abuse and neglect
- Frequent abuse and neglect
- Abuse and neglect carried out over longer time periods, and
- Abuse and neglect occurring with multiple perpetrators in multiple contexts.
Effects of institutional rearing
3.38The scientific literature on the effects of institutional living, abuse and neglect is sparse (Gallagher, 1999; Gilligan, 2000; Powers et al., 1990; Rutter et al., 1990; Rutter et al., 2001; Wolfe et al., 2006). In the short-term, institutional rearing has profound effects on cognitive and social development and some of these difficulties do not resolve when youngsters are placed for adoption. Children reared in institutions from birth until 2 years and then adopted, at 4 and 6 years showed impaired cognitive development, attachment problems, inattention and overactivity, and quasi-autistic features (Rutter et al., 2001). Wolfe et al. (2006) found that 88% of a group of 76 Canadian adult survivors of institutional abuse, at some point in their lives, suffered from a psychological disorder (as defined in the fourth edition of the American Psychiatric Association Diagnostic and Statistical Manual (DSM IV, American Psychiatric Association, 2000). PTSD, other anxiety disorders, depression and alcohol abuse were the most common disorders. The international literature on the long-term effects of being reared in an institution has shown that compared with children reared in families, those reared in institutions had poorer adjustment (Rutter et al., 1990; Rutter, 2002). This was shown by
- Personality disorder
- Criminality (especially in men)
- Marked marital problems
- Multiple broken co-habitations
- Teenage pregnancy (in women), and
- Having one’s children taken into care (for women).
Processes mediating the long-term effects of child abuse
3.39The long-term outcomes of child abuse are probably mediated by psychological processes (Wolfe et al., 2003), particularly the following:
- Traumatization and humiliation – as indexed by accounts of having been strongly negatively affected by physical, sexual and emotional abuse and neglect
- Betrayal and loss of trust in others – as indexed by accounts of loss of trust in others, and an insecure adult attachment style
- Fear of, and disrespect for authority – as indexed by accounts of being anxious or angry about authority figures
- Stigmatization, shame and guilt – as indexed by low self-esteem, a sense of being ‘dirty’ or ‘used goods’ and self-blaming
- Powerlessness – as indexed by accounts of feeling one has no influence in the world, an external locus of control, and low self-efficacy
- Avoidance of reminders of abuse – as indexed by accounts of avoiding abuse-related situations
- Re-enactment of abuse on self or others – as indexed by accounts of urges or actions involving harming the self or others in ways similar to the abuse suffered.
Clerical abuse
3.40The small international research literature on clerical abuse indicates that this may have a detrimental effect on spirituality and lead to a disengagement from religious and spiritual beliefs and practices. This includes a loss of faith in God and organized religion; abandonment of the practice of private prayer; and withdrawal from public religious rituals such as mass attendance (e.g. Bottoms et al., 1995; Farrell & Taylor, 2000; Fater & Mullaney, 2000; McLaughlin, 1994, Rossetti, 1997; Wolfe et al., 2006). This may be conceptualized as an aspect of disrespect for authority (mentioned above) uniquely associated with clerical abuse.
3.41In Ireland, a small qualitative study of 22 survivors of clerical abuse is contained in the Time to Listen Report on Confronting Child Sexual Abuse by Catholic Clergy (Goode, McGee & O’Boyle, 2003). Some but not all, survivors in this study experienced anxiety, depression, suicidal ideation, intimacy difficulties, family relationship problems, a decline in confidence in the Church and loss of faith. These findings are consistent with those from international studies.
Functional and dysfunctional coping strategies
3.42The international scientific literature on stress, coping, risk and resilience in children exposed to early childhood adversity suggests that children may engage in functional and dysfunctional coping strategies to deal with adversity including the process of institutional rearing and institutional abuse (Luthar, 2003; Rutter et al., 1990). Functional coping strategies, which may protect children from the negative impact of abuse, include
- Social support
- Skill mastery
- Planning, and
- Spiritual support.
3.43Social support refers to developing socially supportive relationships which make enduring abuse more tolerable. Skill mastery involves having positive experiences in which academic, sporting, musical or technical skills are developed and refined, usually within the context of mentoring relationships with teachers who foster such achievement. Planning skills refer to short and long-term planning to avoid abuse and escape from adversity. In the short-term this may mean organizing each day to keep away from abusers and have basic needs met. In the long-term it involves making an active and reasoned vocational choice, and choice of marital or co-habiting partner. Active vocational choice means deciding what sort of work one might be good at and then trying to find such work rather than drifting into various jobs opportunistically. Active choice of partner means knowing a partner for more than 6 months before deciding that they are suitable for a long-term relationship, rather than impulsively entering a long-term relationship. A supportive marital relationship refers to developing a relationship with a non-deviant, marital partner in whom the person can confide. Spiritual support involves deriving a sense of support from religious practices such as praying or talking with priests.
3.44Dysfunctional coping strategies may include either fully complying with the abusive regime or aggressively opposing it without due regard to the risks of further abuse entailed by this. Excessive consumption of alcohol, drugs and food are other potentially dysfunctional coping strategies.
Conclusions
3.45From this cursory review, a number of tentative conclusions may be drawn. Negative childhood experiences may lead to significant adult adjustment problems including psychological disorders and an impoverished quality of life. The negative effects of such early adversity is probably strongly related to the variety, severity, frequency, and duration of negative experiences. The long-term outcomes of negative childhood experiences may be mediated by critical psychological processes for example, traumatization and re-enactment of negative experiences on self or others. If the negative childhood experiences occur within the context of a religious institution, religious disengagement may also occur. The negative effects of adversity may be attenuated by the use of functional coping strategies such as developing social support or mastering skills. In contrast, the adverse effects of negative experiences may be exacerbated by the use of dysfunctional coping strategies such as overcompliance or avoidance. These conclusions are summarized in the model presented in Figure 1.1.
Figure 1.1. A model of the effects of childhood institutional abuse on adult adjustment.
Part 2 Methodology
Summary of Part 2
3.46The overarching aim of the present study was to profile subgroups of adult survivors of institutional child abuse on demographic, historical and psychological variables with a view to detecting associations between recollections of institutional living and current adjustment. In particular the aim was to profile subgroups of survivors defined by (1) the number of years spent in an institution and the circumstances under which admission occurred; (2) the worst type of institutional abuse experienced; and (3) the number and type of psychological disorders displayed. An additional aim was to develop a way to assess psychological processes and coping strategies associated with institutional abuse, and establish the correlates of these processes and coping strategies.
3.47Between May 2005 and February 2006 just under 250 adult survivors of institutional living recruited through CICA were interviewed in Ireland and the UK by a team which included 29 trained interviewers, all of whom had degrees in psychology. The overall exclusion rate was 26% (326 of 1267); the participation rate was 20% (246 of 1267); and the response rate for the study was 26% (246 of 941). (This low response is not unusual. A response rate of 9% was obtained in the Time to Listen Report on Confronting Child Sexual Abuse by Catholic Clergy (Goode, McGee & O’Boyle, 2003)).
3.48The sample of participants interviewed was not representative of all CICA attenders, or indeed of adult survivors of institutional living. It is probable that participants were better adjusted than CICA attenders who did not take part because the old and the ill were excluded. The interview protocol covered demographic characteristics, history of family and institutional living, recollections of child abuse within the family and institutions, psychological processes associated with institutional life, coping strategies used to deal with institutional life, current trauma symptoms, current and past diagnoses of psychological and personality disorders, relationships with partners and children, adult attachment style, main life problems, current quality of life, and global level of functioning. Interviews were conducted in an ethical way that safeguarded participants’ wellbeing. Data were managed in a way to safeguard participants’ anonymity.
Aims of the study
3.49Survivors of institutional living who have attended CICA are by no means a homogeneous group. They may be classified in a variety of ways. For example, they may be classified by historical factors such as the number of years they have spent in an institution, the circumstances under which they were admitted and the type of institutional abuse they experienced. They may also be classified by their current psychological status, for example, by the number and type of psychological disorders they display. The overarching aim of the present study was to investigate this variability shown by groups of adult survivors of institutional living with a view to profiling these groups and detecting associations between recollections of child abuse and current adjustment.
3.50In the first instance we set out to profile subgroups of participants with different histories of institutional living, specifically:
- People raised in institutions from birth
- People who entered institutions in childhood or early adolescence because parents could no longer care for them
- People who entered institutions in childhood or adolescence through the courts
- People who spent only a brief period in institutions in childhood or adolescence.
3.51In profiling subgroups our interest was in the status of these groups on historical and demographic factors, recollections of child abuse, psychological disorders, trauma symptoms, life problems, quality of life, global functioning, current family relationships, and attachment style. The main hypothesis suggested by the literature review was that people who had spent more time living in an institution would show poorer adjustment that those who had spent only a brief period living in an institution.
3.52Next, we aimed to profile subgroups of participants with different histories of institutional abuse, specifically those whose worst abusive experience was multiple forms of severe abuse, versus those who identified their worst experience as involving a single form of abuse: physical, sexual or emotional.
3.53The third aim was to profile subgroups of participants with different numbers and types of psychological disorders.
3.54The fourth aim of the study was to develop a way to assess psychological processes and coping strategies associated with institutional abuse, and investigate the relationships between these processes and coping strategies on the one hand, and past abuse and current adjustment on the other.
3.55To achieve these aims, the methodology described in this Part was used. A project team was established. An assessment protocol was developed. Participants were recruited into the study by CICA and the research team. Interviewers engaged participants in interviews using the assessment protocol. Data from the protocol were analysed by computer using statistical procedures appropriate to address the aims of the study outlined above. Procedures were built into the methodology to safeguarded the welfare of participants. These procedures were consistent with the ethics code of the Psychological Society of Ireland and the research plan was approved by the UCD human research ethics committee. This Part contains a detailed description of these research methods. Data analysis and results are presented in subsequent Parts.
Time frame
3.56This research project was planned between January and April 2005. Data were collected between May 2005 and February 2006, and the report was produced between March and June 2006.
Research team
3.57The research team included
- A project director and administrator
- Three postgraduate clinical psychology doctoral candidates
- A panel of 29 interviewers, all of whom had degrees in psychology
- Two appointment organizers
- Four project consultants.
Project director and administrator
3.58Professor Alan Carr, PhD, Director of the Doctoral programme in Clinical psychology UCD, was the Principal Investigator and Project Director. Muriel Keegan, MA, Administrator for the Doctoral Programme in Clinical Psychology was the Project administrator. She managed communication within the project team and between the team, CICA and participants. She also administered project finances and arranged document production.
Three clinical psychology postgraduates
3.59Mark Fitzpatrick, BA, MSc, DipCounsPsych; Edel Flanagan, BA, MSc, and Roisín Flanagan, BA, MSc, all of whom were doctoral postgraduates in clinical psychology at UCD trained, supervised and supported a team of interviewers (mentioned below). They conducted a portion of the interviews. They also checked all interview protocols for completeness, conducted data entry, managed data analysis, and tabulated statistical results. In addition, at the time of writing this report, each of these three postgraduates are in the process of writing doctoral theses and articles for publication in peer reviewed journals based on analyses of specific aspects of the data set arising form the project. All three postgraduates are members of cohorts of 10 candidates selected bi-annually from over 150 applicants to the UCD doctoral programme in clinical psychology. They are highly qualified, having masters degrees in psychology, and a significant amount of clinical experienced and training.
Interview organizers
3.60Kevin Tierney, BA (Hons Psych) and Megan White BA (Hons Psych) organized and scheduled interviews linking with participants, the interview team, and contact people at the various regional interview sites. They also offered back-up support to interviewers in meeting and greeting participants at UCD where this was appropriate.
Panel of interviewers
3.61Interviews were conducted by a panel of 29 interviewers which included the three clinical psychology postgraduates, the two interview organizers and the following 24 interviewers: 1. Carmel Howard, HDipPsych; 2. Susan Gavin, BA ; 3. Philomena Crotty, HDipPsych; 4. Anne Donnelan, HDipPsych; 5. Tara Davis, MLitt; 6. Aongus McGrane, HDipPsych; 7. Mimi Tatlow, HDipPsych; 8. Dervalla Mannion, HDipPsych; 9. Barbara Hernon, BA; 10. Maria Mannion, HDipPsych; 11. Su Yin Yap, BA; 12. Eimear McMahon, HDipPsych; 13. Aoife McCann, HDipPsych; 14. Evita O’Malley, HDipPsych; 15. Mairead Dowling, HDipPsych; 16. Marie McGrath, BA; 17. Mary Keating, BA; 18. Eoin O’Connell, MLitt; 19. Faye Scanlan, BA; 20. Lynsey O’Keeffe, BA; 21. Elaine Smith, PhD; 22. Lucy Smith, MA; 23. Brid O’Donoghue, BA; and 24. Julie Grace, BA. All interviewers had an honours degree in psychology or a higher diploma in psychology and were eligible for graduate membership of the Psychological Society of Ireland. All interviewers were trained in administering the interview protocol by the clinical psychology postgraduates, who in turn were trained by the project director.
Project consultants
3.62Dr Barbara Dooley, PhD, Director of Postgraduate Research and Head of the School of Psychology at UCD and Dr Mark Shevlin, PhD, Senior Lecturer, School of Psychology, University of Ulster provided statistical consultancy to the project. Dr Jonathon Egan, M Psych Sc, PsyD, Director of NCS Arches Counselling Service, National Health Executive, liaised between the project team and the directors of the network of National Counselling Service centres around the country. He advised on how best to arrange counselling for those participants who required referral to the NCS following participation in the study. He also advised on how to make the interviewing process as user-friendly and minimally distressing as possible. Margaret Daly, MPsychSc, Lecturer in Psychology UCD, provided interviewer support consultancy to the project.
Participants
3.63247 adult survivors of institutional abuse in industrial and reformatory schools participated in this study. All but one had attended the Commission to Inquire into Child Abuse (CICA). The one non-CICA attender, was the sibling of a person who attended CICA. Both siblings came to the interview centre together and asked that each be interviewed and that data from both be included in the study. For ethical reasons, an exception was made in this one case and the data from this non-CICA attender has been included in the analysis.
3.64Of the 246 CICA attenders, 175 were recruited from the confidential committee and 71 from the investigation committee. 126 were living and interviewed in Ireland. 120 were living and interviewed in the UK.
3.65The path of recruitment and attrition for both the confidential and investigation committees is presented in Figure 2.1. The 175 confidential committee attenders were recruited in the following way. 1086 people had attended the confidential committee when recruitment into the research study began in 2005. Of these 1086, 775 reported abuse in industrial and reformatory schools and 311 reported abuse in other institutional and out of home care settings such as children’s homes, residential institutions for children with special needs, hospitals, national and secondary schools and foster care. Of the 775 who reported institutional abuse in industrial and reformatory schools, 571 were invited to participate in the research study. Invitations were not sent to 204 cases who met at least one of the following criteria: whereabouts unknown; resident outside Ireland and UK; previously stated they did not want to participate in research project; previously stated they did not want to be contacted by CICA; known to be deceased; or known to be in poor health or to have a significant disability. Of the 571 cases invited, 347 replied, and 224 did not. Of those that did not, 9 invitations were returned as unknown at address and 2 were returned without any identifying details. Of the 347 who replied, 225 agreed to participate and 122 declined the invitation. Of the 225 who agree to participate, 175 attended interviews and 50 did not.
3.66The 71 investigation committee attenders were recruited in the following way. The investigation committee had heard, or had scheduled to hear, or had interviewed, or had scheduled for interview 492 complainants prior to December 2005. Of these 492 complainants, invitations were sent to 370 between July and November 2005. These 370 complainants were within the remit of the research project; were resident in Ireland or UK or contactable through a solicitor; had decided to remain with the investigation committee; and were not likely to submit additional evidence to the investigation committee hearings after December 2005. Of the 370 complainants, the investigation committee received 110 positive replies. Of the 110 replies, 11 were not forwarded to the research team because they were not resident in Ireland or UK; were not proceeding with the investigation committee; or had indicated they did not wish to take part in the research project. Of the 99 who agreed to participate, 71 attended interviews and 28 did not. The path of recruitment and attrition for the combined confidential and investigation committees is presented in Figure 2.2.
3.67The overall exclusion rate was 26%. 326 of 1267 potential participants who attended CICA and reported abuse were excluded from the study for various reasons such as living outside Ireland and the UK, being untraceable, being too ill or disabled to participate, and not wishing to take part in the study.
3.68Approximately 20% of CICA attenders participated in this study. Out of a total pool of 1267 people who attended either of CICAs committees and reported institutional abuse, 246 completed interviews. This group were clearly not a representative sample of CICA attenders, or of the total population of adult survivors of institutional living of whom CICA attenders form a subgroup. Our sample is not representative of the very ill, those who live outside Ireland and the UK, those who were untraceable, and those who did not wish to participate in the study. It is probable that the group who participated in the study were better adjusted than those who did not take part.
3.69The response rate for the study was 26%. Out of a pool of 941 people invited for interview, 246 were actually interviewed.
Assessment interview
3.70Participants were interviewed with a standard assessment protocol which is contained in appendix 1. This protocol covered the following domains
- Demographic profile
- History of family and institutional life
- Recollections of negative experiences
- Personal strengths
- Psychological processes associated with institutional abuse
- Coping strategies used to deal with institutional abuse
- Current and past diagnoses of psychological and personality disorders
- Current trauma symptoms
- Main life problems
- Current quality of life.
- Global functioning
- Relationships with partners and children, and
- Adult attachment style
3.71The protocol included the following instruments:
- Demographic and historical questionnaire (DHQ)
- Institutional Abuse Scale (IAS)
- Childhood Trauma Questionnaire (CTQ, Bernstein & Fink,1998)
- Most Severe forms of Physical and Sexual Abuse (SPSA)
- Institutional Abuse Processes and Coping Inventory (IAPCI)
- Personal strengths (PS)
- Structured Clinical Interview for Axis I Disorders of DSM IV 41(SCID I, First et al., 1996)
- Structured Clinical Interview for DSM IV Personality Disorders 41(SCID II, First et al., 1997)
- Trauma Symptom Inventory (TSI, Briere, 1996).
- Life problem checklist (LPC)
- World Health Organization Quality of Life 100 UK (WHOQOL, Skevington, 2005).
- Global Assessment of Functioning (GAF, Luborsky, 1962).
- Kansas Marital Satisfaction Scale (KMS, Schumm et al, 1986)
- Kansas Parenting Satisfaction Scale (KPS, James et al, 1985)
- Experiences in Close Relationships Inventory (ECRI, Brennan, et al., 1998)
A description of each of these instruments is given below.
Demographic and historical questionnaire
3.72The DHQ was used to obtain information on age, gender, education, occupational status, marital status, parental status, children, socioeconomic status, and dates and circumstances of entering and leaving institutional care.
Institutional abuse scale
3.73The 13 item IAS covered items unique to institutional settings and predominantly involving emotional abuse. The items were identified during pilot testing of the original interview protocol, when participants indicated that the Childhood Trauma Questionnaire did not cover areas unique to the institutional setting. These items cover fear of unpredictable punishment; being told that the self and parents are bad; that the parents no longer love the child; separation from siblings; having clothes and treasured possessions taken away; and the experience of having hope taken away. The reliability of the instrument was confirmed in the present study and reliability data are contained in Table 3.11.
Childhood Trauma Questionnaire
3.74The CTQ is a 28-item self-report inventory that provides a reliable and valid assessment of current recollection of the overall pattern of childhood abuse and neglect (Bernstein & Fink,1998). It yields scores for five maltreatment scales: (1) physical abuse, (2) sexual abuse, (3) emotional abuse, (4) physical neglect, and (5) emotional neglect. Also included is a 3 item minimization and denial scale for detecting false-negative trauma reports. CTQ scores for any case can be compared to norms from more than 2,200 males and females from seven different clinical and community samples, representing a broad range of ages, socioeconomic status and different racial and ethnic groups. In the present study cut-off scores for the CTQ were based on norms developed in a large community study of 1007 18-65 year old men and women in Memphis, USA (Scher et al., 2001). The CTQ has good test-retest reliability and scores from it are very stable over time. It has good convergent and divergent validity with trauma histories from other measures. It is highly sensitive to identifying individuals with verified histories of abuse. In the present study participants completed two versions of the CTQ, one to evaluate their recollections of abuse within their families (if they spent any time in their families as children) and one to evaluate their recollections of abuse while living in an institution.
Most severe forms of physical and sexual abuse
3.75For the SPSA participants were asked to recall the most severe forms of physical and sexual abuse to which they were subjected in both their families and institutions and these were rated on scales derived from Slep and Heyman’s severity rating system (2004). In each instance they were asked to indicate the frequency and duration of this most severe form of physical and sexual abuse and the age at which it began. Retrospective reports of such events tend to be more valid than those of events open to greater interpretation. In a review of 8 studies of the validity of retrospective reports of abuse, Hardt and Rutter (2004) found a substantial rate of false negatives among adult reports of major adverse experiences in childhood that allowed a reasonable operationalisation (such as most severe events). Thus, retrospective reports of clearly describable episodes of child abuse are a conservative index of abuse in adult survivors. In the studies Hardt and Rutter reviewed, validity was assessed by means of comparisons with contemporaneous, prospectively obtained, court or clinic or research records; by agreement between retrospective reports of two siblings; and by the examination of possible bias with respect to differences between retrospective and prospective reports in their correlates and consequences. Hardt and Rutter (2004) in a further review of 6 studies found that over periods of at least 6 months, adult retrospective reports of child abuse showed good test-retest reliability. These results justify the use retrospective reports of abuse in the current study. The reliability of the institution version of the SPSA was confirmed in the present study, but the family version of the SPSA had low reliability, so cautious interpretation of the family version is warranted. Reliability data are contained in Table 3.11.
Institutional Abuse Processes and Coping Inventory
3.76The 58 item IAPCI was designed specifically for this study to evaluate psychological processes and coping strategies associated with the experience of institutional abuse and later life difficulties. The following processes were covered in a series of rational scales: (1) traumatization, (2) betrayal, (3) disrespect of authority, (4) religious disengagement, (5) stigmatization, (6) powerlessness, (7) avoidance, and (8) re-enactment. The following functional coping strategies were covered: (1) social support, (2) skill mastery, (3) planning; and (4) spiritual support. The inventory also assessed these dysfunctional coping strategies: (1) overcomplying; (2) aggressively opposing, and (3) substance abuse. Five point response formats were used for all items ranging from 1=never true to 5=very often true. In the present study two versions the IACPI were used. The first inquired about processes and coping strategies used while living in an institution and the second inquired about the same processes and coping strategies in the person’s present life.
3.77The factorial structure and reliability of the IAPCI were evaluated in the present study and this is described in Part 6. Six factors scales with moderate to good reliability were developed. The scales were (1) traumatization which assesses negative emotions arising from abuse, betrayal and loss of trust, stigmatization, shame, guilt, and disrespect of authority; (2) re-enactment which assesses re-enactment of abuse, powerlessness, coping by opposing and coping by using alcohol and drugs; (3) spiritual disengagement which assesses disengagement from religious practice and not using spiritual coping strategies; (4) positive coping which assesses coping through planning, skill mastery and social support; (5) coping by complying which assesses coping by complying with the wishes of people in authority; and (6) avoidant coping which assesses coping by avoiding thoughts and situations associated with abuse.
Personal strengths
3.78Participants’ views of their personal strengths and resources that have helped them to cope with life’s challenges were evaluated with three items. These were included at the end of the interview so that participants closed the interview with an awareness of their strengths rather than their deficits.
Structured Clinical Interview for Axis I Disorders of DSM IV
3.79The SCID I (First et al., 1996) is a reliable and valid semistructured interview for assessing psychological disorders listed in the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR, APA, 2000). In this study the modules for assessing anxiety, mood and substance use disorders were used, since previous studies suggest that these are the main psychological disorders shown by adult survivors of child abuse. The anxiety disorders module yields diagnoses for posttraumatic stress disorder, panic disorder with and without agoraphobia, agoraphobia, social phobia, specific phobias, obsessive compulsive disorder, and generalized anxiety disorder. The mood disorders module yields diagnoses for major depression and dysthymia. The substance use module yields diagnoses for alcohol and other substance dependence and abuse disorders. The presence of both current disorders and past (or lifetime) disorders were assessed. Diagnoses were reliably made with inter-rater reliabilities between .77 and 1.00 as shown in Table 3.7.
Structured Clinical Interview for DSM IV Personality Disorders
3.80The SCID II is a reliable and valid semistructured interview for assessing all DSM-IV-TR axis II personality disorders (First et al., 1997). In this study the modules for antisocial, borderline, avoidant and dependent personality disorders were used, since previous studies suggest that these are the main personality disorders associated with adult survival of child abuse. With the SCID II, only current (but not past) personality disorders were assessed. Diagnoses were reliably made with inter-rater reliabilities between .96 and 1.00 as shown in Table 3.7.
Trauma symptom Inventory
3.81The 100 item TSI is a reliable and valid instrument which evaluates posttraumatic symptomatology (Briere,1996). A four point response format was used for all items from 0 = never to 3 = often. The TSI yields scores for three validity scales and ten clinical scales. The three validity scales are: (1) response level which assesses a tendency toward defensiveness or a need to appear unusually symptom-free; (2) atypical response which assesses attempts to appear very dysfunctional; and (3) inconsistent response which reflects a random response set or difficulty understanding items. The clinical scales are (1) anxious arousal; (2) depression; (3) anger and irritability; (4) intrusive experiences which assesses PTSD symptoms such as flashbacks, nightmares, and intrusive thoughts; (5) defensive avoidance of cues that remind the person of trauma ; (6) dissociation which covers depersonalization, out-of-body experiences, and psychic numbing; (7) sexual concerns which covers distress associated with sexual dissatisfaction, sexual dysfunction, and unwanted sexual thoughts or feelings; (8) dysfunctional sexual behaviour ; (9) impaired self-reference which covers identity confusion; and (10) tension reduction behaviour which covers self-harm, and anger control problems. Sex- and age-normed T scores are provided for all 13 scales. These allow statements to be made about the percentage of cases that scored outside the normal range compared with specific reference groups.
Life problem checklist
3.82The LPC is a 14 item list constructed for the present study. It provided a rapid survey of key problem areas including unemployment, homelessness, frequent illness, frequent hospitalization for physical and mental health problems, psychological disorders, substance use, self-harm, anger control in close relationships and criminality. The reliability of the instrument was confirmed in the present study and reliability data are contained in Table 3.11.
World Health Organization Quality of Life 100 UK Version
3.83The WHOQOL is a reliable and valid instrument which yields an overall quality of life score along with scores for 6 domains and 24 facets (Skevington, 2005). Four items are included for each facet, as well as four general items covering overall QOL and health, and there are 2 items unique to the UK version of the instrument, producing a total of 102 items. All items were rated on five point scales. The domains are physical well-being; psychological well-being; level of independence; quality of social relationships; quality of the environment; and quality of spiritual life. The 24 facets are classified by domain. The following facets fall within the physical well-being domain: (1) pain and discomfort, (2) energy and fatigue, and (3) sleep and rest. The following facets fall within the psychological well-being domain: (4) positive feelings, (5) thinking, learning, memory and concentration, (6) self-esteem, (7) bodily image and appearance, and (8) negative feelings. These facets fall within the level of independence domain: (9) mobility, (10) activities of daily living, (11) dependence on medication or treatments, and (12) work capacity. The domain of social relationships contains the following facets: (13) personal relationships, (14) social support, and (15) sexual activity. The environment domain contains these facets: (16) physical safety and security, (17) home environment, (18) financial resources, (19) accessibility and quality of health and social care, (20) opportunities for acquiring new information and skills, (21) participation in and opportunities for recreation/ leisure activities, (22) physical environment (pollution/noise/traffic/climate), and (23) transport. The spiritual domain contains the single facet of spirituality. The reliability of the instrument was confirmed in the present study and reliability data are contained in Table 3.11.
Global assessment of functioning
3.84The GAF is a reliable and valid rating scale for recording a global judgement about a person’s overall psychological, social, and occupational functioning, excluding impairment due to physical or environmental factors following a semi-structured interview (Luborsky, 1962). It is included in DSM-IV-TR as the Axis V assessment and forms part of the SCID. In the present study interviewers gave a single rating from 1–100. The scale was divided into ten ranges of functioning, but intermediate scores were given when applicable.
Kansas Marital Satisfaction Scale
3.85The 3 item KMS assesses perceptions of the quality of marital or long-term cohabiting relationships (Schumm et al., 1986). Seven point response formats were used for the three items ranging from 1=extremely dissatisfied to 7=extremely satisfied. The items assess satisfaction with one’s partner and the relationship as a whole. Despite its brevity, the KMS has been shown to correlate highly with other more extensive measures of marital satisfaction.
Kansas Parenting Satisfaction Scale
3.86The 3 item KPS assesses parents’ perceptions of the quality of their relationship with their children (James et al., 1985). Seven point response formats were used for the three items ranging from 1=extremely dissatisfied to 7=extremely satisfied. The items assess satisfaction with one’s children, the parenting process and overall parent-child relationships. Despite its brevity, the KPS has been shown to correlate highly with other more extensive measures of parenting satisfaction.
Experiences in Close Relationships scale
3.87The 36-item ECRI is a reliable and valid instrument for assessing adult romantic attachment style and yields scores on interpersonal anxiety and interpersonal avoidance dimensions (Brennan et al., 1998). On the basis of scores on these two dimensions, using an SPSS algorithm, cases may be assigned to one of four adult attachment style categories: secure, fearful, dismissive and preoccupied. Cases with low anxiety and avoidance scores are classified as having a secure attachment style. People with this attachment style tend to make and maintain stable relationships with adult romantic partners, while those with the other three styles typically have relationship difficulties. Cases with both high anxiety and avoidance scores are classified as having a fearful attachment style. Cases with high interpersonal anxiety and low avoidance scores are classified as having a preoccupied attachment style. Interpersonal anxiety leads these people to consistently demand excessive proximity and closeness from their partners. Cases with high interpersonal avoidance and low anxiety scores are classified as having a dismissive attachment style. Such people insist on excessive emotional distance without experiencing interpersonal anxiety. Seven point response formats are used for all items ranging from 1=disagree strongly to 7=agree strongly. The ECRI was developed from a pool of over 600 items identified in a review of 14 self-report measures of adult attachment. The avoidance and anxiety factors were identified by factor analyses, so there is evidence for the construct validity of the scale.
Procedure
3.88Specific procedures were used for
- Recruiting participants into the study
- Pilot testing the interview protocol
- Interviewer training, supervision and support
- Interviewing process
- Conducting conjoint interrater reliability interviews
- Managing ethical issues
Recruiting participants
3.89The CICA confidential and investigation committees invited all those who had reported institutional abuse and attended these committees prior to December 2005 to participate in the study, with some exceptions. Those resident outside Ireland or the UK, those too ill to participate, and those who indicated that they did not wish to participate were excluded (along with a small number of cases deemed unsuitable for other reasons specified in the ‘Participants’ section above). Confidential committee attenders were contacted personally and investigation committee attenders were contacted through their solicitors. Between June and December 2005, CICA provided the research team at UCD with lists of participants, who had agreed in writing to be contacted by the research team.
3.90The interview organizer contacted each participant, described what participating in a research interview would involve and offered an interview, using the recruitment script in Appendix 2.
Pilot testing the interview protocol
3.91The 3 clinical psychology postgraduates pilot-tested and fine-tuned the optimal way for conducting interviews with 3 participants prior to interviewer training. The pilot testing informed the way in which the panel of interviewers were trained.
Interviewer training, supervision and support
3.92The three clinical psychology postgraduates under the supervision of the project director developed and delivered an interviewer training programme to the panel of interviewers. The programme involved coaching interviewers in meeting participants; taking them to the interview room; explaining the rationale for the study; obtaining informed consent; developing rapport; conducting interviews; offering breaks and refreshments; adhering to the interview protocol; checking interviews for completeness; managing client distress; informing clients about how to contact NCS or ICAP counsellors; and parting from clients in an appropriate way with the reminder that a follow-up contact would be made. Part of the training programme involved viewing videotapes about how to rate the SCID I and II when making DSM IV diagnoses. The three postgraduates also met as required with members of the panel of interviewers during the data collection period to offer supervision and support.
Interviewing process
3.93Interviews were conducted by the team of 29 interviewers who each conducted between 1 and 30 interviews. Interviews were conducted at 35 sites, 12 in Ireland and 23 in the UK. The sites included university psychology departments, counselling and survivor support centres, and hotels. In addition 14 cases were interviewed in their homes, 2 in Ireland and 12 in the UK. For all interviews (excluding home visits), participants met interviewers at designated meeting points arranged with the interview organizer. Interviewers identified themselves by carrying a white card with INTERVIEWER written on it, so that participants did not have to identify themselves to reception staff. This preserved the anonymity of participants. Participants were greeted warmly and escorted to interview rooms. Interviewers again explained the way the interview would be conducted and the overall context of the study. It was mentioned that the study was being conducted by a team from University College Dublin at the invitation of the Commission to Inquire into Child Abuse; that it would involve an interview of about 2 hours duration; that participation was voluntary; that the interview would be fully confidential; that participants could withdraw from the study at any time; and that they might be invited to participate in a follow-up interview. Participants then were invited to sign the consent form at the top of the interview protocol. The interviewer then worked through the interview questions in the sequence specified in the protocol.
3.94Where participants wanted to deviate from the protocol and discuss specific issues in details, interviewers said the following script: ‘ I understand that this is something you need to discuss. However, for this study we both have to follow the questions in this questionnaire. But, if you need to talk further about this issues, we can advise you how to contact a counsellor in your area who specializes in helping survivors of institutional living address these sorts of issues.’
3.95Where participants became distressed or tired, interviewers said this script: ‘I can see that you are distressed/tired. Would you like to take a break for a few minutes?’ Clients were offered water, soft drinks, tea or coffee during these breaks and during interviews.
3.96The final set of questions in the interview were about personal strengths and resources. This allowed clients to focus on positive aspects of their lives and contributed to eliciting a positive mood as the interviews ended. At the conclusion of each interview, interviewers thanked participants, informed them that the independent report of the results of the study of survivors of institutional living would be submitted to the Commission to Inquire into Child Abuse and referred to in the final Report of the Commission to Inquire Into Child Abuse, to which they would have access. They were also informed that as a routine procedure all participants would be given a leaflet on how to contact a counsellor as described below under ethical issues. Participants were also given an opportunity to add further comments or ask questions. In addition they were offered the option of receiving a call in a few days to check that they were ok and that there was nothing further that they wish to add or ask at that point. This provided a way of maintaining contact with participants who may have found the interview distressing. Almost all participants availed of this offer.
Interrater reliability interviews
3.97Inter-rater reliability of all scales was evaluated by conducting interviews with 52 participants in which 2 interviewers were present and each completed independent protocols for the same set of 52 cases. Data from pairs of independently completed interview protocols were analysed to evaluate the inter-rater reliability of the scales and items in the protocols. When inviting participants to engage in the inter-rater reliability study, interviewers said at the outset of the interview ‘There will be three of us in this meeting (indicating the 2 interviewers and the participant). Each of us will be keeping a record of the interview, but only I will be talking with you.’ The 52 cases involved in the reliability study constituted part of the overall sample of 247 cases.
Ethical issues
3.98The study was designed to comply with the code of ethics of the Psychological Society of Ireland. In addition, ethical approval for the study was obtained through the Human Research Ethics Committee at University College Dublin.
3.99Every effort was made to insure that the research interviews were carried out in a way that was minimally distressing for participants. However, for some candidates answering questions about traumatic events and life problems was distressing. All candidates were informed at the outset of the interview that they could take breaks during the interview to reduce distress, or leave the interview altogether at any time if it became too distressing. All participants were given the leaflet in Appendix 2 containing the addresses and telephone numbers of the National Counselling Service (NCS) national network of counselling centres and contact details for the Immigrant Counselling and Psychotherapy service (ICAP) in the UK. They were advised to contact their regional office at any time if they required counselling for abuse-related issues including those arising from the research interview. Dr Jonathon Egan, Director of the NCS Midland Office, was a consultant to the proposed research project. He briefed colleagues in all NCS centres about the study, and was available to provide information on its possible impact on participants, and the appropriate NCS response to study participants who contacted the NCS following participation in the study. In the UK Teresa Gallagher, Director of ICAP was contacted for advice on referrals to ICAP centres in the UK. Over the 6 months of data collection fewer than 5% of participants required referral for counselling.
Data management
3.100Hardcopies of interview protocols were stored in locked filing cabinets in the School of Psychology at UCD. Each protocol contained a case number. Data from each protocol identified by case number, but not the participants name were entered into an SPSS data file by the team of 3 postgraduates and interview organizer. This master SPSS data file was held on three laptop computers and each of the three Postgraduates had responsibility for these laptops. They each undertook specific data analysis tasks.
3.101The entries in the data file followed the order in the assessment protocol. The variable names were those specified in the left column (e.g. D1, D2, D3….KMS1, KMS2, KMS3, E1, E2 etc.). The variable values for each case were the numbers associated with the responses to each question, marked in ink on the protocol. When the data file was complete, the ranges of all variables were checked to detect errors such as double keying. Missing data points were identified and a rational approach to manual mean substitution was used for missing data, where possible. For ‘reverse scored’ items from multi-item scales, ‘recode’ SPSS commands were used to reverse the direction of scoring. ‘Compute’ SPSS commands were used to calculate multi-item scale scores.
Conclusions
3.102The aim of the present study was to profile subgroups of adult survivors of institutional child abuse on demographic, historical and psychological variables with a view to detecting associations between recollections of institutional living and current adjustment. In particular the aim was to profile subgroups of survivors defined by (1) the number of years spent in an institution and the circumstances under which admission occurred; (2) the worst type of institutional abuse experienced; and (3) the number and type of psychological disorders they displayed. An additional aim was to develop a way to assess psychological processes and coping strategies associated with institutional abuse, and establish the correlates of these processes and coping strategies. Between May 2005 and February 2006 just under 250 adult survivors of institutional living recruited through CICA were interviewed in Ireland and the UK by a team which included 29 trained interviewers, all of whom had degrees in psychology. The overall exclusion rate was 26% (326 of 1267). The participation rate was 20% (246 of 1267). The response rate was 26% (246 of 941). The sample of participants interviewed was not representative of all CICA attenders, or indeed of adult survivors of institutional living. It is probable that participants were better adjusted than CICA attenders who did not take part because the old and the ill were excluded. The interview protocol covered a range of areas related to current adjustment and past history. Interviews were conducted in an ethical way that safeguarded participants’ wellbeing. Data were managed in a way to safeguard participants’ anonymity.
Figure 2.1. The path of recruitment and attrition for participants from the CICA confidential and investigation committees
Part 3 Characteristics of the sample
Summary of Part 3
3.103The 247 participants in this study included roughly equal numbers of men and women of about 60 years of age, who had entered institutions run by nuns or religious brothers due to family adversity or petty criminality. The majority were of lower socioeconomic status and low educational attainment. The majority had been or were currently married or in long-term relationships, with a high rate of relationship stability. Most married participants had children, with three children being the average, and most brought up their own children.
3.104On the institutional version of the Childhood Trauma Questionnaire, more than 90% of participants were classified as having experienced institutional physical and emotional child abuse and about half as having experienced institutional child sexual abuse. More than 90% were classified as having experienced physical and emotional neglect within institutions.
3.105For about 40% of participants, severe physical abuse was the worst thing that happened to them in an institution. For a further third it was humiliation and degradation. For 16% it was sexual abuse and for about a tenth it was combined physical and sexual abuse. On average, worst institutional abusive experiences began at about 9 years and lasted for 5 about years.
3.106On the family version of the Childhood Trauma Questionnaire just over a third of those who had memories of having lived with their families reported family-based child abuse or neglect.
3.107All participants had experienced one or more significant life problems. Mental health problems, unemployment and substance use were the three most common difficulties.
3.108Self-reliance, optimism, work and skills were the most frequently reported sources of personal strength and factors that helped participants face life challenges.
3.109About four fifths of participants at some point in their life had had a psychological disorder and only a fifth had never had any psychological disorder. Anxiety disorders were the most common, followed by mood disorders, followed by substance use disorders. Personality disorders were the least common. The overall rates of psychological disorders among survivors of institutional living in the present study, were far higher, and in most cases double those found in normal community populations in major international epidemiological studies
3.110The majority of participants showed clinically significant posttraumatic symptomatology on the Trauma Symptom Inventory, indicative of continuing posttraumatic adjustment difficulties.
3.111On the Experiences in Close Relationships Inventory more than four fifths of participants were classified as having an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships. A fearful attachment style characterized by high interpersonal anxiety and avoidance was by far the most common. Less than a fifth of cases were classified as having a secure adult attachment style,
3.112Institutional sexual abuse was found to be associated with current post-traumatic symptomatology and major life problems.
3.113Male and female participants had different profiles. Male participants spent longer living with their families before entering institutions and fewer years in institutions. More entered institutions run by religious brothers or priests for petty crime and left because their sentence was over, while more females lived in institutions run by nuns. Male participants achieved a higher SES than females and more had children who spent time living separately form them with the child’s other parent. While their worst abusive experiences began at an older age for male participants, they reported more institutional sexual abuse. While significantly more female participants had lifetime diagnoses of panic disorder with agoraphobia, significantly more male participants had lifetime diagnoses of alcohol and substance use disorders, especially alcohol dependence. Male participants had significantly higher numbers of life problems, but also higher levels of global functioning and marital satisfaction than females.
3.114Participants under and over 59 years of age (the median age for the sample) had distinct profiles. More older participants left their institutions because they were too old to stay on and more were now retired. They had longer relationships with their current partners and were older when their first children were born. Younger participants reported greater institutional, physical, sexual and emotional abuse. More had current anxiety, mood and personality disorders, especially PTSD, generalized anxiety disorder and avoidant personality disorder. Younger participants had more trauma symptoms, adult life problems, a lower quality of life and lower level of global functioning compared with older participants.
3.115Participants from the confidential and investigation committees had distinct profiles. Participants from the confidential committee had spent fewer years with their families before entering an institution and more years in institutions run by nuns. More entered because they were illegitimate and left because they were too old to stay on. They were younger when their worst experiences began. More had maintained stable long-term relationships with their partners and provided their own children with a stable family in which to grow up. More participants from the investigation committee entered intuitions run by religious brothers or priests through the courts for petty crime and left because their sentences were over. They reported greater institutional sexual abuse than participants from the confidential committee. More participants from the investigation committee had a current diagnosis of major depression.
Introduction
3.116The overall characteristics of the sample of 247 participants is presented in this Part under the following headings:
• Historical characteristics
• Demographic characteristics
• History of abuse
• Life problems
• Strengths
• Psychological disorders
• Trauma symptoms on the Trauma Symptom Inventory
• Adult attachment styles
• Reliability of multi-item scales
• Correlations between indices of abuse and adjustment
• Factors associated with age, gender and CICA committee attended
Historical characteristics
3.117Historical characteristics are summarized in Table 3.1. Participants had spent an average of 5.4 years living with their families before entering an institution and on average spent 10 years living in an institution. Participants reported entering institutions for various reasons including their parents being unable to look after them (42.1%), petty crime (23.5%), illegitimacy (19.43%), and parental death (14.17%). Participants gave the following reasons for leaving institutions: I was too old to stay on (71.25%), my family wanted to take me home (13.76%), my sentence was over (7.69%), I ran away (3.23%), and the institution closed down (1.61%). About half (49%) of participants had lived in institutions managed by nuns. Just under at third (31.17%) had lived in institutions managed by religious brothers or priests. About a fifth (19.83%) had lived in both types of institutions. The majority of participants were happy to leave institutions (61.5%) or had mixed feelings (34%).
Demographic characteristics
3.118Demographic characteristics are summarized in Table 3.2. The sample included almost equal numbers of males (54.7%) and females (45.3%), with a mean age of 60 years.
Current Socio-economic Status
3.119Participants were predominantly of lower socio-economic status (SES) with 24% unemployed; 15.4% unskilled manual workers; 28% semiskilled manual workers; and 12% skilled manual worker. Only 3.2% were non-manual workers. Only 3.65% were in lower professional and managerial posts, and only 0.4% had higher professional or managerial appointments. 34% of participants were retired.
Highest Socio-economic Status
3.120Since leaving school the highest socio-economic status achieved by most participants was at the lower end of the spectrum. For 42% the highest status achieved was unskilled manual work; for 25.1% is was semiskilled manual work; and for 12.6% it was skilled manual work. Since leaving school a far smaller proportion had achieved high socio-economic status. Only 8.5% had worked in non-manual jobs. Only 6.1% had worked in lower professional and managerial posts and only 0.8% had achieved higher professional or managerial appointments.
Education
3.121With respect to education, 49% had never passed any state, college or university examination. 25% had passed the Primary Certificate Examination which is usually taken at about 12 years of age at the end of primary school education. 6.1% had passed the Intermediate Certificate Examination, which it usually taken at about 15 or 16 years of age, midway through secondary school. Only 5.3% had passed the Leaving Certificate Examination, which it usually taken at about 18 years of age, and marks the completion of secondary school education. Only 3.2% had a bachelors level university degree.
Marital status
3.122With respect to marital status, 39.7% were married in their first relationship. 9.3% were married in their second relationship. 8.9% were widowed and 11.3% had never married. 19% were single and separated or divorced from their first marital or cohabiting partner. 4.5% were single and separated or divorced from second or later partner.
Stability of long term relationships
3.123With respect to the stability of long-term romantic or marital relationships, 34.6% of the 217 participants who had long term relationships were still in these relationships. 36.4% reported that they had been in one long-term relationship that had ended. 17.1% had ended two long-term relationships. 12% reported that they had been in 3 or more long-term relationships that had ended. For the 134 participants who were currently in long-term relationships or marriages, the average duration of these relationships was 31.1 years.
Children’s living arrangements
3.124For the 212 participants with children, the average number of children was 3.38, and the average age when these participants had their first child was 25.53 years. For 76.8% of these participants, their children had lived with them while they were growing up. For 13%, the children spent sometime living with the other parent. For 2.8% the children spent some time living with relatives. Only 4.7% of parents reported that their children spent some time living in care and only 2.4% had put a child up for adoption.
History of abuse
3.125Participants’ history of child abuse within institutions and families is summarized in Table 3.3.
Institution version of the Childhood Trauma Questionnaire
3.126On the total scale of the institution version of the Childhood Trauma Questionnaire (CTQ) 99.2% of cases were classified as having experienced child abuse, with most cases experiencing multiple forms of child abuse and neglect. On the CTQ subscales, 97.2% were classified as having been physically abused; 47% as having been sexually abused; 94.7% as having been emotionally abused; 97.6% as having been physically neglected and 95.1% as having been emotionally neglected. For the CTQ scales, the following cut-off scores were used in classifying cases as abused: emotional abuse 13, emotional neglect 14, physical abuse 11, physical neglect 10, sexual abuse 9, and overall CTQ child abuse score 52. These cut-off scores were two standard deviations above the mean for combined male and female normative community samples (Scher, Stein, Asmundson, McCreary & Forde, 2001).
Institutional Abuse Scale
3.127On the institutional abuse scale cases were classified as having experienced specific forms of abuse, particular to living in an institution, if participants rated items as often true or very true. 92.3% reported that they were punished unfairly by their carers. 88.7% reported that they were terrified of their carers. 88.3% reported that they could never predict when they would be punished by their carers. 85% noted that their carers tried to break them. 80.1% noted that their carers tried to take away their hope. 75.7% said that their carers told them that they were bad . 64.7% said that their carers took away their own clothes. 47% mentioned that their carers separated them from their siblings. 43% noted that their carers said their mothers were bad. 38% said that their carers destroyed their treasured possessions such as pictures, teddy bears, and mementoes. 30.4% reported that their carers told them that their mothers did not love them. 26.4% mentioned that their carers said that their fathers were bad and 21% reported that their carers told them that their fathers did not love them.
Most severe form of physical institutional abuse
3.128All participants reported that they had experienced physical abuse, serious enough to mention in answer to questions about the most severe form of physical institutional abuse they had experienced. (This is close to the 97.2% rate of physical abuse obtained on the institution version of the CTQ, a normed psychometric instrument.) 42.1% reported that being assaulted to lead to medical attention was the most severe form of physical institutional abuse to which they had been exposed. For 30% it was being hit to leave bruises; for 20.6 % it was being assaulted to lead to cuts; and for 5.7% it was being hit without being bruised. 46.6% reported that the most severe form of physical institutional abuse occurred more than 100 times. 23.9% mentioned that the most severe form of physical institutional abuse occurred 11-100 times. For 19.6% it occurred 2-10 times and for 9.7% it occurred only once. The average age when the most severe form of physical institutional abuse began was 8.5 years and the average duration was 6.7 years.
Most severe form of sexual institutional abuse
3.12950.6% of participants reported that they had experienced sexual abuse, serious enough to mention in answer to questions about the most severe form of sexual institutional abuse they had experienced. (This is close to the 47% rate of sexual abuse obtained on the institution version of the CTQ, a normed psychometric instrument.) 21.5% reported that fondling and masturbation was the most severe form of sexual institutional abuse they had experienced. For 18.6% it was oral, anal or vaginal penetration. For 6.9% it was attempted oral, anal or vaginal penetration. For 3.2% it was non-contact sex, for example, exposure. 16.6% reported that the most severe form of sexual institutional abuse occurred more than 2-10 times. 14.2 % mentioned that the most severe form of sexual institutional abuse occurred 11-100 times. For 10.5% it occurred only once and for 9.3% it occurred more than 100 times. The average age when the most severe form of sexual institutional abuse began was 10.73 years and the average duration was 2.83 years.
Worst thing that ever happened in an institution
3.130Answers to the open-ended question ‘What was the worst thing that happened to you in the institution?’ were classified into four thematically salient groups, with inter-rater agreement of over 90% for the classification of a sample of 10% of all statements. The statements from 247 participants, classified into four thematic categories, are presented in Table 3.4. For 40.1% of participants, severe physical abuse was the worst thing that happened to them in an institution. For 34.4% it was humiliation and degradation. For 16.2%, it was sexual abuse and for 9.3%, the worst thing that happened in an institution was severe combined physical and sexual abuse. Participants reported that their worst experiences began, on average, at 9.1 years and lasted, on average, for 5.3 years.
Family version of the Childhood Trauma Questionnaire
3.131121 participants had lived with their family and had sufficient memories of that time to complete the family version of the Childhood Trauma Questionnaire (CTQ). On the total scale of the family version of the CTQ 38% of these 121 cases were classified as having experienced child abuse. On the CTQ subscales, 26.4% were classified as having been physically abused; 8.3% as having been sexually abused; 20.7% as having been emotionally abused; 47.9% as having been physically neglected; and 28.9% as having been emotionally neglected. These rates are considerably lower than the rates of institutional abuse given by the institutional version of the CTQ reported above, most of which were above 90%.
Most severe form of physical abuse in the family
3.13244 participants reported that they had experienced physical abuse, serious enough to mention in answer to questions about the most severe from of physical abuse they had experienced within the family. 44 is 36%, or just over a third, of the group of 121 who had sufficient memory of living with their families to answer detailed questions about this period of their lives. Expressed as percentages of 121, 18.18% reported that being hit to leave bruises was the most severe form of physical abuse to which they had been exposed within the family. For 9% it was being assaulted to lead to medical attention; for 5.78% it was being hit without being bruised; and for 3.3% it was being assaulted to lead to cuts. Expressed as percentages of 121, 14.05% reported that the most severe form of physical abuse within the family occurred 11-100 times. 11.57 % mentioned that the most severe form of physical abuse within the family occurred 2-10 times, and for 10.74% it occurred more than 100 times. The average age when the most severe form of physical abuse within the family began was 7.29 years and the average duration was 5.2 years.
Most severe form of sexual abuse within the family
3.13314 participants reported that they had experienced sexual abuse, serious enough to mention in answer to questions about the most severe form of sexual abuse they had experienced within the family. 14 is 11.57%, or just over a tenth, of the group of 121 who had sufficient memory of living with their families to answer detailed questions about this period of their lives. Expressed as percentages of 121, 5.78% reported that fondling and masturbation was the most severe sexual abuse they had experienced within the family. For 4.13% it was oral, anal or vaginal penetration. For 1.65% it was attempted oral, anal or vaginal penetration. 4.13% reported that the most severe form of sexual abuse within the family occurred only once. 3.3 % mentioned that the most severe form of sexual abuse within the family occurred more than 100 times. For a further 3.3% it occurred 11-100 times. The average age when the most severe form of sexual abuse within the family began was 8.55 years and the average duration was 4.48 years.
Life problems
3.134All participants had experienced one or more significant life problems. Mental health problems (74.1%), unemployment (51.8%) and substance use (38.1%) were the three most common difficulties occurring in a third to three quarters of cases. Less common problems included frequent illness (29.6%), frequent hospitalisation for physical health problems (28.3%), anger control in intimate relationships (25.9%), non-violent crime (22.3%) and homelessness (21.1%). Less than a fifth of cases had problems in the following areas: self-harm (17.8%), anger control with children (13.4%), incarceration for non-violent crime (13.4%), hospitalisation for mental health problems (13%), violent crime (10.1%), and incarceration for violent crime (7.3%). The inter-rater reliability kappa coefficient for each of the life problems was above .7 indicating that the problems were reliably measured.
Strengths
3.135To assess participants perception of their own strengths they were asked – where does your strength come from?; what has helped you most in facing life challenges?; and what is the thing that means most to you in your life? A summary of responses to these questions is given in Table 3.6. Participants’ self-reliance, optimism, work and skills collectively were the most frequently reported sources of personal strength (59.3%) and factors that helped participants face life challenges (58%). Their relationships with their partners and / or family were the most commonly cited things that meant most to participants in their lives (70.2%). This was also the second most common source of strength (16.19%) along with their relationship with God or a spiritual force (16.19%). Their relationships with their partners and /or family was also the second most common factor that helped them face life challenges (25.5%). Relationship with God or a spiritual force and relationship with a friend including other survivors were cited by less than 11% of participants as factors that helped them face life challenges and things that meant most to them in their lives.
Psychological disorders
3.136Anxiety, mood and alcohol or substance use disorders were assessed with the Clinical version of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I, First, Spitzer, Gibbon & Williams, 1996). Avoidant, antisocial, borderline and dependent personality disorders were assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II, First, Spitzer, Gibbon & Williams, 1997). The inter-rater reliability kappa coefficient for each of the diagnostic categories assessed was above .7 indicating that the diagnoses were reliably made (Cohen, 1960).
Overall rates of psychological disorders in survivors of institutional living
3.13781.78% of participants at some point in their life had met the diagnostic criteria for an anxiety, mood, alcohol or substance use, or personality disorder. 18.21% (or 45 participants) had never had any psychological disorder.
3.138With respect to DSM IV Axis I disorders, 64.8% of participants had at some point in their lifetime met the diagnostic criteria for a diagnosis of an anxiety, mood, alcohol or substance use disorder. 51.4% met the diagnostic criteria for a diagnosis of an anxiety, mood, or alcohol or substance use disorder when they were interviewed. With respect to DSM IV Axis II disorders, 30.4% had a personality disorder when interviewed.
3.139From Table 3.7 it may be seen that for combined current and lifetime diagnoses, anxiety disorders were the most common (current: 44.9%, lifetime: 34.4%); followed by mood disorders (current: 26.7%, lifetime: 36%); followed by substance use disorders (current: 4.9%, lifetime: 35.2%); with the rate of personality disorders being the lowest of all broad categories of diagnoses (30.4%). (Only current and not lifetime diagnoses of personality disorders may be made.)
Comparison with rates of psychological disorders in the community
3.140The overall rates of psychological disorders among survivors of institutional living in the present study, were far higher than those found in major international epidemiological studies of normal community populations conducted in Europe, the USA and the UK, summarized in Table 3.8 (Alonso et al., 2004; Grant et al., 2004; Kessler, Berglund et al., 2005; Kessler, Chiu et al., 2005; Singleton et al., 2001; Torgersen et al., 2001). The prevalence of current anxiety, mood and personality disorders among survivors of institutional living was more than twice that found in normal European, North American or British populations. The prevalence of lifetime diagnoses of anxiety, mood, and substance use among survivors of institutional living exceeded those found in normal European, North American or British populations by between 5 and 30%.
Anxiety disorders
3.141From Table 3.7 it may be seen that for anxiety disorders the three most common conditions were social phobia (current: 19.8%, lifetime: 10.9%); generalized anxiety disorder (current: 17%, lifetime: 6.9%); and posttraumatic stress disorder (current: 16.6%, lifetime: 8.5%). Other anxiety disorders were less prevalent.
Mood disorders
3.142From Table 3.7 it may be seen that for mood disorders the current (26.7%) and lifetime (36%) prevalence rates for major depression were higher than the rate of current dysthymia (11.3%). (Only current and not lifetime diagnoses of dysthymia may be made.)
Alcohol or substance use disorders
3.143From Table 3.7 it may be seen that for alcohol or substance use disorders 27.1% had a lifetime diagnosis of alcohol dependence and 7.7% for a lifetime diagnosis of alcohol abuse. Prevalence rates for all other current and lifetime substance use diagnoses were below 5%.
Personality disorders
3.144From Table 3.7 it may be seen that 21% of participants had avoidant personality disorder. 6.9% had antisocial personality disorder. 5.7% had borderline personality disorder and only 1.6% had dependent personality disorder.
Trauma symptoms on the trauma symptom inventory
3.145Cases were classified as showing clinically significant trauma symptoms if they scored two standard deviations above the mean for the normative sample described in Briere’s (1996) manual for the Trauma Symptom Inventory (TSI). A summary of the rates of cases showing clinically significant trauma symptoms on the TSI is given in Table 3.9. More than half of all participants showed clinically significant levels of avoidance of reminders of early trauma (59.9%) and intrusive experiences such as flashbacks (55.9%). Between a third and almost a half had clinically significant problems with impaired self-reference (46.2%), dissociation (44.1%), depression (41.7%), anxious arousal (38.5%) and maladaptive tension reduction (35.2%). For less than a third, anger (32%), sexual concerns (23.9%) and sexual dysfunction (12.6%) were clinically significant problems.
Adult attachment styles
3.146Cases were classified as falling into four adult attachment style categories using the Experiences in Close Relationships Inventory, SPSS algorithm described in Brennan, Clark, & Shaver’s (1998) chapter: Self-report measures of adult attachment: An integrative overview. A summary of the numbers of cases falling into the four categories is given in Table 3.10. Using this system, only 16.59% of cases were classified as having a secure adult attachment style, with the remaining 83.41% of cases having an insecure adult attachment style. A fearful adult attachment style, characterized by high interpersonal anxiety and avoidance was by far the most common insecure style, with 44.12% of participants being classified in this way. 26.72% had dismissive, and 12.55% had preoccupied adult attachment styles. A dismissive style is characterized by low interpersonal anxiety, but a high level of interpersonal avoidance, whereas a preoccupied style is characterized by high interpersonal anxiety and a low level of interpersonal avoidance.
Reliability of multi-item scales
3.147Multi-item scales were used to assess participants’ recollections of abuse and a number of aspects of current functioning. These scales were used in correlational analyses reported below, and in other analyses reported in the next Part. Before these analyses were conducted, the reliability of the scales was evaluated. Internal consistency reliability was evaluated with Cronbach’s (1951) alpha and inter-rater reliability was assessed using the split-half method, treating ratings by each rater as two halves of the same scale. The ranges, means, standard deviations and reliability coefficients for the scales used in the correlational and later analyses are summarized in Table 3.11.
3.148With three exceptions, internal consistency and inter-rater reliability co-efficients close to or greater than .7 were obtained, indicating that scales had acceptable levels of reliability. The exceptional scales deserve mention. The total and severe physical abuse scales of the family version of the Severe Physical and Sexual abuse yielded internal consistency reliability co-efficients of .27 and .26 respectively; and the severe sexual abuse scale of the family version of the Severe Physical and Sexual abuse yielded an inter-rater reliability co-efficient of .53. These co-efficients indicate that these scales were relatively unreliable, and so results from them should be interpreted cautiously.
Correlations between indices of abuse and adjustment
3.149Pearson product-moment correlations were computed between indices of institutional living and institutional and family-based child abuse on the one hand, and indices of adjustment on the other. These analyses are summarized in Table 3.12. In these analyses, the indices of institutional living and abuse were: the number of years spent living in an institution; the total score on the Institutional Abuse Scale (IAS); the total, physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect scale scores of the institution and family versions of the Childhood Trauma Questionnaire (CTQ); and the total, severe physical and severe sexual abuse scale scores of the institution and family versions of the Severe Physical and Sexual Abuse scale (SPSA). In these analyses the indices of adjustment were: total number of current and lifetime psychological disorders; the total score on the Life Problems Checklist (LPC); the score on the Global Assessment of Functioning (GAF) scale; the total score on the Trauma Symptom Inventory (TSI); Socio economic status (SES); the number of failed marital or cohabiting relationships in a participants life; the total score on the Kansas Marital Satisfaction scale (KMS); scores on the interpersonal anxiety and avoidance scales of the Experiences in Close Relationships Inventory (ECRI); the total score on the Kansas Parent Satisfaction scale; and the total score on the World health Organization Quality of Life Scale.
3.150To avoid type 1 error (accepting spurious correlations as significant) and to identify correlations in which variables shared at least 9% of the variance, only correlations with an absolute value of .3 or greater and significant at p<.01 were interpreted as significant and meaningful.
3.151There were two important sets of findings. First, correlations larger than .3 and significant at p<.01 occurred between the total trauma symptoms score on the TSI on the one hand and the following indices of abuse on the other: the total (r=.38), sexual (r=.35), and emotional abuse (r=.32) scales of the institution version of the CTQ; and the total (r=.34) and severe sexual institutional abuse (r=32) scales of the institution version of the SPSA. These correlations show that participants who reported greater numbers of trauma symptoms also reported greater institutional sexual and emotional abuse.
3.152The second set of findings was that correlations larger than .3 and significant at p<.01 occurred between the total problems score on the LPC on the one hand and the following indices of abuse on the other: the sexual abuse scale of the institutional version of the CTQ (r=.39); the severe institutional sexual abuse scale of the institution version of the SPSA (r=.36); and the total (r=.32) and severe family physical abuse (r=.34) scales of the family version of the SPSA. However, correlations between the LPC and the scales from the family version of the SPSA must be interpreted cautiously because of the low reliability of the total and severe physical abuse scales of the family version of the SPSA. These correlations show that participants who reported greater numbers of life problems in adulthood also reported greater institutional sexual abuse, and severe family-based physical abuse (although this finding is tentative).
Factors associated with age, gender and CICA committee attended
3.153To identify factors associated with age, gender and CICA committee attended, three sets of analyses were conducted. In the first of these, 135 males participants were compared with 112 female participants on all main variables. In the second analysis, 134 older participants whose age fell above the median age for all 247 participants were compared with 113 younger participants. In the third analysis, 175 participants who had attended the confidential committee were compared with 71 who attended the investigative committee. In each of these sets of analyses, to evaluate the statistical significance of intergroup differences, chi square tests were conducted for categorical variables and t-test were used for continuous variables. In all of these tests, p values were set conservatively at p<.01 to reduce the probability of type 1 error (misinterpreting spurious group differences as significant). In a further attempt to control for type 1 error, for continuous variables, where possible multivariate analyses of variance (MANOVAs) were conducted on groups of conceptually related variables, and only if the results of MANOVAs were significant were t-tests on individual variables conducted. For the TSI and the WHOQOL, which are multiscale instruments, unless the pattern of subscale scores differed greatly from that of total scores, for brevity, only analyses of total scores are reported. To facilitate interpretation of profiles of tabulated means, all psychological variables on continuous scales were transformed to T-scores (with means of 50 and standard deviations of 10) before analyses were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. In the interests of brevity only statistically significant results from these three sets of analyses are tabulated and reported.
Comparison of male and female participants
3.154135 males participants were compared with 112 female participants on all main variables. From Table 3.13 it may be seen that there were statistically significant differences between male and female participants on the following historical and demographic variables: years spent living with the family before entering an institution, years spent in an institution, reason for entering and leaving an institution, institution management, age when worst experiences began, highest socioeconomic status (SES) attained since leaving school, and their own children’s living arrangements. Male participants spent longer living with their families before entering institutions; they spent fewer years in institutions; more entered institutions for petty crime; more left because their sentences were over; more lived in institutions managed by religious brothers and priests (not nuns); their worst experiences began at an older age; they achieved a higher SES; and more had children who spent time living separately from them with the child’s other parent.
3.155From Table 3.14 it may be seen that that there were statistically significant differences between male and female participants in their recollections of child abuse on the following variables: the sexual and emotional abuse subscales of the institution version of the CTQ; the severe physical and sexual abuse scales of the institutional version of the SPSA. These results show that male participants reported more institutional sexual abuse than female participants, while females reported more emotional and physical abuse.
3.156From Table 3.15 it may be seen that while significantly more female participants had lifetime diagnoses of panic disorder with agoraphobia, significantly more male participants had lifetime diagnoses of alcohol and substance use disorders, especially alcohol dependence.
3.157From Table 3.16 it may be seen that male participants had significantly higher numbers of life problems, but also higher levels of global functioning and marital satisfaction than females.
Comparison of younger and older participants
3.158134 older participants whose age fell at or above the median age of 59 for all 247 participants were compared with 113 younger participants on all main variables. From Table 3.17 it may be seen that there were statistically significant differences between older and younger participants on the following historical and demographic variables: reason for leaving the institution, current socio-economic status, duration of relationship with current partner, and age when first child was born. More older participants left their institutions because they were too old to stay on; more were retired; they had longer relationships with their current partners; and were older when their first children were born.
3.159From Table 3.18 it may be seen that there were statistically significant differences between older and younger participants in their recollections of child abuse on the following variables: the total score on the IAS; the emotional abuse scale of the institutional version of the CTQ; and the total, severe physical and severe sexual abuse scales of the institution version of the SPSA. Younger participants reported greater institutional, physical, sexual and emotional abuse. Younger and older participants did not differ in their recollections of family-based abuse.
3.160From Table 3.19 it may be seen that significantly more younger participants had current anxiety, mood and personality disorders. With regard to specific disorders, rates of PTSD, generalized anxiety disorder and avoidant personality disorder were significantly higher among younger participants.
3.161From Table 3.20 it may be seen that younger participants had significantly more trauma symptoms on the TSI, and more life problems in adulthood on the LPC. They also had a significantly lower quality of life on the WHOQOL 100 UK and a lower level of global functioning on the GAF.
Comparison of participants from the confidential and investigative committees
3.162175 participants who had attended the confidential committee were compared with 71 who attended the investigative committee. From Table 3.21 it may be seen that there were statistically significant differences between participants from the confidential and investigation committees on the following historical and demographic variables: number of years spent living with the family before entering an institution; years spent in an institution; reasons for entering and leaving an institution; institution management; age when worst experiences began; number of long term relationships or marriages that have ended; and participants’ own children’s current living arrangements. Participants from the confidential committee had spent fewer years with their families before entering an institution; they spent more years in an institution; more entered because they were illegitimate and left because they were too old to stay on; more lived in institutions managed by nuns; they were younger when their worst experiences began; more had maintained stable long term relationships with their partners; and more had provided their own children with care when they were growing up. More participants from the investigative committee entered institutions through the courts for petty crime and left because their sentences were over, and more lived in institutions run by religious brothers or priests.
3.163From Table 3.22 it may be seen that there were statistically significant differences between participants from the confidential and investigative committees in their recollections of child abuse on the following variables: the total and sexual abuse scale of the institution version of the CTQ, and the severe sexual abuse scale of the institution version of the SPSA. Participants from the investigative committee reported greater institutional sexual abuse than participants from the confidential committee.
3.164Significantly more participants from the investigative committee had a current diagnosis of major depression (Investigative Committee=25.4%, Confidential Committee=11.4%, Chi Square (df=1, N=247)=7.5, p<.01).
Conclusions
3.165The 247 participants in this study included roughly equal numbers of men and women of about 60 years of age, who had entered institutions run by nuns or religious brothers due to family adversity or petty criminality. The majority were married with children and of lower socioeconomic status and low educational attainment. More than 90% of participants were classified as having experienced institutional physical and emotional child abuse and about half as having experienced institutional child sexual abuse. Just over a third of those who had memories of having lived with their families reported family-based child abuse or neglect. All participants had experienced one or more significant life problems. About four fifths of participants at some point in their lives had had a psychological disorder and this rate of psychological disorders was far higher than in normal community populations. The majority of participants showed post-traumatic symptoms and an insecure adult attachment style. Institutional sexual abuse was found to be associated with current post-traumatic symptomatology and major life problems. Male and female, and younger and older participants had different profiles as had participants from the confidential and investigation committees.
Table 3.1. Historical characteristics
| Variable | Categories | Values | |
|---|---|---|---|
| Years with family before entering an institution (N=246) | M | 5.40 | |
| SD | 4.55 | ||
| Years in an institution (N=247) | M | 10.03 | |
| SD | 5.21 | ||
| Reason for entering an institution (N=247) | |||
| Parents could not provide care | f | 104.00 | |
| % | 42.10 | ||
| Petty crime | f | 58.00 | |
| % | 23.50 | ||
| Illegitimate | f | 48.00 | |
| % | 19.43 | ||
| Parent died | f | 35.00 | |
| % | 14.17 | ||
| Unknown or other | f | 2.00 | |
| % | 0.80 | ||
| Reason for leaving the institution (N=247) | |||
| Too old to stay on | f | 176.00 | |
| % | 71.25 | ||
| Family wanted to take him / her home | f | 34.00 | |
| % | 13.76 | ||
| Sentence was over | f | 19.00 | |
| % | 7.69 | ||
| Ran away | f | 8.00 | |
| % | 3.23 | ||
| The institution closed down | f | 4.00 | |
| % | 1.61 | ||
| Unknown or other | f | 6.00 | |
| % | 2.42 | ||
| Institution management (N=247) | |||
| Nuns | f | 121.00 | |
| % | 49.00 | ||
| Religious brothers or priests | f | 77.00 | |
| % | 31.17 | ||
| Nuns and religious brothers or priests | f | 49.00 | |
| % | 19.83 | ||
| Were you happy to leave the institution? (N=247) | |||
| Yes | f | 152.00 | |
| % | 61.50 | ||
| Mixed feelings | f | 84.00 | |
| % | 34.00 | ||
| No | f | 11.00 | |
| % | 4.50 | ||
Note: For each variable with multiple categories, the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places.
Table 3.2. Demographic characteristics
| Variable | Categories | Values | |
|---|---|---|---|
| Gender (N=247) | Male | f | 135.00 |
| % | 54.70 | ||
| Female | f | 112.00 | |
| % | 45.30 | ||
| Age (N=247) | M | 60.05 | |
| SD | 8.33 | ||
| Current socio-economic status (SES) (N=241) | |||
| Unemployed | f | 60.00 | |
| % | 24.30 | ||
| Unskilled manual | f | 38.00 | |
| % | 15.40 | ||
| Semi-skilled manual and farmers owning less than 30 acres | f | 28.00 | |
| % | 11.30 | ||
| Skilled manual and farmers owning 30-49 acres | f | 12.00 | |
| % | 4.90 | ||
| Other non-manual and farmers owning 50-99 acres | f | 8.00 | |
| % | 3.20 | ||
| Lower professional and l managerial; farmers owning 100-199 acres | f | 9.00 | |
| % | 3.65 | ||
| Higher professional and managerial; farmers owning 200 acres | f | 1.00 | |
| % | 0.40 | ||
| Retired | f | 85.00 | |
| % | 34.40 | ||
| Highest SES attained since leaving school (N=235) | |||
| Unskilled manual | f | 104.00 | |
| % | 42.10 | ||
| Semi-skilled manual and farmers owning less than 30 acres | f | 62.00 | |
| % | 25.10 | ||
| Skilled manual and farmers owning 30-49 acres | f | 31.00 | |
| % | 12.60 | ||
| Other non-manual and farmers owning 50-99 acres | f | 21.00 | |
| % | 8.50 | ||
| Lower professional and managerial; farmers owning 100-199 acres | f | 15.00 | |
| % | 6.10 | ||
| Higher professional and managerial; farmers owning 200 acres | f | 2.00 | |
| % | 0.80 | ||
| Education: Highest exam passed (N=244) | |||
| None | f | 121.00 | |
| % | 49.00 | ||
| Junior school exam in 5th or 6th class (e.g. primary cert) | f | 62.00 | |
| % | 25.10 | ||
| Mid high school exam (e.g. Inter or junior cert) | f | 15.00 | |
| % | 6.10 | ||
| Leaving cert | f | 13.00 | |
| % | 5.30 | ||
| Certificate or diploma or apprenticeship exam | f | 25.00 | |
| % | 10.10 | ||
| Primary degree (e.g. BA) | f | 8.00 | |
| % | 3.20 | ||
| Marital status (N=245) | |||
| Married in first long term relationship | f | 98.00 | |
| % | 39.70 | ||
| Married in second or later marriage | f | 23.00 | |
| % | 9.30 | ||
| Cohabiting in first long term relationship | f | 2.00 | |
| % | 0.80 | ||
| Cohabiting in second or later long term relationship | f | 14.00 | |
| % | 5.70 | ||
| Single and widowed | f | 22.00 | |
| % | 8.90 | ||
| Single and never married or cohabited | f | 28.00 | |
| % | 11.30 | ||
| Single and divorced from first married partner | f | 24.00 | |
| % | 9.70 | ||
| Single and separated from first cohabiting partner | f | 6.00 | |
| % | 2.40 | ||
| Single and separated from first marital partner | f | 17.00 | |
| % | 6.90 | ||
| Single and separated or divorced from second or later partner | f | 11.00 | |
| % | 4.50 | ||
| Number of long term relationships or marriages that have ended (N=217) | |||
| No relationship has ended | f | 75.00 | |
| % | 34.60 | ||
| 1 relationship | f | 79.00 | |
| % | 36.40 | ||
| 2 relationships | f | 37.00 | |
| % | 17.10 | ||
| 3 relationships | f | 13.00 | |
| % | 6.00 | ||
| 4 or more relationships | f | 13.00 | |
| % | 6.00 | ||
| Duration of relationship with current partner (N=134) | M | 31.10 | |
| SD | 10.73 | ||
| Number of children (N=212) | M | 3.38 | |
| SD | 1.92 | ||
| Age when had first Child (N=207) | M | 25.53 | |
| SD | 5.56 | ||
| Children’s living arrangements (N=211) | |||
| Always lived with respondent | f | 162.00 | |
| % | 76.80 | ||
| Spent some time living with their other parent | f | 28.00 | |
| % | 13.30 | ||
| Spent some time living with their relatives | f | 6.00 | |
| % | 2.80 | ||
| Spent some time living in care | f | 10.00 | |
| % | 4.70 | ||
| Children put up for adoption | f | 5.00 | |
| % | 2.40 | ||
Note: For each variable with multiple categories, the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Socio-economic status (SES) was assessed with O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156. The percentages in long term relationships or marriages that have ended was based on the number of cases who had had any marriages or long-term relationships (N=217). The mean duration of relationship with current partner was based on the number of participants who were married or cohabiting (N=134). The mean number of children (N=212), mean age when had first child (N=207) and percentage of children in each of the children’s living arrangements (N=211) categories were based on cases with children only for whom relevant data were reported.
Table 3.3. History of abuse
| Variable | Scales, items or categories | f | % |
|---|---|---|---|
| INSTITUTIONAL CHILD ABUSE (N=247) | |||
| CTQ-Institution | Total child abuse | 245.00 | 99.20 |
| Physical abuse | 240.00 | 97.20 | |
| Sexual abuse | 116.00 | 47.00 | |
| Emotional abuse | 234.00 | 94.70 | |
| Physical neglect | 241.00 | 97.60 | |
| Emotional neglect | 235.00 | 95.10 | |
| Institutional abuse scale (N=247) | |||
| I was punished unfairly by my carers | 228.00 | 92.30 | |
| I was terrified of my carers | 219.00 | 88.70 | |
| I could never predict when I would be punished by my carers | 218.00 | 88.30 | |
| My carers tried to break me | 210.00 | 85.00 | |
| My carers tried to take away my hope | 198.00 | 80.10 | |
| My carers told me I was bad | 187.00 | 75.70 | |
| My carers took away my own clothes | 160.00 | 64.70 | |
| My carers separated me from my brother(s) or sister(s) | 116.00 | 47.00 | |
| My carers said my mother was bad | 106.00 | 43.00 | |
| My carers destroyed my treasured possessions (pictures, teddy bears, mementoes etc) | 94.00 | 38.00 | |
| My carers told me my mother did not love me | 75.00 | 30.40 | |
| My carers said my father was bad | 65.00 | 26.40 | |
| My carers told me my father did not love me | 54.00 | 21.00 | |
| Most severe physical institutional abuse (N=247) | |||
| Being assaulted to lead to medical attention | 104.00 | 42.10 | |
| Being hit to leave bruises | 74.00 | 30.00 | |
| Being assaulted to lead to cuts | 51.00 | 20.60 | |
| Being hit without being bruised | 15.00 | 6.00 | |
| None | 3.00 | 1.30 | |
| Frequency of most severe form of physical institutional abuse (N=247) | |||
| More than 100 times | 115.00 | 46.60 | |
| 11-100 times | 59.00 | 23.90 | |
| 2-10 times | 46.00 | 18.60 | |
| Once | 24.00 | 9.70 | |
| Never | 3.00 | 1.20 | |
| Age when most severe form of physical institutional abuse began (N=233) | |||
| M | 8.50 | ||
| SD | 3.72 | ||
| Duration of most severe form of physical institutional abuse (N=229) | |||
| M | 6.74 | ||
| SD | 4.42 | ||
| Most severe form of sexual institutional abuse (N=246) | |||
| None | 122.00 | 49.40 | |
| Contact (fondling and masturbation) | 53.00 | 21.50 | |
| Penetration (oral, anal or vaginal sex) | 46.00 | 18.60 | |
| Attempted penetration (oral, anal or vaginal sex) | 17.00 | 6.90 | |
| Non-Contact (flashing, exposure) | 8.00 | 3.20 | |
| Frequency of most severe form of sexual institutional abuse (N=247) | |||
| Never | 122.00 | 49.40 | |
| 2-10 times | 41.00 | 16.60 | |
| 11-100 times | 35.00 | 14.20 | |
| Once | 26.00 | 10.50 | |
| More than 100 times | 23.00 | 9.72 | |
| Age when most severe form of sexual institutional abuse began (N=122) | |||
| M | 10.73 | ||
| SD | 2.87 | ||
| Duration of most severe form of sexual institutional abuse (N=111) | |||
| M | 2.83 | ||
| SD | 2.99 | ||
| Worst thing that ever happened to you in an institution (N=247) | |||
| Severe physical abuse | 99.00 | 40.10 | |
| Severe humiliation and degradation | 85.00 | 34.40 | |
| Severe sexual abuse | 40.00 | 16.20 | |
| Severe physical and sexual abuse | 23.00 | 9.30 | |
| Age when worst thing in an institution began (N=237) | |||
| M | 9.18 | ||
| SD | 3.65 | ||
| Duration of worst thing in an institution (N=225) | |||
| M | 5.33 | ||
| SD | 4.66 | ||
| CHILD ABUSE IN THE FAMILY | |||
| CTQ-family (N=121) | Total child abuse | 46.00 | 38.00 |
| Physical abuse | 32.00 | 26.40 | |
| Sexual abuse | 10.00 | 8.30 | |
| Emotional abuse | 25.00 | 20.70 | |
| Physical neglect | 58.00 | 47.90 | |
| Emotional neglect | 35.00 | 28.90 | |
| Most severe physical abuse in the family (N=121) | |||
| Being hit to leave bruises | 22.00 | 18.18 | |
| Being assaulted to lead to medical attention | 11.00 | 9.00 | |
| Being hit without being bruised | 7.00 | 5.78 | |
| Being assaulted to lead to cuts | 4.00 | 3.30 | |
| Frequency of most severe form of physical abuse in the family (N=121) | |||
| 11-100 times | 17.00 | 14.05 | |
| 2-10 times | 14.00 | 11.57 | |
| More than 100 times | 13.00 | 10.74 | |
| Age when most severe form of physical abuse in the family began (N=41) | |||
| M | 7.29 | ||
| SD | 2.80 | ||
| Duration of most severe form of physical abuse in the family (N=42) | |||
| M | 5.20 | ||
| SD | 4.13 | ||
| Most severe sexual abuse in the family (N=121) | |||
| Contact (fondling and masturbation) | 7.00 | 5.78 | |
| Penetration (oral, anal or vaginal sex) | 5.00 | 4.13 | |
| Attempted penetration (oral, anal or vaginal sex) | 2.00 | 1.65 | |
| Frequency of most severe form of sexual abuse in the family (N=121) | |||
| Once | 5.00 | 4.13 | |
| More than 100 times | 4.00 | 3.30 | |
| 11-100 times | 4.00 | 3.30 | |
| Age when most severe form of sexual abuse in the family began (N=11) | |||
| M | 8.55 | ||
| SD | 2.46 | ||
| Duration of most sever form of sexual abuse in the family (N=11) | |||
| M | 4.48 | ||
| SD | 4.08 | ||
Note: CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). For the CTQ scales, the following cut-off scores were used in classifying cases as abused: emotional abuse: 13; emotional neglect: 14; physical abuse: 11; physical neglect: 10; sexual abuse: 9; and overall CTQ child abuse score: 52. These cut-off scores are two standard deviations above the mean for combined male and female normative samples reported in Scher, C., Stein, M., Asmundson, G., McCreary, D. & Forde, D. (2001). The Childhood Trauma Questionnaire in a Community Sample: Psychometric properties and normative data. Journal of Traumatic Stress, 14 (4), 843- 857. On the institutional abuse scale items, cases were classified as having experienced the abuse specified in the item if they were rated as often true or very true. For both institutional and family versions of the CTQ, categories and for the items on the institutional abuse scale, percentages sum to more than 100%. For ‘most severe form of physical abuse’ and ‘frequency of most severe form of physical abuse,’ percentages in 5 categories for each question sum to about 100. For ‘most severe form of sexual abuse’ and ‘frequency of most severe form of sexual abuse’ percentages in 5 categories for each question sum to about 100. Minor deviations from 100 are due to rounding of decimals to two places. For the ‘worst thing that ever happened’, verbatim responses were classified into 4 categories and percentages in these 4 categories sum to about 100.
Table 3.4. Statements of ‘worst thing’ that happened to participants while living in an institution
| Severe physical and sexual abuse | |
|---|---|
| Abused sexually by older boys (but not by brothers). Emotional and physical abuse by the brothers | |
| Stripped naked by a nun and beaten with a stick and given no supper and humiliated | |
| After running away having my hair cut off to a very short length and was made to stand naked to be beaten by nun in front of other people | |
| I was raped and severely beaten by a male carer | |
| Sexual abuse and beatings | |
| At 6 I was raped by nun and at 10 I was hit with a poker on head by nun | |
| When I told nuns about being molested by ambulance driver, I was stripped naked and whipped by four nuns to “get the devil out of you”. | |
| Sexual abuse, beatings, and no treatment for illness | |
| Beatings, brutality, sexual abuse, starvation and the general abuse | |
| Sexual abuse and physical abuse combined | |
| Sexual and physical abuse, no education, and not enough food. | |
| Sexually abuse and being beaten | |
| Sexual and physical abuse and living in fear | |
| Sexual abuse and the physical beatings | |
| Forced oral sex and beatings | |
| Being beaten and anally raped | |
| A brother tried to rape me but did not succeed, so I was beaten instead | |
| Taken from bed and made to walk around naked with other boys whilst brothers used their canes and flicked at their penis’ | |
| Scalded by accident and sexually interfered with | |
| Oral sex and being beaten if I refused | |
| Tied to a cross and raped whilst others masturbated at the side | |
| Sexual abuse, beatings and living in fear | |
| Beatings and sexual abuse | |
| Severe physical abuse | |
|---|---|
| I was polishing the floor and a nun placed her foot on my back so I was pushed to the floor. I was locked in a dark room. | |
| Being beaten by nuns when I tried to protect sister from beating | |
| When my carers believed me and 3 others were leaving the institution, they gave me severe physical punishment and took activities away from 200 other boys for 10 weeks, but blamed this on me. The boys were allowed to abuse me often for this. | |
| Having to empty the toilets and being lifted off the ground by my sideburns | |
| Put in bath of Jays fluid with 3 others | |
| They used to make my sisters beat me | |
| Badly physically beaten and humiliated | |
| Having my head submerged in dirty water in the laundry repeatedly by a nun | |
| Being beaten regularly | |
| Burst eardrum because of a beatings and loneliness | |
| Physical abuse and segregation from other children for no reason | |
| A severe beating by two nuns for a trivial misdemeanour until I was bleeding | |
| Being beaten for wetting the bed and allocated to do worst work like cleaning potties and minding children | |
| Tied to a bed and physically abused by three carers | |
| Being physically beaten by a paid employee and left unconscious | |
| I was beaten and hospitalised by the head brother and not allowed to go to my fathers funeral in case my bruises were seen; also the head brother threatened to killed me | |
| Being accused of sexually interfering with other boys and being beaten until made to write down the names of boys I had touched. In the end I wrote down two names to stop the torture | |
| They made me change my surname and beat me until I accepted it. They took my identity from me. The put me through mental torture which is still with me now. They separated me from my sister and sent her to another institution. | |
| Being physically beaten by nuns and referred to as a number. My head was pushed under water in the bath. The nuns threw food into a group of children and I would have to struggle to get some food. | |
| Beatings not getting a proper education | |
| Being told at 6.30pm on way to bed that would be beaten next morning at 6.30am. It was torture waiting for it. | |
| Beatings with shoe horn | |
| Being beaten | |
| One brutal beating at 12 or13 years old; and being left for long periods of time facing the wall | |
| A very severe beating with wooden curtain pole, the hunger and the cold | |
| Being stripped and thrown into nettles and sleeping with pigs for a week | |
| Beatings | |
| Constant physical abuse which made me terrified all the time | |
| A violent physical beating | |
| I was left hanging out of a window for hours with finger stuck in it, and was guaranteed to be beaten everyday | |
| Beatings | |
| Beaten for wetting bed and humiliated in front of others. I was forced to stand in dormitory for hours at a time | |
| Everything was the worst: physical abuse and mental torture | |
| Not being fed one day and then being beaten on the table in the dining hall | |
| Beatings | |
| Being beaten with wooden clothes hangers by the nuns | |
| Beatings and name-calling | |
| Having my hair cut off in spite and being beaten on the floor | |
| I got beaten twice because I stole a sandwich, | |
| Beatings and verbal abuse | |
| Being locked in a furnace room and left, bitten by rats, found by coal delivery man, removed, washed in cold water, bites cleaned and them put back there | |
| Being punished when tired and no-one listening to me about the abuse | |
| I was punished a lot for running away, beaten with strap, and had my head shaved a few times | |
| Being beaten in my underwear in the large washroom by prefects | |
| Starving and beatings like a concentration camp. There were so many worst things. Everyday was a nightmare. | |
| Severe beatings and taking away of our dignity “scamping” . | |
| The hidings and the appalling hygiene | |
| The beatings, the lack of education and not being fed properly | |
| Having my neck sliced in an attempt to treat a growth on neck> This was not medical treatment, it was cruel. | |
| My hair was cut short as punishment and I was beaten very badly in front of everyone when I came home late | |
| Being beaten by an older girl who was in charge. I was hit all over mainly on the legs, and this caused welts | |
| We were all lined up naked and slapped in the face a lot. We all had to drink water from toilets and were all washed in same dirty bath water | |
| Receiving a severe beatings and witnessing my younger brother returning from a severe beating | |
| Being beaten with a cane and strap; being separated me from my family | |
| Being beaten naked and flogged so hard that marks remained for months afterwards | |
| Extreme physical abuse leading to a burst ear drum and receiving no medical attention for days | |
| Severe physical abuse and feelings of helplessness | |
| Lashing; name calling (the name ‘good for nothing’ is still with me today); starving while watching pets being fed | |
| Being beaten by a lay night-watchman 60 times until I wet myself because I was awake and being beaten by a brother on the bare backside. He bruised and battered me. | |
| Physical abuse by the brothers and the lay night-watchman | |
| Physical abuse and eating from the rabbit huts | |
| Punished for stealing apples by being hit with a belt and having my hair cut | |
| Physical and mental abuse. Being beaten every day by brothers and older boys. | |
| The physical beatings, the emotional abuse, and no opportunity for learning or education. | |
| The brothers tied to flog me to death | |
| Physical abuse, my trousers were taken down and I was beaten on bare skin | |
| Being beaten until knocked out and my head split. Having my finger placed in boiling water until all feeling was lost; the finger swelled up, skin wore away, and the nail fell off | |
| Emotional and physical abuse; being placed there for no reason; the removal of all emotion from me | |
| Beatings and starvations | |
| Being thrown and ducked in scalding hot baths; being taken to hospital and anaesthetised with ether when getting my tonsils out. I have awful memories of feeling like being smothered with ether, similar to being ducked in the bath; I came as near death as you can imagine | |
| On my second day I was badly kicked, and beaten with fists and belts | |
| Physical abuse | |
| Being whipped and humiliated in front of the other children | |
| Kicked and beaten after running away | |
| Beatings | |
| Beaten severely | |
| Being abused; once my tongue was almost cut out | |
| Constant beatings; I was forced to sit on potty until my rectal muscle popped out | |
| Beaten by nuns with cat-o-nine-tails that left deep cuts | |
| Beaten and scared with hurley | |
| Kicked down the stairs | |
| I was badly beaten and witnessed extreme beatings | |
| Beaten till my hands bled | |
| Beatings | |
| I was beaten whilst naked, pushed down stairs and broke my foot | |
| Being beaten and ridiculed | |
| Being beaten with hosepipe and fear of further beatings | |
| Beaten so bad that I had to stay in bed for a week | |
| Being strangled by a brother | |
| Hunger and being slapped | |
| Badly beaten after running away | |
| Bad beatings | |
| Being hit on my back by a brother and sustaining a life long injury | |
| I was beaten in the shower naked, and not allowed to say goodbye when leaving | |
| Whipping | |
| Beaten until I had bones broken | |
| Being stripped and flogged and locked in room for 2-3 weeks | |
| Beaten | |
| Severe sexual abuse | |
|---|---|
| Sexual abuse — molested at night | |
| Sexual abuse | |
| Oral and anal sexual abuse on one occasion | |
| Molested and masturbation | |
| Rape | |
| Sexual abuse and made to feel so insecure | |
| Sexual abuse, starvation and secrecy in an institution that wasn’t fit for habitation | |
| Gang-rape | |
| Sexual assault | |
| Sexually molested by a priest visiting the institution on 6-8 occasions | |
| The day I entered the institution another boy tried to sexually assault me | |
| Sexual abuse perpetrated by gardeners, a social worker and other male convent employees | |
| Sexual abuse | |
| Being left out in the cold one winter and staying out near the boiler where older boys who had been sent by the courts tried to molest him and I had to fight them off | |
| A brother sexually abused me | |
| Child sexual abuse by older boys (not the brothers) | |
| Sexual abuse | |
| Sexual abuse | |
| Raped by a brother | |
| Sexually abused in a toilet twice, and mental abuse, shown horror movies. | |
| Sexual abuse and witnessing violence. I had a rubber hoses stuck up me and I had to watch my carers beating the youngest most vulnerable children. | |
| Sexual abuse | |
| Being raped by the director of the school | |
| Rape | |
| Being raped by Christian Brothers | |
| Being asked by other students to abuse younger child sexually as an initiation right | |
| Touched in a sexual way in bed at night by a Brother | |
| Raped | |
| Molested every week by brothers and older boys | |
| Anal penetration by a Christian Brother | |
| Sexual abuse | |
| I was raped | |
| Sexual abuse and rape | |
| Raped by a brother | |
| Rape | |
| Sexually assaulted | |
| Sexual abuse | |
| Rape | |
| Rape | |
| Sexual Abuse | |
| Severe emotional abuse | |
|---|---|
| When my mother first came to visit after 6 months, she cried lots at how much weight I and all the kids had lost. She cried lots saying ‘I didn’t put ye here’ | |
| Watching other boys who had just been beaten for wetting the bed coming out of the office in pain, hearing the crying and seeing other boys trying to help | |
| Having to go into church and kiss a dead man in his coffin | |
| Father prevented from seeing me | |
| They told my brothers I had died. I was hit for crying in response and told to stop | |
| Not being loved | |
| Neglect. Craving love but getting none | |
| After a disagreement with a nun, my long hair was cut off in my sleep as they knew I loved it | |
| Living in fear | |
| Being painted with a paint brush | |
| The night I entered the institution, my clothes and teddy thrown away | |
| Getting chilblains frostbite, and sores so deep I could see my bones on my hand from working in the fields was worse than the beatings | |
| The fear, starvation and hard labour | |
| Deprived of chance to go to my grandmother’s funeral | |
| The first day I was told my mother didn’t want me | |
| Humiliation of being sent to school with wet sheets wrapped around me after bed wetting incident | |
| Being force fed and held down | |
| Seeing a young boy die. He was 12 years old, beaten by brothers on landing and fell over banister | |
| Told to say I was the devil and had to wear a “devil’s tongue” hat | |
| Unfair way I and the others were treated. The fear – I was always afraid | |
| I had my identity taken away. I was known by a number only. | |
| Having pubic hair shaved off and a nun telling people about it at dinner . She said “I shaved the monkey”. | |
| I can take any abuse, but the worst thing was having no one. Seeing other kids going out with their families and not knowing why I had no one. I was lied to: told that my parents were dead. I only found out in my 50’s that they were alive | |
| I could stand the beating, The worst thing was the mental abuse: being put in there in the first place and not understanding why | |
| Put in a bath of cold water | |
| I was humiliated when the teacher of sixth class insulted me because of my father arguing with the head of industrial school | |
| At age nine I was sent to pluck turkeys in a coal shed in the cold and had freezing fingers | |
| The worst thing was the emotional removal of self: it still has a huge effect on my life | |
| Lack of education: Not being taught how to read or write. That’s the most hurtful thing | |
| Having soiled sheets put over my head for one hour when I wet the bed at night | |
| It was threatened that my father would lock me in a mental institution if I didn’t stop causing trouble | |
| Punishment was meted out repeatedly for the same misdemeanour. Constantly being threatened with punishment. | |
| Getting an artificial limb without my or my mother’s consent. I was the only child in the institution with a physical disability and I felt marked out. | |
| Nightmares due to living with constant uncertainty and unpredictability | |
| Listening to them talking badly about my mother and being taunted about my physical appearance. I was called “four eyes” | |
| Loneliness at Christmas time | |
| Public humiliation about my mother being unmarried | |
| Loss of finger through gangrene due to lack of medical attention. She loved to play the piano and this meant loss of hope to become a music teacher | |
| Poor hygiene and not being informed or provided with information or sanitation | |
| Looking at younger kids being beaten | |
| We were children and we did so much hard work. We were up at six o’clock in the morning. We have no childhood memories. We knew no better | |
| Just being there was the worst thing and the humiliation especially | |
| Being a celiac was never detected, because the nuns were not educated enough to know about the disease | |
| The worst thing was the overall effect of breaking my spirit; the violence; and the constant blanket of terror | |
| The constant fear. I was called into the office and told my mother had died. I actually felt relief that it wasn’t a punishment | |
| The leg of a chair was pressed against my temple for interrupting the teacher at the blackboard when I asked to go to the toilet | |
| Feeling alone and unloved | |
| I was afraid to tell the nuns I had a sore on my leg. They found out and cut my hair off. | |
| Witnessed my sister being whipped until she bled, then made to kneel in refectory for 3 months | |
| Being locked in a cupboard in the attic | |
| The emotional abuse was worse than the physical abuse and its effects have stuck since then | |
| My leg was badly burnt and I was kept hidden in a room for 5 weeks without any medical treatment. I was ill with mumps and not allowed stay in bed. I had to get up for Holy Communion. Witnessing physical abuse of other children. Watching their heads being shaved. Being hungry. | |
| Psychological trauma of living in fear most of the time | |
| The worst thing was the sense of being an orphan and being incarcerated and criminalised: the monotony; the ball-aching mind-aching hopelessness | |
| Being locked in a coal-shed three times | |
| I hated being in the band and hated the priest in charge | |
| I found a little girl dead in her bed after they’d gone for a walk and the girl hadn’t been feeling up to it. The lack of sex-education was terrible, I didn’t know what was happening when period started. The coldness at night. | |
| Feeling like a ’nobody’ and that everyone was better. Always feeling insecure. | |
| Constantly being told I was worthless and shouldn’t have been born. Being called a ’dying cat’. | |
| Seeing a woman with intellectual disabilities having her baby taken away from her | |
| Fear of every thing. Fear of God. Fear of the Christian Bros. Fear that I would go to hell. | |
| I overheard someone say that my mother had died the night before. When I asked about it I was ignored and dismissed. My friend was beaten so badly for wetting the bed that I watched her die. I was constantly starving. I had to bribe my carers with bread so I wasn’t beaten. | |
| Emotional abuse. I was never allowed to show my feelings | |
| Being put in a lower streamed class | |
| Having cold baths in the morning | |
| Being taken away from my friends and moved around between four institutions | |
| Being locked in a cattle shed in the dark | |
| I was put naked into a coffin as punishment | |
| Chained in front of whole convent 26 times for marking paintwork | |
| Not being able to go home at Christmas when the other boys did | |
| Feeling of being alone and having no one | |
| Being made to use a bucket for toilet and having no toilet paper | |
| I was put in a cellar to peel potatoes for three days after wetting myself | |
| Seeing my brother being beaten | |
| It was all bad | |
| Witnessing another boy drown and no one showing concern for him or the dead boy | |
| Being taken into the office and told my foster mother had died and then immediately sent away again | |
| Fear of being punished | |
| Getting BCG injection 3 times. I had a very bad pain in my arm and was on a bed trolley | |
| I was left all night on landing, It was a very frightening experience | |
| The worst thing was going into and institution and leaving my family | |
| I was left alone in the school yard for up to 10 hours | |
| The worst thing was, they took away my dignity | |
| The lack of food. The feeling of being unsafe and de-valued | |
| The worst thing was when they got me to hold out brothers hand whilst they slapped it | |
Note: N=247. There were 23 cases where the worst thing reported was severe physical and sexual abuse; 99 cases where it was severe physical abuse; 40 cases where it was severe sexual abuse; and 85 cases where it was severe emotional abuse. Statements were classified as severe physical abuse if the person reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements.
Table 3.5. Life problems
| Life problems | Frequency | % | Inter-rater reliability Kappa |
|---|---|---|---|
| Mental health problems | 183 | 74.10 | 1.00 |
| Unemployment | 128 | 51.80 | 1.00 |
| Substance use | 94 | 38.10 | 1.00 |
| Frequent illness | 73 | 29.60 | 0.95 |
| Frequent hospitalisation for physical health | 70 | 28.30 | 0.95 |
| Anger control in intimate relationships | 64 | 25.90 | 1.00 |
| Non-violent crime | 55 | 22.30 | 1.00 |
| Homelessness | 52 | 21.10 | 1.00 |
| Self-harm | 44 | 17.80 | 0.81 |
| Anger control with children | 33 | 13.40 | 1.00 |
| Incarceration for non-violent crime | 33 | 13.40 | 1.00 |
| Hospitalisation for mental health problems | 32 | 13.00 | 1.00 |
| Violent crime | 25 | 10.10 | 1.00 |
| Incarceration for violent crime | 18 | 7.30 | 1.00 |
Note: N=247. Life problems do not represent mutually exclusive categories and so percentages sum to more than100%. Inter-rater reliability was assessed on 52 cases with Kappa (Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46). The inter-rater reliability kappa coefficient for each of the life problems was above .7 indicating that the problems were reliably measured.
Table 3.6. Strengths
| Where does your strength come from? | What has helped you most in facing life challenges? | What is the thing that means most to you in your life? | ||
|---|---|---|---|---|
| (N=243) | (N=243) | (N=242) | ||
| Self-reliance, my optimism, my work, and my skills | f | 144.00 | 141.00 | 53.00 |
| % | 59.30 | 58.00 | 21.80 | |
| Relationship with current partner / family | f | 40.00 | 63.00 | 170.00 |
| % | 16.50 | 25.90 | 70.20 | |
| Relationship with God or spiritual force | f | 40.00 | 25.00 | 7.00 |
| % | 16.50 | 10.30 | 2.90 | |
| Relationship with a friend including other survivors | f | 19.00 | 14.00 | 12.00 |
| % | 7.80 | 5.80 | 5.00 | |
Table 3.7. Psychological disorders
| Frequency | % | Inter-rater reliability Kappa |
|
|---|---|---|---|
| Any current or lifetime anxiety, mood, substance use or personality disorders | 202 | 81.78 | — |
| Any anxiety, mood or substance use disorder | |||
| Any lifetime disorder | 160 | 64.80 | 0.95 |
| Any current disorder | 127 | 51.40 | 0.84 |
| Anxiety disorders | |||
| Any lifetime anxiety disorder | 85 | 34.40 | 0.95 |
| Any current anxiety disorder | 111 | 44.90 | 0.88 |
| Social phobia, lifetime | 27 | 10.90 | 1.00 |
| Social phobia , current | 49 | 19.80 | 1.00 |
| Generalized anxiety disorder, lifetime | 17 | 6.90 | 1.00 |
| Generalized anxiety disorder , current | 42 | 17.00 | 0.77 |
| Posttraumatic stress disorder, lifetime | 21 | 8.50 | 0.85 |
| Posttraumatic stress disorder, current | 41 | 16.60 | 0.86 |
| Panic disorder without agoraphobia, lifetime | 22 | 8.90 | 1.00 |
| Panic disorder without agoraphobia, current | 16 | 6.50 | 1.00 |
| Panic disorder with agoraphobia, lifetime | 16 | 6.50 | 1.00 |
| Panic disorder with agoraphobia, current | 18 | 7.30 | 1.00 |
| Agoraphobia without panic disorder, lifetime | 1 | 0.40 | 1.00 |
| Agoraphobia without panic disorder, current | 8 | 3.20 | 1.00 |
| Specific phobia, lifetime | 10 | 4.00 | 1.00 |
| Specific phobia, current | 25 | 10.10 | 0.91 |
| Obsessive compulsive disorder, lifetime | 9 | 3.60 | 1.00 |
| Obsessive compulsive disorder, current | 8 | 3.20 | 1.00 |
| Mood Disorders | |||
| Any lifetime mood disorder | 89 | 36.00 | 1.00 |
| Any current mood disorder | 66 | 26.70 | 1.00 |
| Major depression, lifetime | 89 | 36.00 | 1.00 |
| Major depression, current | 38 | 15.40 | 1.00 |
| Dysthymia | 28 | 11.30 | 1.00 |
| Alcohol or substance use disorders | |||
| Any lifetime alcohol and substance use disorder | 87 | 35.20 | 1.00 |
| Any current alcohol or substance use disorder | 12 | 4.9 | 1.00 |
| Alcohol dependence, lifetime | 67 | 27.10 | 1.00 |
| Alcohol dependence, current | 9 | 3.60 | 1.00 |
| Alcohol abuse, lifetime | 19 | 7.70 | 1.00 |
| Alcohol abuse, current | 1 | 0.40 | 1.00 |
| Other substance dependence, lifetime | 8 | 3.20 | 1.00 |
| Other substance dependence, current | 3 | 1.20 | 1.00 |
| Other substance abuse, lifetime | 2 | 0.80 | 1.00 |
| Other substance abuse, current | 0 | 0.00 | 1.00 |
| Personality disorders | |||
| Any personality disorder | 75 | 30.40 | 0.96 |
| Avoidant personality disorder | 52 | 21.10 | 0.96 |
| Antisocial personality disorder | 17 | 6.90 | 1.00 |
| Borderline personality disorder | 14 | 5.70 | 1.00 |
| Dependent personality disorder | 4 | 1.60 | 1.00 |
Note: N=247. Mood, anxiety and substance use disorders were assessed with the SCID-I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press). Personality disorders were assessed with the SCID-II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Psychological disorders do not represent mutually exclusive categories and so percentages sum to more than 100%. With N=52, the inter-rater reliability kappa coefficient for each of the diagnostic categories assessed was above .7 indicating that the diagnoses were reliably made (Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46).
Table 3.8. Rates of psychological disorders among survivors of institutional living compared with rates in normal community samples in Europe, UK and USA.
| CICA | Europe | USA | UK | |
|---|---|---|---|---|
| Anxiety disorders | ||||
| Any lifetime Anxiety disorder | 34.40 | 13.60 | 28.80 | — |
| Any current anxiety disorder | 44.90 | 6.00 | 18.10 | 7.97 |
| Mood Disorders | ||||
| Any lifetime mood disorder | 36.00 | 14.00 | 20.80 | — |
| Any current mood disorder | 26.70 | 4.20 | 9.50 | 2.58 |
| Substance induced disorders | ||||
| Any lifetime alcohol and substance use disorder | 35.20 | 5.20 | 14.60 | — |
| Any current alcohol or substance use disorder | 4.9 | 1.00 | 3.80 | — |
| Personality disorders | ||||
| Any personality disorder | 30.40 | 13.10 | 14.79 | 4.00 |
Note. European current (1 year) and lifetime prevalence rates for anxiety mood and substance use disorders are from Alonso, J., Angermeyer, M., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., de Girolamo, G., de Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J.M., Katz, S., Kessler, R.C., Kovess, V., Lépine, J.P., Ormel, J., Polidori, G., Vilagut, G. (2004). Prevalence of Mental Disorders in Europe: Results from the European Study of Epidemiology of Mental Disorders (ESEMeD) Project. Acta Psychiatrica Scandninavica, 109 (suppl 420), 21-27. USA current (1 year) prevalence rates are from Kessler, R., Chiu, W., Demler, O. & Walters, E.E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 617-627. USA lifetime prevalence rates are from Kessler, R., Berglund, P., Demler, O., Jin, R. & Walters, E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 593-602. USA prevalence rates of personality disorders are from Grant, B., Hasin, D., Stinson, F., Dawson, D., Chou, S. & Ruan, W. J. et al. (2004). Prevalence, correlates, and disability of personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 65, 948-58. UK current (1 week ) prevalence rates are from Singleton, N., Bumpstead, R., O’Brien, M., Lee, A. & Meltzer, H. (2001). Psychiatric Morbidity Among Adults Living in Private Households, 2000. London, UK: Stationary Office. The European prevalence rate for personality disorders is based on a study in Norway: Torgersen, S., Kringlen, E. & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590-596.
Table 3.9. Trauma symptoms on the Trauma Symptom Inventory
| Trauma symptoms | Frequency | % |
|---|---|---|
| Avoidance | 148 | 59.90 |
| Intrusive experiences | 138 | 55.90 |
| Impaired self-reference | 114 | 46.20 |
| Dissociation | 109 | 44.10 |
| Depression | 103 | 41.70 |
| Anxious arousal | 95 | 38.50 |
| Maladaptive tension reduction | 87 | 35.20 |
| Anger | 79 | 32.00 |
| Sexual concerns | 59 | 23.90 |
| Sexual dysfunction | 31 | 12.60 |
Note: N=247. Cases were classified as showing trauma symptoms if they scored 2 standard deviations above the mean for the normative sample. The following cut-offs were derived from the normative sample described in Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources: Anxious arousal: 15; Depression:14; Anger: 16; Intrusive experiences: 14; Avoidance: 16; Dissociation: 12; Sexual concerns: 9; Sexual dysfunction: 5; Impaired self-reference: 12; and Maladaptive tension reduction behaviour: 5. Trauma symptoms do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%.
Table 3.10. Attachment patterns on the Experiences in close relationships inventory
| Adult Attachment style | Frequency | % |
|---|---|---|
| Fearful | 109 | 44.12 |
| Dismissive | 66 | 26.72 |
| Secure | 41 | 16.59 |
| Preoccupied | 31 | 12.55 |
Note: N=247. Cases were classified as falling into the four attachment style categories using the Experiences in Close Relationships Inventory, SPSS algorithm in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. The four attachment categories are mutually exclusive, so percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places.
Table 3.11. Reliability of scales
| Domain Instrument | Constructs and variables | No. of items in the scale | Possible range | Actual range | M | SD | Internal consistency Reliability | Interrater reliability | |
|---|---|---|---|---|---|---|---|---|---|
| Institutional abuse | |||||||||
| IAS (N=247) | Specific Institutional abuse | 13 | 13-65 | 17-65 | 44.46 | 10.82 | .99 | .98 | |
| CTQ-Institution (N=247) | Total abuse score | 25 | 25-125 | 50-124 | 90.81 | 14.81 | .98 | .97 | |
| Physical abuse | 5 | 5-25 | 5-25 | 19.26 | 4.12 | .98 | .96 | ||
| Sexual abuse | 5 | 5-25 | 5-25 | 11.26 | 7.42 | .99 | .98 | ||
| Emotional abuse | 5 | 5-25 | 5-25 | 44.86 | 4.55 | .97 | .94 | ||
| Physical neglect | 5 | 5-25 | 8-25 | 17.26 | 3.57 | .98 | .97 | ||
| Emotional neglect | 5 | 5-25 | 9-25 | 19.23 | 3.49 | .98 | .98 | ||
| SPSA-Institution (N=247) | Total severe institutional abuse | 8 | 0-32 | 0-29 | 14.59 | 5.73 | .69 | .98 | |
| Severe institutional physical abuse | 4 | 0-16 | 0-16 | 10.43 | 3.11 | .66 | .97 | ||
| Severe institutional sexual abuse | 4 | 0-16 | 0-14 | 4.17 | 4.40 | .88 | .98 | ||
| Family-based child abuse | |||||||||
| CTQ-Family (N=121) | Total CTQ-F score | 25 | 25-125 | 32-128 | 54.12 | 19.07 | .99 | .99 | |
| CTQ-F Physical abuse | 5 | 5-25 | 5-25 | 8.43 | 5.36 | .98 | .97 | ||
| CTQ-F Sexual abuse | 5 | 5-25 | 5-25 | 6.26 | 4.27 | .99 | .99 | ||
| CTQ-F Emotional abuse | 5 | 5-25 | 5-25 | 6.87 | 5.81 | .99 | .99 | ||
| CTQ-F Physical neglect | 5 | 5-25 | 5-25 | 10.48 | 10.40 | .99 | .99 | ||
| CTQ-F Emotional neglect | 5 | 5-25 | 5-25 | 10.83 | 6.16 | .99 | .99 | ||
| SPSA-family (N=121) | Total severe family abuse | 8 | 0-32 | 0-26 | 4.27 | 6.02 | .27 | .90 | |
| Severe family physical abuse | 4 | 0-16 | 0-14 | 3.49 | 4.82 | .26 | .98 | ||
| Severe family sexual abuse | 4 | 0-16 | 0-13 | 0.79 | 2.61 | .92 | .53 | ||
| Trauma symptoms | |||||||||
| TSI (N=247) | Total trauma symptoms | 95 | 0-255 | 1-241 | 94.95 | 50.03 | .99 | .99 | |
| Life Problems | |||||||||
| LPC (N=247) | Total number of life problems | 14 | 0-14 | 0-12 | 3.66 | 2.80 | .99 | .98 | |
| Quality of Life | |||||||||
| WHOQOL (N=247) | Total WHOQOL 100 score | 102 | 1-5 | 1-5 | 91.53 | 16.95 | .99 | .99 | |
| Global functioning | |||||||||
| GAF (N=235) | Global functioning | 10 | 1-91 | 1-91 | 61.00 | 16.77 | — | .90 | |
| Relationships | |||||||||
| KMS (N=136) | Marital satisfaction | 3 | 0-21 | 3-21 | 17.00 | 4.39 | 1.00 | 1.00 | |
| KPS (N=212) | Parental satisfaction | 3 | 0-21 | 0-21 | 15.98 | 4.70 | .99 | .99 | |
| ECRI (N=247) | Anxiety | 18 | 0-122 | 18-122 | 66.86 | 25.26 | .99 | .99 | |
| Avoidance | 18 | 0-126 | 20-126 | 74.76 | 27.15 | .99 | .99 | ||
Note. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A Retrospective Self-report. Manual. San Antonio, TX: The Psychological Cooperation.) IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. IAPCI=Institutional Abuse Processes and Coping Inventory . TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life problems chceklist. WHOQOL 100 UK= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). ECRI=Experiences in Close Relationships Inventory (Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press).
Table 3.12. Correlations between indices of abuse and adjustment
| Instru-ment | Abuse Scales | Total number of current and lifetime psycho-logical disorders | LPC Total no. of life problems |
GAF Global Func-tioning |
Total trauma symptoms on TSI |
SES | Number of failed relation-ships | KMS Marital satis-faction |
ECRI Anxiety |
ECRI Avoid-ance |
KPS Parental satis-faction |
WHOQOL 100 UK Total QoL |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of years in institution | .00 | -.23 | .01 | .01 | -.01 | -.05 | -.05 | -.01 | .02 | -.13 | -.02 | |
| IAS | Specific Institutional abuse | . .12 | .19 | -.11 | .29 | -.05 | .01 | .03 | .21 | .15 | .15 | -.14 |
| (N=247) | ||||||||||||
| CTQ-I | Total institutional abuse score | .15 | .28 | -.22 | .38 | -.05 | .06 | .00 | .29 | .16 | .09 | -.25 |
| (N=247) | Physical abuse | .07 | .12 | -.02 | .24 | .04 | .04 | .08 | .19 | .06 | .12 | -.15 |
| Sexual abuse | .11 | .39 | -.15 | .35 | -.11 | .08 | -.02 | .22 | .10 | -.06 | -.19 | |
| Emotional abuse | .21 | .14 | -.25 | .32 | -.07 | .02 | -.03 | .26 | .10 | .13 | -.20 | |
| Physical neglect | -.01 | .04 | -.07 | .15 | .02 | .04 | .05 | .18 | .05 | .08 | -.12 | |
| Emotional neglect | .07 | -.02 | -.19 | .02 | .03 | -.03 | -.05 | .03 | .19 | .16 | -.11 | |
| SPSA-I | Total severe institutional abuse | .16 | .25 | -.07 | .34 | -.16 | -.01 | -.02 | .21 | .16 | .03 | -.18 |
| (N=247) | Severe institutional physical ab. | .13 | -.06 | -.01 | .17 | -.14 | -.06 | .01 | .16 | .16 | .09 | -.13 |
| Severe institutional sexual ab. | .11 | .36 | -.08 | .32 | -.11 | .03 | -.03 | .16 | .09 | -.03 | -.15 | |
| CTQ-F | Total family abuse score | .04 | .24 | -.11 | .09 | -.01 | .06 | .04 | .04 | .00 | .09 | -.03 |
| (N=121) | Physical abuse | .06 | .29 | -.13 | .11 | .01 | .09 | .07 | .05 | -.04 | .06 | -.02 |
| Sexual abuse | .04 | .18 | -.06 | .04 | -.04 | .16 | .00 | .00 | .03 | .09 | -.00 | |
| Emotional abuse | .09 | .22 | -.14 | .13 | -.03 | .07 | -.01 | .07 | .04 | .05 | -.08 | |
| Physical neglect | -.02 | .12 | -.05 | .05 | .00 | -.01 | .07 | .02 | .00 | .14 | -.01 | |
| Emotional neglect | .02 | .22 | -.12 | .09 | .01 | .01 | .03 | .04 | .02 | .09 | -.03 | |
| SPSA-F | Total severe family abuse | .11 | .32 | -.18 | .17 | -.08 | .17 | -.08 | .12 | .04 | -.02 | -.11 |
| (N=121) | Severe family physical abuse | .10 | .34 | -.19 | .18 | -.04 | .12 | -.06 | .12 | .01 | -.02 | -.09 |
| Severe family sexual abuse | .08 | .16 | -.08 | .08 | -.12 | .19 | -.09 | .06 | .06 | -.01 | -.11 | |
Note: N=247. Pearson correlations significant at p<.01 and greater than .3 are in bold. IAS=Institutional abuse scale. CTQ-I=Childhood Trauma Questionnaire, Institutional version and CTQ-F is the family version (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A Retrospective Self-report. Manual. San Antonio, TX: The Psychological Cooperation). SPSA-I =Most severe forms of physical and sexual abuse, institution version and SPSA-F is the family version. LPC=Life problems checklist. GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417).TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). SES=Socio Economic Status (O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). ECRI=Experiences in Close Relationships Inventory (Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). WHOQOL 100 UK= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath).
Table 3.13. Historical and demographic characteristics on which males and females differed significantly
| Variable | Group 1 Males |
Group >2 Females |
Chi square or t |
||
|---|---|---|---|---|---|
| N=135 | N=112 | ||||
| Years with family before entering an institution (N=246) | M SD |
6.90 4.78 |
3.61 3.50 |
6.23*** | |
| Years spent in an institution (N=247) |
M | 8.58 | 11.80 | 5.08*** | |
| SD | 5.08 | 4.80 | |||
| Reason for entering an institution (N=247) |
|||||
| Illegitimate | f | 16.00 | 32.00 | 56.45*** | |
| % | 11.90 | 28.80 | |||
| Petty crime | f | 56.00 | 2.00 | ||
| % | 41.50 | 1.80 | |||
| Parents could not provide care | f | 41.00 | 58.00 | ||
| % | 32.60 | 53.60 | |||
| Parents died | f | 18.00 | 17.00 | ||
| % | 13.30 | 15.20 | |||
| Unknown/Other | f | 1.00 | 1.00 | ||
| % | 0.70 | 0.90 | |||
| Reason for Leaving (N=237) | |||||
| Too old to stay on | f | 93.00 | 83.00 | 16.96*** | |
| % | 71.00 | 80.30 | |||
| Sentence was over | f | 18.00 | 1.00 | ||
| % | 13.70 | 0.90 | |||
| Family wanted him/her home | f | 13.00 | 21.00 | ||
| % | 9.90 | 15.50 | |||
| Ran away | f | 4.00 | 4.00 | ||
| % | 3.10 | 3.70 | |||
| Institution management (N=247) | |||||
| Nuns | f | 12.00 | 109.00 | 192.02*** | |
| % | 8.90 | 97.30 | |||
| Religious brothers or priests | f | 77.00 | 0.00 | ||
| % | 57.00 | 0.00 | |||
| Nuns and religious brothers or priests | f | 46.00 | 3.00 | ||
| % | 34.10 | 2.70 | |||
| Age when Worst Experiences Began (N=237) | M | 10.32 | 7.85 | 5.44*** | |
| SD | 3.17 | 3.74 | |||
| Highest SES attained since leaving school (N=235) | |||||
| Unskilled manual | f | 49.00 | 55.00 | 16.34** | |
| % | 38.28 | 51.40 | |||
| Semi-skilled manual and farmers owning < 30 acres | f % |
44.00 34.37 |
18.00 16.82 |
||
| Skilled manual and farmers owning 30-49 acres | f % |
21.00 16.40 |
10.00 9.34 |
||
| Non-manual, professional, managerial, and farmers with more than 50 acres | f | 14.00 | 24.00 | ||
| % | 10.93 | 22.42 | |||
| Children’s living arrangements (N=211) |
|||||
| Spent some time living with their other parent | f % |
26.00 23.20 |
2.00 2.00 |
25.09*** | |
| Spent some time living with their relatives or in care | f | 8.00 | 8.00 | ||
| % | 7.10 | 8.10 | |||
| Always lived with respondent | f | 78.00 | 84.00 | ||
| % | 69.60 | 84.80 | |||
| Children put up for adoption | f | 0.00 | 5.00 | ||
| % | 0.00 | 5.10 | |||
Note: Group 1 contained all male participants. Group 2 contained all female participants. For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Socio-economic status (SES) was assessed with O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156. For continuous variables t-values are from independent t-tests. For categorical variables chi square tests were used. **p<0.01. ***p<0.001.
Table 3.14. Recollections of child abuse by males and females
| Variable | Group 1 Males |
Group >2 Females |
t | ||
|---|---|---|---|---|---|
| N=135 | N=112 | ||||
| INSTITUTIONAL ABUSE | |||||
| IAS | Specific institutional abuse | M | 49.06 | 51.13 | 1.62 |
| (N=247) | SD | 9.61 | 10.38 | ||
| CTQ-Institution | Total institutional abuse | M | 50.96 | 48.84 | 1.67 |
| (N=247) | SD | 10.41 | 9.40 | ||
| Physical abuse | M | 51.11 | 48.65 | 1.94 | |
| SD | 9.77 | 10.15 | |||
| Sexual abuse | M | 53.01 | 46.38 | 5.60*** | |
| SD | 10.35 | 8.24 | |||
| Emotional abuse | M | 47.93 | 52.50 | 3.73*** | |
| SD | 10.70 | 8.50 | |||
| Physical neglect | M | 50.08 | 49.87 | 0.16 | |
| SD | 9.85 | 10.24 | |||
| Emotional neglect | M | 48.94 | 51.29 | 1.84 | |
| SD | 9.45 | 10.55 | |||
| SPSA-Institution (N=247) | Total severe institutional abuse | M | 50.74 | 49.11 | 2.19 |
| SD | 5.32 | 6.42 | |||
| Severe institutional physical abuse | M | 48.50 | 51.75 | 2.53** | |
| SD | 8.60 | 11.22 | |||
| Severe institutional sexual abuse | M | 52.67 | 46.76 | 4.84*** | |
| SD | 9.28 | 9.88 | |||
Note: Group 1 contained all male participants. Group 2 contained all female participants. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t-values are from independent samples t-tests. For the MANOVA on total subscale of the family versions of the CTQ and SPSA, F (2, 118) = 2.85, NS. For the MANOVA on the total subscale of the institution version of the CTQ, SPSA & the IAS, F (3, 243) = 4.75, p<0.01. **p<0.01; ***p<0.001.
Table 3.15. Psychological disorders in males and females
| Variable | Group 1 Males | Group 2 Females | Chi square | |
|---|---|---|---|---|
| N=135 | N=112 | |||
| Anxiety disorders | ||||
| Panic disorder with agoraphobia, lifetime | f | 2.00 | 14.00 | 12.27*** |
| % | 1.50 | 12.50 | ||
| Alcohol and substance use disorders | ||||
| Any alcohol & substance use disorder, lifetime | f | 64.00 | 24.00 | 18.01*** |
| % | 47.40 | 21.40 | ||
| Alcohol dependence, lifetime | f | 50.00 | 16.00 | 16.18*** |
| % | 37.00 | 14.30 | ||
Note: N=247. Group 1 contained all male participants. Group 2 contained all female participants. Diagnoses were made using the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Psychological disorders do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%.
Table 3.16. Current adjustment of males and females
| Group 1 Males |
Group >2 Females |
t-value | ||
|---|---|---|---|---|
| N=135 | N=112 | |||
| Total trauma symptoms (TSI) (N=247) | M | 49.59 | 50.50 | 0.71 |
| SD | 10.06 | 9.94 | ||
| Total No of life problems (LPC) (N=247) | M | 51.98 | 47.61 | 3.58*** |
| SD | 10.81 | 8.34 | ||
| Total quality of life (WHOQOL) (N=247) | M | 51.01 | 48.78 | 1.76 |
| SD | 9.96 | 9.97 | ||
| Global functioning (GAF) (N=235) | M | 51.82 | 47.83 | 3.10** |
| SD | 9.69 | 9.98 | ||
| Marital satisfaction (KMS) (N=136) | M | 55.23 | 46.80 | 4.76*** |
| SD | 8.01 | 11.52 | ||
| Parental satisfaction (KPS) (N=212) | M | 47.89 | 50.85 | 1.93 |
| SD | 12.12 | 9.94 | ||
Note: Group 1 contained all male participants. Group 2 contained all female participants. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001.
Table 3.17. Historical and demographic characteristics on which older and younger participants differed significantly
| Variable | Group 1 Younger |
Group 2 Older |
Chi square or t |
||
|---|---|---|---|---|---|
| N=113 | N=134 | ||||
| Reason for leaving institution (N=247) | |||||
| Too old to stay on | f | 68.00 | 108.00 | 19.93** | |
| % | 60.20 | 80.60 | |||
| Sentence was over | f | 9.00 | 10.00 | ||
| % | 8.50 | 7.50 | |||
| Family wanted him/her home | f | 24.00 | 10.00 | ||
| % | 21.20 | 7.50 | |||
| Ran away | f | 6.00 | 2.00 | ||
| % | 5.30 | 1.50 | |||
| Institution closed | f | 4.00 | 0.00 | ||
| % | 3.50 | 0.00 | |||
| Unknown/Other | f | 2.00 | 4.00 | ||
| % | 1.80 | 3.00 | |||
| Current socio-economic status (SES) (N=241) | |||||
| Unemployed | f | 41.00 | 19.00 | 70.43*** | |
| % | 36.00 | 14.30 | |||
| Unskilled manual | f | 24.00 | 14.00 | ||
| % | 22.00 | 10.60 | |||
| Semi-skilled manual / farmers owning less than 30 acres | f % |
20.00 18.30 |
8.00 6.10 |
||
| Skilled manual, non-manual professional, managerial and farmers owning more than 30 acres | f % |
16.00 14.70 |
14.00 10.60 |
||
| Retired | f | 8.00 | 77.00 | ||
| % | 7.30 | 58.30 | |||
| Duration of relationship with current partner (N=134) |
|||||
| M | 26.02 | 34.97 | 5.24*** | ||
| SD | 9.01 | 10.36 | |||
| Age when had first child (N=207) | M SD |
24.38 5.47 |
26.52 5.46 |
2.82** | |
Note: Group 1 contained all participants all participants aged 58 years and younger (below median age). Group 2 contained all participants aged 59 or more years (above median age). For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Socio-economic status (SES) was assessed with O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156. For continuous variables t-values are from independent t-tests. For categorical variables chi square tests were used. **p<0.01. ***p<0.001.
Table 3.18. Recollections of child abuse in younger and older participants
| Variable | Group 1 Younger |
Group 2 Older |
t | ||
|---|---|---|---|---|---|
| N=113 | N=134 | ||||
| INSTITUTIONAL ABUSE | |||||
| IAS | Specific institutional abuse | M | 52.80 | 47.64 | 4.17*** |
| (N=247) | SD | 9.37 | 9.93 | ||
| CTQ-Institution | Total institutional abuse | M | 51.69 | 48.57 | 2.47 |
| (N=247) | SD | 9.58 | 10.16 | ||
| Physical abuse | M | 50.85 | 49.28 | 1.23 | |
| SD | 9.69 | 10.24 | |||
| Sexual abuse | M | 51.54 | 48.71 | 2.22 | |
| SD | 10.54 | 9.36 | |||
| Emotional abuse | M | 52.05 | 48.27 | 3.08** | |
| SD | 8.25 | 11.01 | |||
| Physical neglect | M | 50.14 | 49.86 | 0.22 | |
| SD | 10.18 | 9.89 | |||
| Emotional neglect | M | 50.18 | 49.85 | 0.25 | |
| SD | 9.95 | 10.10 | |||
| SPSA-Institution | Total severe institutional abuse | M | 51.48 | 48.76 | 3.71*** |
| (N=247) | SD | 6.20 | 5.32 | ||
| Severe institutional physical abuse | M | 51.86 | 48.40 | 2.75** | |
| SD | 10.22 | 9.55 | |||
| Severe institutional sexual abuse | M | 51.92 | 48.36 | 2.80** | |
| SD | 10.56 | 9.19 | |||
Note: Group 1 contained all participants all participants aged 58 years and younger (below median age). Group 2 contained all participants aged 59 or more years (above median age). CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t-values are from independent samples t-tests. For the MANOVA on total subscale of the family versions of the CTQ and SPSA, F (2, 118) = 4.06, p=0.02, but all t-tests were NS. For the MANOVA on the total subscale of the institution version of the CTQ, SPSA & the IAS, F(3, 243) = 8.90, p<0.0001. **p<0.01; ***p<0.0001.
Table 3.19. Psychological disorders in younger and older participants
| Variable | Group 1 Younger | Group 2 Older | Chi square | |
|---|---|---|---|---|
| N=113 | N=134 | |||
| Any anxiety, mood or substance use disorder | f | 71.00 | 57.00 | 10.90*** |
| % | 62.80 | 42.50 | ||
| Anxiety disorders | ||||
| Any anxiety disorder, current | f | 63.00 | 50.00 | 8.40** |
| % | 55.80 | 37.50 | ||
| Posttraumatic stress disorder, current | f | 27.00 | 14.00 | 8.01** |
| % | 23.90 | 10.40 | ||
| Generalized anxiety disorder, current | f | 27.00 | 15.00 | 7.01** |
| % | 23.90 | 11.20 | ||
| Mood disorders | ||||
| Any mood disorder, current | f | 44.00 | 22.00 | 15.88*** |
| % | 38.90 | 16.40 | ||
| Personality disorders | ||||
| Any Personality Disorder | f | 46.00 | 28.00 | 11.47** |
| % | 40.70 | 20.90 | ||
| Avoidant Personality Disorder | f | 33.00 | 19.00 | 8.33** |
| % | 29.20 | 14.20 | ||
Note: N=247. Group 1 contained all participants aged 58 years and younger (below median age). Group 2 contained all participants aged 59 or more years (above median age). Anxiety and mood disorders were assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Personality disorders were assessed with the SCID-II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Psychological disorders do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%.
Table 3.20. Current adjustment of older and younger participants
| Group 1 Younger | Group 2 Older | t | ||
|---|---|---|---|---|
| N=113 | N=134 | |||
| Total trauma symptoms (TSI) (N=247) | M | 53.54 | 47.02 | 5.38*** |
| SD | 9.61 | 9.36 | ||
| Total No of life problems (LPC) (N=247) | M | 52.51 | 47.88 | 3.72*** |
| SD | 10.20 | 9.33 | ||
| Total quality of life (WHOQOL) (N=247) | M | 47.07 | 52.47 | 4.38*** |
| SD | 10.21 | 9.16 | ||
| Global functioning (GAF) (N=235) | M | 47.60 | 52.00 | 3.44** |
| SD | 10.09 | 9.50 | ||
| Marital satisfaction (KMS) (N=136) | M | 51.65 | 51.73 | 0.04 |
| SD | 9.73 | 11.06 | ||
| Parental satisfaction (KPS) (N=212) | M | 49.63 | 48.98 | 0.42 |
| SD | 10.57 | 11.79 | ||
Note: Group 1 contained all participants all participants aged 58 years and younger (below median age). Group 2 contained all participants aged 59 or more years (above median age). TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001.
Table 3.21. Historical and demographic characteristics on which participants from the confidential and investigation committees differed significantly
| Variable | Categories | Group 1 CC |
Group 2 IC |
Chi square or t |
|
|---|---|---|---|---|---|
| N=175 | N=71 | ||||
| Number of years with family before entering an institution (N=246) |
M SD |
4.60 4.10 |
7.38 5.03 |
4.11*** | |
| Years spent in an institution (N=246) |
M SD |
10.94 4.86 |
7.84 5.41 |
4.38*** | |
| Reason for entering an institution (N=245) | |||||
| Illegitimate | f | 40.00 | 8.00 | 22.60*** | |
| % | 23.10 | 11.30 | |||
| Petty crime | f | 27.00 | 31.00 | ||
| % | 15.60 | 43.70 | |||
| Parents could not provide care | f | 80.00 | 24.00 | ||
| % | 46.20 | 33.80 | |||
| Parent died | f | 26.00 | 9.00 | ||
| % | 15.00 | 11.30 | |||
| Reason for leaving (N=236) | |||||
| Too old to stay on | f | 139.00 | 36.00 | 26.82*** | |
| % | 82.73 | 52.90 | |||
| Sentence was over | f | 7.00 | 12.00 | ||
| % | 4.16 | 17.60 | |||
| Family wanted him/her home | f | 19.00 | 15.00 | ||
| % | 11.30 | 22.10 | |||
| Ran away | f | 3.00 | 5.00 | ||
| % | 1.78 | 7.40 | |||
| Institution management (N=246) |
|||||
| Nuns | f | 105.00 | 16.00 | 31.76*** | |
| % | 60.00 | 22.50 | |||
| Religious brothers or priests | f | 38.00 | 38.00 | ||
| % | 21.70 | 53.50 | |||
| Nuns and religious brothers or priests | f % |
32.00 18.30 |
17.00 23.90 |
||
| Age when worst experiences began (N=246) | M SD |
8.75 3.68 |
10.19 3.37 |
2.77*** | |
| Number of long term relationships or marriages that have ended (N=216) | |||||
| No relationship has ended | f | 61.00 | 164.00 | 10.77 | |
| % | 40.10 | 21.90 | |||
| 1 relationship | f | 50.00 | 29.00 | ||
| % | 32.90 | 45.30 | |||
| 2 relationships | f | 28.00 | 9.00 | ||
| % | 18.40 | 15.50 | |||
| 3 or more relationships | f | 13.00 | 12.00 | ||
| % | 8.60 | 18.80 | |||
| Children’s living arrangements (N=210) | |||||
| Spent some time living with their other parent | f | 12.00 | 16.00 | 16.99** | |
| % | 8.00 | 26.70 | |||
| Spent some time living with their relatives or in care | f | 8.00 | 7.00 | ||
| % | 5.30 | 11.70 | |||
| Always lived with respondent | f | 126.00 | 36.00 | ||
| % | 84.00 | 60.00 | |||
| Children put up for adoption | f | 4.00 | 1.00 | ||
| % | 2.70 | 1.70 | |||
Note: Group 1 contained all participants from the Confidential Committee (CC). Group 2 contained all participants from the Investigative Committee (IC). For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Socio-economic status (SES) was assessed with O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156. For continuous variables t-values are from independent t-tests. For categorical variables chi square tests were used. **p<0.01. ***p<0.001.
Table 3.22. Recollections of child abuse among participants who attended the confidential and investigation committees
| Variable | Group 1 CC |
Group 2 IC |
t | ||
|---|---|---|---|---|---|
| N=175 | N=71 | ||||
| INSTITUTIONAL ABUSE | |||||
| IAS | Specific institutional abuse | M | 50.01 | 50.11 | 0.07 |
| (N=246) | SD | 10.28 | 9.32 | ||
| CTQ-Institution | Total institutional abuse | M | 49.01 | 52.57 | 2.56** |
| (N=246) | SD | 9.55 | 10.69 | ||
| Physical abuse | M | 49.62 | 50.91 | 0.91 | |
| SD | 9.77 | 10.62 | |||
| Sexual abuse | M | 48.33 | 54.26 | 4.08*** | |
| SD | 9.17 | 10.75 | |||
| Emotional abuse | M | 50.17 | 49.71 | 0.33 | |
| SD | 10.09 | 9.88 | |||
| Physical neglect | M | 49.34 | 51.76 | 1.72 | |
| SD | 10.07 | 9.68 | |||
| Emotional neglect | M | 50.18 | 49.58 | 0.42 | |
| SD | 10.40 | 9.11 | |||
| SPSA-Institution | Total severe institutional abuse | M | 49.70 | 50.78 | 1.31 |
| (N=246) | SD | 5.78 | 6.16 | ||
| Severe institutional physical abuse | M | 50.80 | 47.89 | 2.08 | |
| SD | 9.99 | 9.80 | |||
| Severe institutional sexual abuse | M | 48.75 | 53.19 | 3.23*** | |
| SD | 9.92 | 9.48 | |||
Note: Group 1 contained all participants from the Confidential Committee (CC). Group 2 contained all participants from the Investigative Committee (IC). CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t-values are from independent samples t-tests. For the MANOVA on total subscale of the family versions of the CTQ and SPSA, F (2, 118) = 4.05, p=0.02, but all t-tests were NS. For the MANOVA on the total subscale of the institution version of the CTQ, SPSA & the IAS, F (3, 242) = 3.12, p<0.05.
Part 4 Profiles of groups with different histories
Summary of Part 4
3.166The adult survivors of institutional living who participated in this study were not a homogenous group. Four subgroups with varying histories of institutional living had distinct profiles. What follows is a summary of the profiles of the four groups from this analysis.
3.167Group 1 included those who had spent more than 12 years in an institution and entered before 5 years of age. They had spent the least time with their families (under one and a half years) and the longest time living in institutions (about fifteen years) of any of the four groups. Compared to groups 3 and 4, more were girls placed in orphanages run by nuns because they were illegitimate, or because their parents had died or could not look after them. More left because they were too old to stay on, and more had mixed feelings about leaving. More had experienced physical abuse which began at a younger age and persisted longer than in group 4. Severe emotional abuse was most commonly cited as the worst thing that happened to this group and it began at an earlier age and lasted longer than worst experiences of other groups. Compared with groups 3 and 4, this group reported fewer psychological disorders and life problems. They identified relationships with friends, self-reliance, optimism, and their work and skills as the sources of their strength.
3.168Group 2 included participants who had spent 5-11 years in institutions because of family problems. Participants in this group entered institutions run predominantly by nuns because their parents could not cope or died, and left when they were too old to stay. Compared with groups 3 and 4, more members of group 2 were female, younger when their most severe form of sexual abuse began, and more identified severe emotional abuse as the worst thing that had happened to them. Compared with group 4 more identified self-reliance, optimism, and their work and skills as the source of their strength.
3.169Group 3 included participants who had spent 5-11 years in institution and entered through the courts. Compared with groups 1 and 2, more members of this group were male, lived in institutions run by religious brothers or priests, and were survivors of institutional sexual abuse. Compared to the other three groups they identified sexual abuse as the worst thing that had happened to them, and more had experienced physical abuse within their families. Compared with groups 1 and 2, this group had more alcohol and substance use disorders, antisocial personality disorders, violent and non-violent crime, imprisonment for violent and non-violent crime, and unemployment. For this group, their self-reliance, optimism, and their work and skills were identified as the main sources of their strength in adulthood, compared with group 4.
3.170Group 4 included participants who had spent 4 or fewer years in institution. Participants in this group spent the most time with their families (more than ten and a half years) and the shortest time living in an institution (just under three years) compared with the other three groups. Most were boys placed in institutions run by religious brothers or priests because of petty crime and left because their short sentences were over, or because their families wanted them back, and few had mixed feelings about leaving. Institutional sexual abuse was the form of maltreatment that distinguished this group, and compared with groups 1 and 2, they showed more alcohol and substance use disorders, antisocial personality disorders, non-violent crime, imprisonment for non-violent crime and unemployment. Their relationships with their partners was identified as the main source of their strength in adulthood.
3.171A second analysis was conducted in which cases were classified into 4 groups defined by the type of worst abusive experiences they had suffered in institutions. What follows is a summary of the profiles of the four groups from this analysis.
3.172Group 1 included participants for whom severe sexual and physical abuse was the worst thing they had experienced. Participants in this group had experienced more physical and sexual institutional abuse than at least two of the other 3 groups (in this analysis). They had spent less time with their families before entering an institution than group 3. Like members of group 3, more had children who spent some time living separately with the child’s other parent. Compared with groups 2 and 4, more had a current diagnosis of posttraumatic stress disorder (PTSD) and multiple trauma symptoms.
3.173Group 2 included participants for whom severe physical abuse was the worst thing they had experienced. Participants in this group had the lowest educational achievement, were older than groups 1 and 3 (in this analysis), and more had put their own children up for adoption. Compared with group 3, their worst abusive experience had lasted longer. Like group 4, fewer had PTSD than groups 1 and 3, and they had fewer life problems than group 3.
3.174Group 3 included participants for whom severe sexual abuse was the worst thing they had experienced. Compared with group 4 (in this analysis), more participants in group 3 were male and were admitted through the courts to institutions run by religious brothers for petty crime. Like group 1, more had children who spent time with their other parent who lived separately compared to group 4. Also, compared to group 4, more had PTSD, multiple trauma symptoms, lifetime alcohol and substance use disorders, antisocial personality disorders and multiple life problems.
3.175Group 4 included participants for whom severe emotional abuse was the worst thing they had experienced. Compared to group 3 (in this analysis), more participants in this group were female and on average had spent the longer living in institutions run by nuns. Their worst experiences began at an earlier age than any other group and more had mixed feelings about leaving.
3.176In the analysis of groups of participants who had spent different amounts of time in institutions and entered under different circumstances, the most poorly adjusted as adults were not those who had spent longest living in institutions, but rather those who had spent a moderate amount of time in institutions and who had suffered institutional sexual abuse. In the analysis of groups of participants who reported suffering differing types of worst abusive experiences in institutions, the most poorly adjusted included those who pinpointed severe sexual abuse as the worst thing that had happened to them while living in an institution. Thus institutional sexual abuse, was associated in both analyses with a particularly poor outcome.
Questions addressed
3.177Profiles of groups with different histories of institutional living and differing histories of institutional abuse are the main focus of this Part. Survivors of institutional living who attended CICA fell into a number of discrete groups, with respect to their different histories of institutional living. There include
- People raised in institutions from birth
- People who entered institutions in childhood or early adolescence because parents could no longer care for them
- People who entered institutions in childhood or adolescence through the courts
- People who spent only a brief period in institutions in childhood or adolescence.
3.178The main question addressed in this Part is: What are the profiles of these four subgroups of cases with varying histories of institutional living with respect to historical and demographic factors, recollections of child abuse, psychological disorders, trauma symptoms, life problems, quality of life, global functioning, current family relationships, attachment style and personal strengths. The main hypothesis suggested by the literature review was that people who had spent more time living in an institution would show poorer adjustment than those who had spent only a brief period living in an institution.
3.179A subsidiary question was: What are the profiles of subgroups of participants with different histories of institutional abuse?
Statistical analysis strategy
3.180The results of analyses conducted to address these questions will be presented in two sections, corresponding to the two questions. In answering the questions addressed in this Part, the following strategy was used in all statistical analyses. For categorical variables, chi square tests were conducted with p values set conservatively at p<.01 to reduce the probability of type 1 error (misinterpreting spurious group differences as significant). Where chi square tests were significant at p<.01, group differences were interpreted as significant if standardised residuals in table cells exceeded an absolute value of 2. For continuous variables, to control for type 1 error, where possible multivariate analyses of variance (MANOVAs) were conducted on groups of conceptually related variables. Where MANOVAs were significant at p<.05, specific variables on which groups differed at a significance level of p<.01 were identified by conducting one-way analyses of variance (ANOVAs). Scheffe post-hoc comparison tests for designs with unequal cell sizes were conducted to identify significant intergroup differences in those instances where ANOVAs yielded significant F values. Dunnett’s test was used instead of Scheffe’s, where the assumption of homogeneity of variance was violated. In addition to these parametric analyses of continuous variables, in those instances where dependent variables were not normally distributed, non-parametric Kruskall Wallace tests were conducted as well as ANOVAs. If these non-parametric tests yielded results that differed from those of the ANOVAs these were reported. For continuous variables where MANOVAs were not conducted, because there were no grounds for conceptually grouping variables, to control for type 1 error, t-tests or ANOVAs were interpreted as statistically significant if p<.01. For the TSI and the WHOQOL, which are multiscale instruments, unless the pattern of subscale scores differed greatly from that of total scores, for brevity, only analyses of total scores are reported. To facilitate interpretation of profiles of tabulated means, all psychological variables on continuous scales were transformed to T-scores (with means of 50 and standard deviations of 10) before analyses were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. A full tabulation of both statistically significant and non-significant results is presented for analyses conducted to address the main question concerning cases with differing histories of institutional living. In the interests of brevity, for analyses conducted to address the subsidiary question concerning cases with differing histories of institutional living, many non-significant results were not tabulated.
History of institutional living
3.181In this section results are presented of analyses which address the question: What are the profiles of four subgroups of cases with varying histories of institutional living with respect to historical and demographic factors , recollections of child abuse, psychological disorders, trauma symptoms, life problems, quality of life, global functioning, current family relationships, attachment style and personal strengths. To address this question cases were classified into these four groups. Group 1 contained participants who spent more than 12 years in an institution and entered before 5 year of age. Participants in Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 contained participants who spent 5-11 years in an institution and placement occurred through the courts. Those in group 4 spent 4 or fewer years in institutions. There were 110 participants in group 1 (44.5%); 67 in group 2 (27.1%); 22 in group 3 (8.9%); and 48 in group 4 (19.4%).
Historical factors
3.182From Table 4.1 it may be seen that the four groups differed significantly on a range of historical factors including length of time spent with their families before entering an institution; the number of years spent in an institution; their reasons for entering and leaving an institution; the management of the institution in which they lived; and their reaction to leaving the institution.
3.183Participants in group 1 (defined as those who had spent more than 12 years in an institution and entered before five years of age) had spent the least time with their families (under one and a half years) and the longest time living in institutions (on average about fifteen years). More were placed in orphanages run by nuns because they were illegitimate, or because their parents could not look after them, or because their parents died. More left because they were too old to stay on, and more had mixed feelings about leaving. Participants in group 4 (defined as having spent four or fewer years in institution) had spent the most time with their families (on average more than ten and a half years) and the shortest time living in an institution (on average, just under three years). Most were placed in institutions run by religious brothers or priests because of petty crime and left because their short sentences were over, or because their families wanted them back and few had mixed feelings about leaving. Members of groups 2 and 3, on historical factors, had profiles which fell between those of groups 1 and 4, with group 2 being more like group 1 and group 3 being more like group 4.
Demographic characteristics
3.184From Table 4.2 it may be seen that gender was the only demographic factor on which the four groups differed significantly. Significantly more members of groups 1 and 2 were female, and significantly more members of groups 3 and 4 were male. The four groups did not differ on past or present socio-economic status, education, marital status, marital relationship stability, number of children, age at birth of first child, and children’s living arrangements.
Institutional abuse
3.185From Table 4.3 it may be seen that the four groups differed significantly on the sexual abuse scale of the institutional version of the CTQ and the total and severe physical abuse scales of the institutional version of the SPSA. On the sexual abuse scale of the institutional version of the CTQ, the mean score for group 3 was significantly greater than that for group 4, which in turn was significantly greater than that of group 1, which in turn was significantly greater than that of group 2. On the total and severe abuse scale of the institution version of the SPSA, the mean scores of for group 1 were significantly greater than those of group 4 with those of groups 2 and 3 occupying intermediate positions.
3.186From table 4.4 it may be seen that the four groups differed significantly on the ages when the most severe form of physical and sexual abuse began; the duration of the most severe form of physical abuse; the worst thing that happened to participants while living in an institution; and the age of onset and duration of the worst thing that had happened to them.
3.187From Table 4.4 it may be seen that compared with group 4, participants in group 1 were significantly younger when their most severe form of physical abuse and the worst thing that happened to them in an institution began, and the duration of these was significantly longer. On these variables the profiles of the other groups fell between those of groups 1 and 4.
3.188From Table 4.4 it may be seen that compared with groups 3 and 4 participants in groups 1 and 2 were significantly younger when their most severe form of sexual abuse began.
3.189From Table 4.4 it may be seen that compared with groups 1 and 2, significantly more members of group 3 reported that severe sexual abuse was the worst thing that happened to them in an institution. Compared to groups 3 and 4, significantly more members of groups 1 and 2 reported that severe emotional abuse was the worst thing that happened to them in an institution.
Family-based child abuse
3.190For family-based child abuse, only data from 121 members of the 137 in groups 2, 3 and 4 were available, since all members of group 1 and some members of groups 2, 3 and 4 had little recollection of the brief period of time they had spent with their parents during their early years. From Table 4.3 it may be seen that groups 2 ,3 and 4 differed significantly on the physical abuse scale of the family version of the CTQ. The mean score for group 3 was greater than that of group 2, with group 4 occupying an intermediate position between these extremes.
Psychological disorders
3.191From Table 4.5 it may be seen that the four groups differed significantly in the proportions of members who had alcohol and substance use disorders and personality disorders. Compared with groups 1 and 2, significantly more members of groups 3 and 4 had a lifetime diagnoses of alcohol dependence or a lifetime classification of any alcohol or substance use disorder. Compared with groups 1 and 2 significantly more members of 3 had an antisocial personality disorder. The four groups did not differ in rates of anxiety or mood disorders.
Current adjustment
3.192From Table 4.6 it may be seen that compared with groups 1 and 2, the average numbers of life problems were significantly higher in groups 3 and 4. Table 4.7 provides details of the specific life problems on which groups differed. From Table 4.7 it may be seen that compared with groups 1 and 2, groups 3 and 4 had significantly higher rates of substance use, non-violent crime, and incarceration for non-violent crime, while group 3 also had significantly higher rates of violent crime, incarceration for violent crime and unemployment. From Table 4.6 it may be seen that the four groups did not differ total number of trauma symptoms on the TSI, quality of life on the WHOQOL, global functioning on the GAF, marital satisfaction on the KMS or parenting satisfaction on the KPS. From Table 4.8 it may be seen that the four groups did not differ in the rates of four different adult attachment styles assessed by the ECRI.
Strengths
3.193From Table 4.9 it may be seen that the four groups differed significantly in the factors they identified as the source of their strength. Compared with groups 1 and 2, significantly more members of group 4 identified their relationships with their partners as the source of their strength. Compared with groups 2, 3 and 4, significantly more members of group 1 identified as the source of their strength relationships with friends. Compared with group 4, significantly more members of groups 1, 2 and 3 identified self-reliance, optimism, and their work and skills as the source of their strength.
Summary of profiles of groups with varying histories of institutional living
3.194Profiles of four subgroups of cases with varying histories of institutional living are summarized in Table 4.10.
3.195Group 1 included those who had spent more than 12 years in an institution and entered before 5 years of age. They had spent the least time with their families (under one and a half years) and the longest time living in institutions (about fifteen years) on any of the four groups. Compared to groups 3 and 4, more were girls placed in orphanages run by nuns because they were illegitimate, or because their parents had died or could not look after them. More left because they were too old to stay on, and more had mixed feelings about leaving. More had experienced physical abuse which began at a younger age and persisted longer than in group 4. Severe emotional abuse was most commonly cited as the worst thing that happened to this group and it began at an earlier age and lasted longer than worst experiences of other groups. Compared with groups 3 and 4, this group reported fewer psychological disorders and life problems. They identified relationships with friends, self-reliance, optimism, and their work and skills as the sources of their strength.
3.196Group 2 included participants who had spent 5-11 years in institutions because of family problems. Participants in this group entered institutions run predominantly by nuns because their parents could not cope or died, and left when they were too old to stay. Compared with groups 3 and 4, more members of group 2 were female, younger when their most severe form of sexual abuse began, and more identified severe emotional abuse as the worst thing that had happened to them. Compared with group 4 more identified self-reliance, optimism, and their work and skills as the source of their strength.
3.197Group 3 included participants who had spent 5-11 years in institution and entered through the courts. Compared with groups 1 and 2, more members of this group were male, lived in institutions run by religious brothers or priests, and were survivors of institutional sexual abuse. Compared to the other three groups they identified sexual abuse as the worst thing that had happened to them, and more had experienced physical abuse within their families. Compared with groups 1 and 2, this group had more alcohol and substance use disorders, antisocial personality disorders, violent and non-violent crime, imprisonment for violent and non-violent crime, and unemployment. For this group, their self-reliance, optimism, and their work and skills were identified as the main sources of their strength in adulthood, compared with group 4.
3.198Group 4 included participants who had spent 4 or fewer years in institution. Participants in this group spent the most time with their families (more than ten and a half years) and the shortest time living in an institution (just under three years) compared with the other three groups. Most were boys placed in institutions run by religious brothers or priests because of petty crime and left because their short sentences were over, or because their families wanted them back, and few had mixed feelings about leaving. Institutional sexual abuse was the form of maltreatment that distinguished this group, and compared with groups 1 and 2, they showed more alcohol and substance use disorders, antisocial personality disorders, non-violent crime, imprisonment for non-violent crime and unemployment. Their relationships with their partners was identified as the main source of their strength in adulthood.
History of child abuse
3.199In this section results are presented of analyses which address the question: What are the profiles of subgroups of participants with different histories of institutional abuse with respect to historical and demographic factors , recollections of child abuse, psychological disorders, trauma symptoms, life problems, quality of life, global functioning, current family relationships, attachment style and personal strengths. To address this question cases were classified into four groups on the basis of their responses to the question: What was the worst thing that happened to you in the institution? Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4 in Part 3. For brevity many non-significant results have not been included in the tables of results arising from the comparison of the four groups who reported suffering differing types of worst types of abusive experiences in institutions.
Historical and demographic characteristics
3.200From Table 4.11 it may be seen that the four groups differed significantly on the following historical and demographic variables: gender, age, length of time with family before entering an institution, years spent in an institution, reason for entering an institution, institution management, feelings about leaving the institution, education and children’s’ living arrangements.
3.201From Table 4.11 it may be seen that participants in group 1, for whom severe physical and sexual abuse was the worst thing that happened to them in institutions, differed significantly from those in one or more of the other groups in the following respects. They were younger (being in their 50s, not their 60s) than participants in group 2 and had spent less time with their families before entering an institution than group 3. More of them had passed the primary certificate (indicating that they had achieved a higher educational level) than groups 2 and 3. Also, like members of group 3, more had children who spent some time living separately with the child’s other parent than members of group 4.
3.202From Table 4.11 it may be seen that participants in group 2, for whom severe physical abuse was the worst thing that happened to them in institutions, differed significantly from those in one or more of the other groups in the following respects. They were older than members of groups 1 and 3 (being in their 60s, not their 50s). They had a lower level of educational attainment than members of groups 1 and 4. Finally, 5.7% of participants in group 2 had put a child up for adoption whereas no members of the other three groups had done this.
3.203From Table 4.11 it may be seen that participants in group 3, for whom severe sexual abuse was the worst thing that happened to them in institutions, differed significantly from those in one or more of the other groups in the following respects. More were male compared with group 4. They were younger than group 2 (being in their 50s, not their 60s). They had spent more time with their families before entering an institution than members of the other 3 groups. Compared with group 4, they had spent fewer years in an institution; more had entered institutions through the courts for petty crime; more had been in institutions run by religious brothers and priests (but not nuns); and more were happy to leave and fewer had mixed feelings. Like members of group 2, fewer had passed their primary certificate compared with group 1. Also, like members of group 1, more had children who spent some time living separately with the child’s other parent than members of group 4.
3.204From Table 4.11 it may be seen that participants in group 4, for whom severe emotional abuse was the worst thing that happened to them in institutions, differed significantly from those in one or more of the other groups in the following respects. Compared with members of group 3, more were female; they spent more years living in institutions; fewer entered through the courts for petty crime; more lived in institutions run by nuns; and more had mixed feelings about leaving. Compared with group 2 more had achieved a higher educational qualification. Compared with groups 1 and 3, fewer had children who spent some time living separately with the child’s other parent.
Recollections of child abuse
3.205From Table 4.12 it may be seen that the four groups differed significantly on the IAS; the total, physical and sexual abuse scales of the institutional version of the CTQ; and the total and severe sexual abuse scales of the institution version of the SPSA.
3.206From Table 4.12 it may be seen that for the IAS, and the total and physical abuse scales of the institutional version of the CTQ, mean scores for group 1 were significantly higher than those of the other three groups. Those for group 4 were significantly lower than those of the other three groups. Mean scores for groups 2 and 3 occupied intermediate positions between these extremes.
3.207From Table 4.12 it may also be seen that for the sexual abuse scale of the institution version of the CTQ and the total and severe sexual abuse scales of the institution version of the SPSA, means scores for groups 1 and 3 were significantly higher than those of groups 2 and 4.
3.208From Table 4.13 it may be seen that the four groups differed on the age when the worst thing that happened to them in an institution began and the duration of these worst experiences. The mean age at which worst experiences began was significantly lower for group 4 than for the other three groups, and significantly higher for group 3, with groups 1 and 2 occupying intermediate positions between these extremes. The average duration of the worst thing that happened to participants in institutions was significantly longer for groups 2 and 4 than for group 3.
Psychological disorders
3.209From table 4.14 it may be seen that the groups differed significantly in the proportion of participants with current PTSD, any lifetime alcohol and substance use disorder, a lifetime diagnosis of alcohol dependence, and antisocial personality disorder. More members of group 3 than group 4 had each of these disorders. In addition, more members of group 1 had current PTSD compared with groups 2 and 4.
Current adjustment
3.210From table 4.15 it may be seen that the groups differed significantly in their total number of trauma symptoms on the TSI and total number of life problems on the LPC. In both areas, group 4 showed significantly better adjustment than two of the other three groups. Groups 1 and 3 had a significantly higher mean level of trauma symptoms than group 4. Group 3 had significantly more life problems than group 2, who in turn has significantly more life problems than group 4. The four groups did not differ significantly on indices of quality of life, global functioning, current family relationships, adult attachment style and personal strengths.
Summary of profiles of groups who reported suffering differing types of worst abusive experiences in institutions
3.211Profiles of these four subgroups of cases who reported suffering differing types of worst abusive experiences in institutions are summarized in Table 4.16.
3.212Summary profile of group 1 for whom severe sexual and physical abuse was the worst thing they had experienced in an institution. Participants in this group had spent less time with their families before entering an institution than the other 3 groups. Like members of group 3, more had children who spent some time living separately with the child’s other parent. Participants in group 1 had experienced more physical and sexual institutional abuse than at least two of the other 3 groups. Compared with groups 2 and 4, more had a current diagnosis of PTSD and multiple trauma symptoms.
3.213Summary profile of group 2 for whom severe physical abuse was the worst thing they had experienced in an institution. Participants in this group had the lowest educational achievement, were older than the other three groups, and more had put their own children up for adoption. Compared with the groups 1 and 3, their worst abusive experience had lasted longer. Like group 4, they showed fewer adjustment problems in adulthood compared to the other two groups.
3.214Summary profile of group 3 for whom severe sexual abuse was the worst thing they had experienced in an institution. Compared with the other three groups, more participants in group 3 were male and admitted through the courts to institutions run by religious brothers for petty crime. Like group 1, more had children who spent time with their other parent who lived separately. This group for whom severe institutional sexual abuse was their worst experience, showed the poorest adjustment as adults of all four groups. Like group 1 they showed PTSD and multiple trauma symptoms. They also had lifetime alcohol and substance use disorders and antisocial personality disorders along with multiple life problems.
3.215Summary profile of group 4 for whom severe emotional abuse was the worst thing they had experienced in an institution. Compared to the other three groups, more participants in this group were female; more had spent the longest time living in institutions; more lived in institutions run by nuns; more reported that their worst experiences began at an earlier age and lasted a longer time; and more had mixed feelings about leaving. Of the four groups, this group showed the best psychological adjustment in adulthood.
Conclusions
3.216The main question addressed in this Part concerned the profiles of subgroups of cases with varying histories of institutional living. Summary profiles of four groups of participants who had spent different amounts of time in institutions and entered under different circumstances are given in Table 4.10. A subsidiary question concerned the profiles of subgroups of participants with different histories of institutional abuse. Summary profiles of four groups of participants who reported suffering differing types of worst abusive experiences in institutions are presented in Table 4.16. A number of broad conclusions may be drawn from the analyses reported in this Part. Adult survivors of institutional living are not a homogenous group. Subgroups, defined by (1) duration of time in an institution and circumstances of entry, and (2) worst form of institutional abuse have distinctive profiles. In the analysis of groups of participants who had spent different amounts of time in institutions and entered under different circumstances, the most poorly adjusted as adults were not those who had spent longest living in institutions, but rather those who had spent a moderate amount of time in institutions and who had suffered institutional sexual abuse. In the analysis of groups of participants who reported suffering differing types of worst abusive experiences in institutions, the most poorly adjusted included those who pinpointed severe sexual abuse as the worst thing that had happened to them while living in an institution. Thus institutional sexual abuse, was associated in both analyses with a particularly poor outcome.
Table 4.1. Historical characteristics of 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group 4 | Chi Square or ANOVA F | Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | |||||
| Years with family before | M | 1.41 | 6.57 | 10.05 | 10.71 | 208.35*** | 4>2>1 | |
| entering an institution (N=246) | SD | 1.66 | 2.76 | 2.24 | 3.30 | |||
| Years spent in an institution (N=247) | M | 15.05 | 8.34 | 5.89 | 2.84 | 567.22*** | 1>2>3>4 | |
| SD | 2.09 | 1.92 | 1.37 | 1.25 | ||||
| Reason for entering an institution (N=245) |
||||||||
| Illegitimate | f | 44.00 | 4.00 | 0.00 | 0.00 | 199.30*** | 1>2,3,4 | |
| % | 40.70 | 6.00 | 0.00 | 0.00 | ||||
| Petty crime | f | 3.00 | 1.00 | 21.00 | 33.00 | 3,4>1,2 | ||
| % | 2.80 | 1.50 | 95.50 | 68.80 | ||||
| Parents could not provide care | f | 47.00 | 45.00 | 1.00 | 11.00 | 1,2>3,4 | ||
| % | 43.50 | 67.20 | 4.50 | 22.90 | ||||
| Parent died | f | 14.00 | 17.00 | 0.00 | 4.00 | 1,2>3 | ||
| % | 13.00 | 25.40 | 0.00 | 8.30 | ||||
| Reason for leaving the institution (N=247) |
||||||||
| I was too old to stay on | f | 97.00 | 51.00 | 15.00 | 13.00 | 18.32*** | 1,2,3>4 | |
| % | 88.20 | 76.10 | 68.20 | 27.10 | ||||
| The institution closed down | f | 1.00 | 1.00 | 2.00 | 0.00 | 3>1,2,4 | ||
| % | 0.90 | 1.50 | 9.10 | 0.00 | ||||
| My short sentence was over | f | 1.00 | 2.00 | 3.00 | 13.00 | 4>1,2 | ||
| % | 0.90 | 3.00 | 13.60 | 27.10 | ||||
| My family wanted to take me home | f | 6.00 | 11.00 | 1.00 | 16.00 | 4>1,3 | ||
| % | 5.50 | 16.40 | 4.50 | 33.30 | ||||
| I ran away | f | 4.00 | 0.00 | 1.00 | 3.00 | NS | ||
| % | 3.60 | 0.00 | 4.50 | 6.30 | ||||
| Others | f | 1.00 | 2.00 | 0.00 | 3.00 | NS | ||
| % | 0.90 | 3.00 | 0.00 | 6.30 | ||||
| Institution management (N=247) | ||||||||
| Nuns | f | 70.00 | 42.00 | 0.00 | 9.00 | 144.96*** | 1,2>3,4 | |
| % | 63.60 | 62.70 | 0.00 | 18.80 | ||||
| Religious brothers and priests | f | 1.00 | 19.00 | 22.00 | 35.00 | 1,2<3,4 | ||
| % | 0.90 | 28.40 | 100.00 | 72.90 | ||||
| Priests, religious brothers and nuns | f | 39.00 | 6.00 | 0.00 | 4.00 | 1>2,3,4 | ||
| % | 35.50 | 9.0 | 0.00 | 8.30 | ||||
| Were you happy to leave the institution (N=247) | ||||||||
| Yes | f | 53.00 | 44.00 | 16.00 | 39.00 | 19.14** | NS | |
| % | 48.20 | 65.70 | 72.70 | 81.20 | ||||
| Mixed feelings | f | 51.00 | 19.00 | 6.00 | 8.00 | 1>4 | ||
| % | 46.40 | 28.40 | 27.30 | 16.70 | ||||
| No | f | 6.00 | 4.00 | 0.00 | 1.00 | NS | ||
| % | 5.50 | 6.00 | 0.00 | 2.10 | ||||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in an institution. For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. For continuous variables F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For categorical variables, where chi square tests were significant at p<.05, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. **p<.01. ***p<.001
Table 4.2. Demographic characteristics of 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group 4 | Chi Square | Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | |||||
| Gender (N=247) | ||||||||
| Male | f | 45.00 | 28.00 | 22.00 | 39.00 | 43.83*** | 3,4>1,2 | |
| % | 40.90 | 42.00 | 100.00 | 81.25 | ||||
| Female | f | 65.00 | 39.00 | 0.00 | 9.00 | 1,2>3,4 | ||
| % | 59.18 | 58.20 | 0.00 | 18.75 | ||||
| Age in years (N=247) | M | 58.59 | 61.11 | 61.82 | 61.27 | 2.32 | NS | |
| SD | 7.65 | 8.64 | 9.92 | 8.31 | ||||
| Current socio-economic status (SES) (N=241) | ||||||||
| Unemployed | f | 23.00 | 13.00 | 5.00 | 19.00 | 17.54 | NS | |
| % | 21.50 | 19.70 | 23.80 | 40.40 | ||||
| Unskilled manual | f | 20.00 | 13.00 | 3.00 | 2.00 | |||
| % | 18.70 | 19.70 | 14.30 | 4.30 | ||||
| Semi-skilled manual and farmers owning less than | f | 14.00 | 6.00 | 3.00 | 5.00 | |||
| 30 acres | % | 13.10 | 9.10 | 14.30 | 10.60 | |||
| Skilled & other non manual, farmers owning 30-200 | f | 16.00 | 7.00 | 0.00 | 7.00 | |||
| acres, lower & higher managerial & professional | % | 15.00 | 10.60 | 0.00 | 14.90 | |||
| Retired | f | 34.00 | 27.00 | 10.00 | 14.00 | |||
| % | 31.80 | 40.90 | 47.60 | 29.80 | ||||
| Highest SES attained since leaving school (N=235) | ||||||||
| Unskilled manual | f | 49.00 | 32.00 | 8.00 | 15.00 | 22.95 | NS | |
| % | 46.2 | 50.00 | 42.10 | 32.60 | ||||
| Semi-skilled manual and farmers owning less than | f | 21.00 | 14.00 | 7.00 | 20.00 | |||
| 30 acres | % | 19.8 | 21.90 | 36.80 | 43.50 | |||
| Skilled & other non manual, farmers owning 30-200 | f | 36.00 | 18.00 | 4.00 | 11.00 | |||
| acres, lower & higher managerial & professional | % | 34.00 | 28.10 | 21.10 | 23.90 | |||
| Education: Highest exam passed (N=244) | ||||||||
| None | f | 49.00 | 27.00 | 14.00 | 31.00 | 17.21 | NS | |
| % | 45.40 | 40.30 | 63.60 | 66.00 | ||||
| Junior school exam in 5th or 6th class | f | 27.00 | 25.00 | 5.00 | 5.00 | |||
| (e.g. primary cert) | % | 25.00 | 37.30 | 22.70 | 10.60 | |||
| Intermediate or Leaving Cert. | f | 13.00 | 8.00 | 1.00 | 7.00 | |||
| % | 12.00 | 11.90 | 4.50 | 14.90 | ||||
| Certificate or diploma or apprenticeship exam, or | f | 19.00 | 7.00 | 2.00 | 4.00 | |||
| primary degree | % | 17.60 | 10.40 | 9.10 | 8.50 | |||
| Marital status (N=245) | ||||||||
| Single and never married or cohabited | f | 18.00 | 5.00 | 2.00 | 3.00 | 13.45 | NS | |
| % | 16.70 | 7.50 | 9.10 | 6.30 | ||||
| Single & separated/ divorced from first | f | 20.00 | 14.00 | 3.00 | 10.00 | |||
| marital/cohabiting partner | % | 18.50 | 20.90 | 13.60 | 20.80 | |||
| Single & separated/ divorced from 2nd/later partner | f | 3.00 | 2.00 | 3.00 | 3.00 | |||
| % | 2.80 | 3.00 | 13.60 | 6.30 | ||||
| Single and widowed | f | 11.00 | 7.00 | 2.00 | 2.00 | |||
| % | 10.20 | 10.40 | 9.10 | 4.20 | ||||
| Married/ cohabiting in 2nd or later marriage or | f | 16.00 | 11.00 | 3.00 | 7.00 | |||
| long term relationship | % | 14.80 | 16.40 | 13.60 | 14.60 | |||
| Married/cohabiting in first long term relationship | f | 40.00 | 28.00 | 9.00 | 23.00 | |||
| % | 37.00 | 41.80 | 40.90 | 47.90 | ||||
| Number of long term relationships or | ||||||||
| marriages that have ended (N=217) |
||||||||
| No relationship has ended | f | 29.00 | 19.00 | 7.00 | 20.00 | 6.90 | NS | |
| % | 32.20 | 30.60 | 35.00 | 44.40 | ||||
| 1 relationship | f | 32.00 | 26.00 | 5.00 | 16.00 | |||
| % | 35.60 | 41.90 | 25.00 | 35.60 | ||||
| 2 relationships | f | 19.00 | 10.00 | 4.00 | 4.00 | |||
| % | 21.10 | 16.10 | 20.00 | 8.90 | ||||
| 3 relationships | f | 10.00 | 7.00 | 4.00 | 5.00 | |||
| % | 11.10 | 11.30 | 20.00 | 11.10 | ||||
| Duration of relationship with | M | 28.68 | 30.68 | 33.64 | 35.35 | 2.79 | NS | |
| current partner? (N=134) | SD | 10.48 | 12.31 | 10.52 | 7.66 | |||
| Number of children (N=212) | M | 3.23 | 3.03 | 3.80 | 3.95 | 2.55 | NS | |
| SD | 1.93 | 1.40 | 1.80 | 2.39 | ||||
| Age when had first child (N=207) | M | 25.38 | 25.61 | 25.86 | 25.52 | 0.05 | NS | |
| SD | 5.63 | 5.66 | 6.13 | 5.15 | ||||
| Children’s living arrangements (N=211) | ||||||||
| Spent some time living with their other parent | f | 9.00 | 5.00 | 8.00 | 6.00 | 17.08 | NS | |
| % | 10.30 | 8.30 | 38.10 | 14.00 | ||||
| Spent some time living with their relatives or in care | f | 8.00 | 3.00 | 0.00 | 5.00 | |||
| % | 9.20 | 5.00 | 0.00 | 11.60 | ||||
| Always lived with respondent | f | 67.00 | 51.00 | 13.00 | 31.00 | |||
| % | 77.00 | 85.00 | 61.90 | 72.10 | ||||
| Children put up for adoption | f | 3.00 | 1.00 | 0.00 | 1.00 | |||
| % | 3.40 | 1.70 | 0.00 | 1.70 | ||||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in an institution. The percentages in long-term relationships or marriages that have ended were based on number of cases who had had any marriages or long-term relationships. The number in each group were: Group 1=90; Group 2=62; Group 3=20; Group 4=45. The mean duration of relationship with current partner was based on the number of participants who were married or cohabiting. The number in each group were: Group 1=56; Group 2=38; Group 3=11; Group 4=29. The mean number of children, mean age when had first child and percentage of children in each of the children’s living arrangements categories were based on cases with children only. The number in each group were: Group 1=87; Group 2=60; Group 3=21; Group 4=43. Socio-economic status (SES) was assessed with O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156. For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. For continuous variables F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For categorical variables, where chi square tests were significant at p<.05, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. ***p<.001.
Table 4.3. Recollections of child abuse in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group 4 | ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | |||||
| INSTITUTIONAL ABUSE | ||||||||
| IAS (N=247) | Specific institutional Abuse | M | 48.31 | 58.39 | 50.84 | 50.13 | 2.41 | NS |
| SD | 9.63 | 10.35 | 11.36 | 9.23 | ||||
| CTQ-Institution >(N=247) | Total institutional abuse score | M | 49.88 | 48.48 | 52.68 | 51.18 | 1.28 | NS |
| SD | 9.48 | 9.40 | 12.09 | 10.82 | ||||
| Physical abuse | M | 49.72 | 49.73 | 53.12 | 49.57 | 0.79 | NS | |
| SD | 9.17 | 10.40 | 11.62 | 10.54 | ||||
| Sexual abuse | M | 49.34 | 47.28 | 56.01 | 52.57 | 5.85*** | 3>4>1>2 | |
| SD | 9.40 | 8.36 | 11.37 | 11.27 | ||||
| Emotional abuse | M | 50.89 | 48.85 | 47.85 | 50.58 | 0.98 | NS | |
| SD | 9.16 | 11.23 | 13.02 | 8.39 | ||||
| Physical neglect | M | 51.34 | 48.94 | 48.38 | 49.10 | 1.23 | NS | |
| SD | 10.00 | 9.93 | 10.98 | 9.59 | ||||
| Emotional neglect | M | 48.59 | 52.12 | 49.73 | 50.42 | 1.78 | NS | |
| 10,84 | 9.54 | 9.54 | 8.53 | |||||
| SPSA-Institution >(N=247) | Total severe institutional abuse | M | 51.58 | 48.69 | 50.09 | 48.17 | 5.59*** | 1>4 |
| SD | 5.86 | 5.87 | 5.45 | 5.35 | ||||
| Severe institutional physical abuse | M | 54.26 | 48.91 | 46.72 | 43.19 | 18.37*** | 1>4 | |
| SD | 9.37 | 9.54 | 8.80 | 7.71 | ||||
| Severe institutional sexual abuse | M | 50.46 | 47.85 | 52.50 | 50.75 | 1.67 | NS | |
| SD | 10.58 | 9.81 | 9.16 | 8.86 | ||||
| CHILD ABUSE IN FAMILY | ||||||||
| CTQ-family (N=121) | Total family abuse Score | M | 0.00 | 49.07 | 52.11 | 50.14 | 0.68 | NS |
| SD | 0.00 | 9.99 | 8.56 | 10.51 | ||||
| Physical abuse | M | 0.00 | 46.84 | 54.27 | 51.70 | 5.56** | 3>4>2 | |
| SD | 0.00 | 7.56 | 11.96 | 10.58 | ||||
| Sexual abuse | M | 0.00 | 50.98 | 47.05 | 50.12 | 1.13 | NS | |
| SD | 0.00 | 11.19 | 0.00 | 10.59 | ||||
| Emotional abuse | M | 0.00 | 49.74 | 50.31 | 50.12 | 0.03 | NS | |
| SD | 0.00 | 10.24 | 10.09 | 9.90 | ||||
| Physical neglect | M | 0.00 | 48.45 | 54.94 | 49.65 | 3.23 | NS | |
| SD | 0.00 | 9.82 | 9.49 | 9.94 | ||||
| Emotional neglect | M | 0.00 | 49.51 | 53.12 | 49.23 | 1.18 | NS | |
| SD | 0.00 | 9.91 | 11.01 | 9.63 | ||||
| SPSA-family (N=121) | Total severe family abuse | M | 0.00 | 48.93 | 49.50 | 48.17 | 0.43 | NS |
| SD | 0.00 | 6.35 | 5.23 | 5.35 | ||||
| (N=121) | Severe family physical abuse | M | 0.00 | 48.13 | 46.21 | 43.19 | 3.94 | NS |
| SD | 0.00 | 9.72 | 9.03 | 7.71 | ||||
| (N=121) | Severe family sexual abuse | M | 0.00 | 48.93 | 51.54 | 50.74 | 0.75 | NS |
| SD | 0.00 | 10.21 | 8.87 | 8.86 | ||||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. Cautious interpretation of scores from the family version of the SPSA is warranted because of the low reliability of scores from this instrument, mentioned in Part 3 and documented in Table 3.11. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analyses of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For the MANOVA on all subscales of the institution versions of the CTQ, SPSA & the IAS, F (24, 685) = 6.16, p<.001. For the MANOVA on all subscales of the family versions of the CTQ and SPSA, F (14, 224) = 2.66, p<.001. *p<0.05 **p<0.01 ***p<0.001. NS=Not significant.
Table 4.4. Timing of severe abuse and worst form of abuse experienced in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group 4 | For Chi Square | Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | |||||
| INSTITUTIONAL ABUSE | ||||||||
| Age when most severe form of physical | ||||||||
| abuse began (N=233) | M | 6.51 | 8.56 | 11.05 | 11.80 | 36.61*** | 1<2<4 | |
| SD | 3.46 | 2.87 | 2.66 | 2.51 | ||||
| Duration of most severe form of | ||||||||
| physical abuse (N=229) | M | 9.26 | 5.98 | 4.86 | 2.68 | 36.90*** | 1>2>4 | |
| SD | 4.41 | 3.40 | 3.31 | 1.32 | ||||
| Age when most severe form of sexual | M | 9.85 | 9.76 | 12.13 | 12.43 | 8.55*** | 1,2<3,4 | |
| abuse began (N=122) | SD | 3.05 | 2.45 | 1.46 | 2.41 | |||
| Duration of most severe form of sexual | M | 3.13 | 3.65 | 2.32 | 1.70 | 2.09 | NS | |
| abuse (N=111) | SD | 3.06 | 4.22 | 1.42 | 1.42 | |||
| Worst thing that ever happened to you | ||||||||
| in an institution (N=247) | ||||||||
| Severe physical and sexual abuse (N=23) | f | 10.00 | 9.00 | 2.00 | 2.00 | 38.20*** | NS | |
| % | 9.10 | 13.40 | 9.10 | 4.20 | ||||
| Severe physical abuse (N=99) | f | 45.00 | 18.00 | 9.00 | 25.00 | NS | ||
| % | 40.90 | 29.90 | 40.90 | 52.10 | ||||
| Severe sexual abuse (N=40) | f | 11.00 | 6.00 | 9.00 | 14.00 | 3>1,2 | ||
| % | 10.00 | 9.00 | 40.90 | 29.20 | ||||
| Severe emotional abuse (N= 85) | f | 44.00 | 32.00 | 2.00 | 7.00 | 1,2>3,4 | ||
| % | 40.00 | 47.80 | 9.10 | 14.60 | ||||
| Age when worst thing began (N=237) | M | 7.74 | 9.11 | 11.69 | 11.70 | 19.40*** | 1<4 | |
| SD | 3.60 | 3.17 | 1.63 | 3.22 | ||||
| Duration of worst thing (N=225) | M | 7.19 | 4.73 | 4.33 | 2.14 | 15.27*** | 1>2,3>4 | |
| SD | 5.13 | 4.19 | 3.37 | 1.51 | ||||
| CHILD ABUSE IN FAMILY | ||||||||
| Age when most severe form of physical | M | 0.00 | 7.00 | 6.91 | 7.65 | 0.31 | NS | |
| abuse began (N=41) | SD | 0.00 | 2.16 | 1.92 | 3.48 | |||
| Duration of most severe form of | M | 0.00 | 2.91 | 5.16 | 6.44 | 2.57 | NS | |
| physical abuse (N=42) | SD | 0.00 | 2.72 | 3.75 | 4.61 | |||
| Age when most severe form of sexual | M | 8.00 | 8.40 | 0.00 | 8.80 | 0.05 | NS | |
| abuse began (N=11) | SD | 0.00 | 2.30 | 0.00 | 3.11 | |||
| Duration of most severe form of sexual | M | 12.00 | 3.42 | 0.00 | 4.04 | 2.45 | NS | |
| Abuse (N=11) | SD | 0.00 | 2.94 | 0.00 | 4.14 | |||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. For the ‘worst thing that ever happened’ , verbatim responses were classified into 4 categories (as shown in table 3.4) and percentages in these 4 categories sum to about 100 for each group. Percentages across rows do not sum to 100. For continuous variables F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For categorical variables, where chi square tests were significant at p<.05, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. ***p<.001
Table 4.5. Psychological disorders in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Disorder | Group 1 | Group 2 | Group 3 | Group 4 | Chi Square |
Group Diffs | |
|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | ||||
| Anxiety disorders | |||||||
| Any anxiety disorder, current | f | 51.00 | 30.00 | 11.00 | 20.00 | 0.26 | NS |
| % | 46.40 | 44.80 | 50.00 | 41.70 | |||
| Any anxiety disorder, lifetime | f | 32.00 | 29.00 | 8.00 | 17.00 | 2.29 | NS |
| % | 29.10 | 43.30 | 36.40 | 35.40 | |||
| Mood Disorders | |||||||
| Any mood disorder, current | f | 29.00 | 17.00 | 9.00 | 11.00 | 2.69 | NS |
| % | 26.40 | 25.40 | 40.90 | 22.90 | |||
| Any mood disorder, lifetime | f | 40.00 | 25.00 | 6.00 | 18.00 | 0.83 | NS |
| % | 36.40 | 37.30 | 27.30 | 37.50 | |||
| Alcohol & substance use disorders | |||||||
| Any alcohol or substance use disorder, current | f | 6.00 | 4.00 | 1.00 | 1.00 | 1.07 | NS |
| % | 5.50 | 6.00 | 4.50 | 2.10 | |||
| Any alcohol and substance use disorder, lifetime | f | 27.00 | 20.00 | 13.00 | 28.00 | 23.61*** | 3,4,>1,2 |
| % | 24.50 | 29.90 | 59.10 | 58.30 | |||
| Alcohol dependence, lifetime | f | 16.00 | 17.00 | 10.00 | 23.00 | 23.35*** | 3,4,>1.2 |
| % | 14.50 | 25.40 | 45.50 | 47.90 | |||
| Personality disorders | |||||||
| Antisocial personality disorder, current | f | 2.00 | 3.00 | 5.00 | 7.00 | 18.07*** | 3>1,2 |
| % | 1.80 | 4.50 | 22.70 | 14.60 | |||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. Diagnoses were made using the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Psychological disorders do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%. Where chi square tests were significant at p<.01, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. ***p<.001.
Table 4.6. Current adjustment of participants in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Group 1 |
Group 2 |
Group 3 |
Group 4 |
ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | ||||
| Total trauma symptoms (TSI) | M | 49.92 | 48.85 | 50.78 | 51.41 | 0.66 | NS |
| (N=247) | SD | 10.00 | 9.99 | 10.80 | 9.74 | ||
| Total No of life problems (LPC) | M | 48.19 | 47.38 | 57.06 | 54.56 | 10.90*** | 3,4>1,2 |
| (N=247) | SD | 8.78 | 8.64 | 11.85 | 10.69 | ||
| Total quality of life (WHOQOL) | M | 50.01 | 50.41 | 49.61 | 49.60 | 0.08 | NS |
| (N=247) | SD | 9.57 | 9.44 | 9.44 | 12.08 | ||
| Global functioning (GAF) | M | 49.39 | 49.63 | 50.60 | 51.76 | 0.64 | NS |
| (N=235) | SD | 9.55 | 10.51 | 9.46 | 10.65 | ||
| Marital satisfaction (KMS) | M | 51.07 | 49.81 | 53.21 | 54.72 | 1.40 | NS |
| (N=136) | SD | 10.52 | 10.85 | 10.31 | 9.69 | ||
| Parental satisfaction (KPS) | M | 48.81 | 51.62 | 46.01 | 48.55 | 1.58 | NS |
| (N=212) | SD | 11.65 | 8.37 | 10.11 | 13.77 | ||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KMS means and SDs are based on the number of participants who lived with partners (N=136). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). KPS means and SDs are based on the number of participants with children (N=212). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. ***p<0.001. NS=Not significant.
Table 4.7. Life problems in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group 4 | Chi Square | Group Diffs | |
|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | ||||
| Substance use | f | 32.00 | 20.00 | 13.00 | 29.00 | 19.94*** | 3,4>1,2 |
| % | 29.10 | 29.90 | 59.10 | 60.40 | |||
| Violent crime | f | 8.00 | 2.00 | 7.00 | 8.00 | 18.38*** | 3>1,2 |
| % | 7.30 | 3.00 | 31.80 | 16.70 | |||
| Incarceration for violent crime | f | 6.00 | 1.00 | 4.00 | 7.00 | 11.52*** | 3>1.2 |
| % | 5.50 | 1.50 | 18.20 | 14.60 | |||
| Non-violent crime | f | 16.00 | 7.00 | 12.00 | 20.00 | 32.88*** | 3,4>1,2 |
| % | 14.50 | 10.40 | 54.50 | 41.70 | |||
| Incarceration for non-violent crime | f | 8.00 | 3.00 | 7.00 | 15.00 | 27.84*** | 3,4>1,2 |
| % | 7.30 | 4.50 | 31.80 | 31.30 | |||
| Unemployment | f | 53.00 | 27.00 | 16.00 | 32.00 | 12.24** | 3,4>2 |
| % | 48.20 | 40.30 | 72.20 | 66.70 | |||
| Homelessness | f | 24.00 | 8.00 | 9.00 | 11.00 | 8.70 | NS |
| % | 21.80 | 11.90 | 40.90 | 22.90 | |||
| Frequent illness | f | 31.00 | 18.00 | 9.00 | 15.00 | 1.76 | NS |
| % | 28.20 | 26.90 | 40.90 | 31.30 | |||
| Frequent hospitalization for physical | f | 29.00 | 15.00 | 8.00 | 18.00 | 4.06 | NS |
| Health | % | 26.40 | 22.40 | 36.40 | 37.50 | ||
| Mental health | f | 84.00 | 47.00 | 16.00 | 36.00 | 0.88 | NS |
| % | 76.40 | 70.10 | 72.70 | 75.00 | |||
| Self-harm | f | 15.00 | 12.00 | 4.00 | 13.00 | 4.13 | NS |
| % | 13.60 | 17.90 | 18.20 | 27.10 | |||
| Hospitalization for mental health | f | 12.00 | 7.00 | 4.00 | 9.00 | 2.74 | NS |
| % | 10.90 | 10.40 | 18.20 | 18.80 | |||
| Anger control in intimate relationships | f | 21.00 | 18.00 | 9.00 | 16.00 | 6.65 | NS |
| % | 19.10 | 26.90 | 40.90 | 33.30 | |||
| Anger control with children | f | 8.00 | 11.00 | 6.00 | 8.00 | 8.20 | NS |
| % | 7.30 | 16.40 | 27.30 | 16.70 | |||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. Life problems do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%. Where chi square tests were significant at p<.05, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. **p<.01. ***p<.001.
1 Professor Alan Carr, PhD, Professor Alan Carr, PhD. June 2006 (revised for minor inaccuracies in December 2008).
Table 4.8. Adult attachment style on the Experiences in Close Relationships Inventory in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Adult Attachment Style | Group 1 | Group 2 | Group 3 | Group4 | Chi Square |
Group Diffs | |
|---|---|---|---|---|---|---|---|
| N=108 | N=67 | N=22 | N=48 | ||||
| Secure | f | 18.00 | 13.00 | 4.00 | 6.00 | 7.29 | NS |
| % | 16.70 | 19.40 | 18.20 | 12.50 | |||
| Fearful | f | 52.00 | 27.00 | 9.00 | 19.00 | ||
| % | 48.10 | 40.30 | 40.90 | 39.60 | |||
| Preoccupied | f | 10.00 | 7.00 | 3.00 | 11.00 | ||
| % | 9.30 | 10.40 | 13.60 | 22.90 | |||
| Dismissive | f | 28.00 | 20.00 | 6.00 | 12.00 | ||
| % | 25.90 | 29.90 | 27.30 | 25.00 | |||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. Cases were classified as falling into the four attachment style categories using the Experiences in Close Relationships Inventory, SPSS algorithm in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. NS=Not significant.
Table 4.9. Strengths in 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| Variable | Group 1 | Group 2 | Group 3 | Group4 | Chi Square |
Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=110 | N=67 | N=22 | N=48 | |||||
| Where does your strength come from? | ||||||||
| Relationship with current partner | f | 8.00 | 8.00 | 7.00 | 17.00 | 37.72*** | 4>1,2 | |
| % | 7.50 | 12.10 | 31.80 | 35.40 | ||||
| Relationship with a friend including other survivors | f | 15.00 | 3.00 | 0.00 | 1.00 | 1>2,3,4 | ||
| % | 14.00 | 4.50 | 0.00 | 2.10 | ||||
| Relationship with God or spiritual force | f | 15.00 | 11.00 | 2.00 | 12.00 | NS | ||
| % | 14.00 | 16.70 | 9.10 | 25.00 | ||||
| Self-reliance, my optimism, my work, my skills | f | 69.00 | 44.00 | 13.00 | 18.00 | 1,2,3>4 | ||
| % | 64.50 | 66.70 | 59.10 | 37.50 | ||||
| What has helped you most in facing life challenges? | ||||||||
| Relationship with current partner | f | 22.00 | 19.00 | 7.00 | 15.00 | 13.84 | NS | |
| % | 20.60 | 28.40 | 31.80 | 31.90 | ||||
| Relationship with a friend including other | f | 11.00 | 1.00 | 0.00 | 2.00 | |||
| Survivors | % | 10.30 | 1.50 | 0.00 | 4.30 | |||
| Relationship with God or spiritual force | f | 9.00 | 11.00 | 1.00 | 4.00 | |||
| % | 8.40 | 16.40 | 4.50 | 8.50 | ||||
| Self-reliance, my optimism, my work, my skills | f | 65.00 | 36.00 | 14.00 | 26.00 | |||
| % | 60.70 | 53.70 | 63.60 | 55.30 | ||||
| What is the thing that means most to | ||||||||
| You in your life? | ||||||||
| Relationship with partner | f | 12.00 | 9.00 | 4.00 | 8.00 | 9.57 | NS | |
| % | 11.10 | 13.40 | 20.00 | 17.00 | ||||
| Relationship with a friend including other | f | 7.00 | 4.00 | 0.00 | 1.00 | |||
| Survivors | % | 6.50 | 6.00 | 0.00 | 2.10 | |||
| Relationship with God or spiritual force | f | 3.00 | 2.00 | 1.00 | 1.00 | |||
| % | 2.80 | 3.00 | 5.00 | 2.10 | ||||
| Self-reliance, my optimism, my work, my skills | f | 31.00 | 11.00 | 3.00 | 8.00 | |||
| % | 28.70 | 16.40 | 15.00 | 17.00 | ||||
| Relationship with Children / Family | f | 55.00 | 41.00 | 12.00 | 29.00 | |||
| % | 50.90 | 61.20 | 60.00 | 61.70 | ||||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. ***p<.001.
Table 4.10. Profiles of 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
|
Group 1 12 years Entered before 5 years |
Group 2 5-11 years Entered due to parental problems |
Group 3 5-11 years Entered through courts |
Group 4 Under 4 years |
|
|---|---|---|---|---|
| PAST HISTORY & DEMOGRAPHICS | ||||
| Few years with family before entry | + | – | – | 0 |
| Many years in institution | + | – | – | 0 |
| Entry reason | ||||
| Illegitimate | + | – | – | – |
| Parents unable to care | + | + | – | – |
| Parental death | + | + | – | – |
| Through courts for petty crime | – | – | + | + |
| Leaving reason | ||||
| Too old | + | + | + | – |
| Institution closed | – | – | + | – |
| Sentence over | – | – | – | + |
| Family wanted person back | – | – | – | + |
| Institution management | ||||
| Nuns | + | + | – | – |
| Religious brothers & priests | – | – | + | + |
| Both | + | – | – | – |
| Mixed feelings leaving | + | – | – | 0 |
| Gender | ||||
| Male | – | – | + | + |
| Female | + | + | – | – |
| INSTITUTIONAL ABUSE | ||||
| Physical institutional abuse | + | – | – | 0 |
| Physical abuse began at an early age | + | – | – | 0 |
| Physical abuse lasted many years | + | – | – | 0 |
| Sexual institutional abuse | – | – | + | + |
| Sexual abuse began at an early age | + | + | – | – |
| Worst thing in institution was severe sexual abuse | 0 | 0 | + | – |
| Worst thing in institution was severe emotional abuse | + | + | – | – |
| Worst thing began at an early age | + | – | – | 0 |
| Worst thing lasted a long time | + | – | – | 0 |
| FAMILY-BASED CHILD ABUSE | ||||
| Physical abuse | 0 | 0 | + | – |
| ADULT PSYCHOLOGICAL ADJUSTMENT | ||||
| Psychological disorders | ||||
| Alcohol & Substance use disorder, lifetime | – | – | + | + |
| Antisocial personality disorder | – | – | + | + |
| Multiple life problems (substance use, crime, unemployment) |
– | – | + | + |
| Strengths | ||||
| Relationship with partner | 0 | 0 | – | + |
| Relationship with friends | + | – | – | – |
| Self-reliance, optimism, work, skills | + | + | + | – |
Note: +=the feature was a significant feature of the group profile. 0=the feature was not a significant element of the group profile. – a moderate level of the feature characterized the groups profile.
Table 4.11. Historical and demographic characteristics on which four groups who reported suffering differing types of worst abusive experiences in institutions differed significantly
| Variable | Categories | Group 1 S&P abuse |
Group 2 P abuse |
Group 3 S abuse |
Group 4 E Abuse |
Chi Square or ANOVA F |
Group Diffs | |
|---|---|---|---|---|---|---|---|---|
| N=23 | N=99 | N=40 | N=85 | |||||
| Gender (N=247) | ||||||||
| Male | f | 15.00 | 55.00 | 35.00 | 30.00 | 31.34*** | 3>4 | |
| % | 65.20 | 55.60 | 87.50 | 35.30 | ||||
| Female | f | 8.00 | 44.00 | 5.00 | 55.00 | 4>3 | ||
| % | 34.80 | 44.40 | 12.50 | 64.70 | ||||
| Age in years (N=247) | M | 56.74 | 62.22 | 57.55 | 59.60 | 4.96** | 2>3,1 | |
| SD | 8.57 | 8.34 | 7.36 | 8.13 | ||||
| Years with family before | M | 4.75 | 5.71 | 7.78 | 4.09 | 6.74*** | 3>4,1 | |
| entering an institution (N=246) | SD | 3.82 | 4.76 | 4.96 | 3.78 | |||
| Years in an institution (N=247) | M | 10.96 | 9.74 | 7.75 | 11.21 | 4.57** | 4>3 | |
| SD | 4.98 | 5.34 | 5.46 | 4.63 | ||||
| Reason for entering an institution (N=245) | ||||||||
| Illegitimate | f | 2.00 | 18.00 | 4.00 | 24.00 | 32.70*** | ||
| % | 8.70 | 18.20 | 10.00 | 28.90 | ||||
| Petty crime | f | 5.00 | 29.00 | 19.00 | 5.00 | 3>4 | ||
| % | 21.70 | 29.30 | 47.50 | 6.00 | ||||
| Parents could not provide care | f | 12.00 | 40.00 | 13.00 | 39.00 | |||
| % | 52.20 | 40.40 | 32.50 | 47.00 | ||||
| Parent died | f | 4.00 | 12.00 | 4.00 | 15.00 | |||
| % | 17.40 | 12.10 | 10.00 | 18.10 | ||||
| Institution management (N=247) | ||||||||
| Nuns | f | 9.00 | 46.00 | 8.00 | 58.00 | 35.64*** | 4>3 | |
| % | 39.10 | 46.50 | 20.00 | 68.20 | ||||
| Religious brothers and priests | f | 7.00 | 35.00 | 24.00 | 11.00 | 3>4 | ||
| % | 30.40 | 35.40 | 60.00 | 12.90 | ||||
| Priests, religious brothers and Nuns | f | 7.00 | 18.00 | 8.00 | 16.00 | |||
| % | 30.40 | 18.20 | 20.00 | 18.80 | ||||
| Were you happy to leave the institution? (N=247) | ||||||||
| Yes | f | 12.00 | 62.00 | 35.00 | 43.00 | 17.75** | 3>4 | |
| % | 52.20 | 62.60 | 87.50 | 50.60 | ||||
| Mixed feelings | f | 9.00 | 32.00 | 5.00 | 38.00 | 4>3 | ||
| % | 39.10 | 32.30 | 12.50 | 44.70 | ||||
| No | f | 2.00 | 5.00 | 0.00 | 4.00 | |||
| % | 8.70 | 5.10 | 0.00 | 4.70 | ||||
| Education – highest exam (N=244) | ||||||||
| None | f | 8.00 | 64.00 | 18.00 | 31.00 | 33.30** | 2>1,4 | |
| % | 34.80 | 66.00 | 45.00 | 36.90 | ||||
| Junior school exam in 5th or 6th class | f | 12.00 | 19.00 | 8.00 | 23.00 | 1>2,3 | ||
| (e.g. primary cert) | % | 52.20 | 19.60 | 20.00 | 27.40 | |||
| Inter/Leaving Cert. | f | 1.00 | 8.00 | 9.00 | 11.00 | |||
| % | 4.30 | 8.20 | 22.50 | 13.10 | ||||
| Certificate, diploma, apprenticeship | f | 2.00 | 6.00 | 5.00 | 19.00 | 4>2 | ||
| exam, or primary degree | % | 8.70 | 6.20 | 12.50 | 22.60 | |||
| Children’s living arrangements (N=211) |
||||||||
| Spent some time living with their other | f | 5.00 | 11.00 | 9.00 | 3.00 | 22.63** | 1,3>4 | |
| parent | % | 25.00 | 12.60 | 26.50 | 4.30 | |||
| Spent some time living with their | f | 0.00 | 7.00 | 1.00 | 8.00 | |||
| relatives or in Care | % | 0.00 | 8.00 | 2.90 | 11.40 | |||
| Always lived with respondent | f | 15.00 | 64.00 | 24.00 | 59.00 | |||
| % | 75.00 | 73.60 | 70.60 | 84.30 | ||||
| Children put up for adoption | f | 0.00 | 5.00 | 0.00 | 0.00 | 2>1,3,4 | ||
| % | 0.00 | 5.70 | 0.00 | 0.00 | ||||
Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4. For each variable with multiple categories, within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. For continuous variables F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For categorical variables, where chi square tests were significant at p<.05, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. **p<.01. ***p<.001
Table 4.12. Recollections of child abuse in four groups who reported suffering differing types of worst abusive experiences in institutions
| Variable | Group 1 S&P Abuse |
Group 2 P abuse |
Group 3 S abuse |
Group 4 E Abuse |
ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|---|---|
| N=23 | N=99 | N=40 | N=85 | |||||
| INSTITUTIONAL ABUSE | ||||||||
| IAS >(N=247) | Specific institutional abuse | M | 55.56 | 49.50 | 52.02 | 48.12 | 4.16** | 1>3>2,4 |
| SD | 8.94 | 9.29 | 9.64 | 10.66 | ||||
| CTQ-Institution >(N=247) | ||||||||
| Total institutional abuse score | M | 58.47 | 49.22 | 56.41 | 45.60 | 20.65*** | 1>3>2>4 | |
| SD | 7.94 | 8.23 | 9.92 | 9.59 | ||||
| Physical abuse | M | 54.75 | 51.70 | 51.55 | 45.99 | 8.20*** | 1>2,3>4 | |
| SD | 6.98 | 8.96 | 9.29 | 10.92 | ||||
| Sexual abuse | M | 59.13 | 47.20 | 61.66 | 45.31 | 55.55*** | 1,3>2,4 | |
| SD | 9.61 | 8.52 | 7.51 | 6.21 | ||||
| Emotional abuse | M | 53.91 | 50.12 | 51.00 | 48.33 | 2.12 | NS | |
| SD | 7.60 | 9.91 | 9.37 | 10.73 | ||||
| Physical neglect | M | 54.99 | 50.71 | 49.13 | 48.18 | 3.20 | NS | |
| SD | 8.63 | 9.50 | 10.11 | 10.47 | ||||
| Emotional neglect | M | 50.46 | 49.75 | 50.49 | 49.95 | 0.07 | NS | |
| SD | 10.81 | 8.57 | 10.83 | 11.07 | ||||
| SPSA-Institution >(N=247) | Total severe institutional abuse | M | 55.34 | 48.40 | 54.30 | 48.40 | 22.70*** | 1,3>2,4 |
| SD | 4.81 | 4.79 | 5.13 | 5.85 | ||||
| Severe institutional physical abuse | M | 54.07 | 49.59 | 49.90 | 49.37 | 1.45 | NS | |
| SD | 7.54 | 9.45 | 9.87 | 11.08 | ||||
| Severe institutional sexual abuse | M | 58.88 | 46.73 | 59.54 | 46.89 | 34.57*** | 1,3>2,4 | |
| SD | 7.55 | 8.64 | 5.78 | 9.33 | ||||
Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted . T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For the MANOVA on all subscales of the institution versions of the CTQ, SPSA & the IAS, F (24, 685) = 7.30, p<.001. For the MANOVA on all subscales of the family versions of the CTQ and SPSA, F (21, 319) = 1.31, p=NS. **p<.01. ***p<.001.
Table 4.13. Timing of severe abuse and worst abuse in four groups who reported suffering differing types of worst abusive experiences in institutions
| Variable | Group 1 S&P abuse |
Group 2 P abuse |
Group 3 S abuse |
Group 4 E Abuse |
Chi Square |
Group Diffs | |
|---|---|---|---|---|---|---|---|
| N=23 | N=99 | N=40 | N=85 | ||||
| Age when most severe form of | M | 8.06 | 8.91 | 9.50 | 7.60 | 3.00 | NS |
| physical abuse began (N=233) | SD | 3.02 | 3.49 | 4.24 | 3.56 | ||
| Duration of most severe form of | M | 6.67 | 6.49 | 5.94 | 7.45 | 1.18 | NS |
| physical abuse (N=229) | SD | 3.66 | 4.58 | 4.71 | 4.26 | ||
| Age when most severe form of | M | 10.28 | 11.06 | 11.36 | 9.79 | 2.02 | NS |
| sexual abuse began (N=122) | SD | 2.63 | 2.64 | 2.76 | 3.27 | ||
| Duration of most severe form of | M | 3.04 | 2.75 | 2.09 | 3.34 | 1.01 | NS |
| sexual abuse (N=111) | SD | 2.46 | 3.12 | 2.15 | 3.99 | ||
| Age when worst thing began | M | 9.20 | 9.02 | 11.48 | 8.24 | 7.72*** | 3>1,2>4 |
| (N=237) | SD | 2.92 | 3.65 | 2.95 | 3.71 | ||
| Duration of worst thing (N=225) | M | 4.49 | 5.86 | 2.63 | 5.92 | 5.70*** | 2,4>3 |
| SD | 3.67 | 4.49 | 2.82 | 5.40 | |||
Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4.
F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. ***p<.001
Table 4.14. Psychological disorders in four groups who reported suffering differing types of worst abusive experiences in institutions
| Variable | Group 1 S&P abuse |
Group 2 P abuse |
Group 3 S abuse |
Group 4 E Abuse |
Chi Square |
Group Diffs | |
|---|---|---|---|---|---|---|---|
| N=23 | N=99 | N=40 | N=85 | ||||
| Anxiety disorders | |||||||
| Posttraumatic stress disorder, current | f | 8.00 | 10.00 | 14.00 | 9.00 | 20.51*** | 1,3>2,4 |
| % | 34.80 | 10.10 | 35.00 | 10.60 | |||
| Alcohol and substance use disorders | |||||||
| Any alcohol and substance use disorder, lifetime | f | 12.00 | 33.00 | 23.00 | 20.00 | 16.74*** | 3>4 |
| % | 52.20 | 33.30 | 57.50 | 23.50 | |||
| Alcohol dependence, lifetime | f | 7.00 | 27.00 | 20.00 | 12.00 | 18.14*** | 3>4 |
| % | 30.40 | 27.30 | 50.00 | 14.10 | |||
| Personality disorders | |||||||
| Antisocial personality disorder | f | 2.00 | 4.00 | 9.00 | 2.00 | 19.31*** | 3>4 |
| % | 8.70 | 4.00 | 22.50 | 2.40 | |||
Note: Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4. Diagnoses were made using the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Psychological disorders do not represent mutually exclusive categories and so percentages within and across groups sum to more than 100%. Where chi square tests were significant at p<.01, group differences were interpreted as significant if standardised residuals exceeded an absolute value of 2. ***p<.001.
Table 4.15. Current adjustment of participants in four groups who reported suffering differing types of worst abusive experiences in institutions
| Group 1 S&P abuse |
Group 2 P abuse |
Group 3 S Abuse |
Group 4 E Abuse |
ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|---|
| N=23 | N=99 | N=40 | N=85 | ||||
| Total trauma symptoms (TSI) | M | 54.74 | 49.14 | 53.24 | 48.20 | 4.46** | 1,3>4 |
| (N=247) | SD | 8.32 | 10.76 | 9.44 | 9.11 | ||
| Total No of life problems (LPC) | M | 51.06 | 49.66 | 57.46 | 46.59 | 12.37*** | 3>2>4 |
| (N=247) | SD | 10.79 | 8.35 | 11.99 | 8.66 | ||
| Total quality of life (WHOQOL) | M | 47.44 | 50.57 | 49.43 | 50.30 | 0.68 | NS |
| (N=247) | SD | 9.90 | 9.92 | 10.42 | 9.98 | ||
| Global functioning (GAF) | M | 47.67 | 50.26 | 49.22 | 50.73 | 0.66 | NS |
| (N=235) | SD | 7.99 | 10.46 | 10.93 | 9.57 | ||
| Marital satisfaction (KMS) | M | 24.16 | 30.38 | 32.49 | 25.72 | 0.89 | NS |
| (N=136) | SD | 20.89 | 21.33 | 23.57 | 19.46 | ||
| Parental satisfaction (KPS) | M | 48.35 | 49.15 | 48.96 | 49.85 | 0.12 | NS |
| (N=212) | SD | 11.91 | 11.20 | 11.04 | 11.36 | ||
Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where it was severe physical abuse. Group 3 contained 40 cases where it was severe sexual abuse. Group 4 contained 85 cases where it was severe emotional abuse. Participants’ statements were classified as severe physical abuse if they reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. Details of statements are in Table 3.4. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KMS means and SDs are based on the number of participants who lived with partners (N=136). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). KPS means and SDs are based on the number of participants with children (N=212). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. **p<0.01 ***p<0.001. NS=Not significant.
Table 4.16. Profiles of 4 groups of participants who reported suffering differing types of worst abusive experiences in institutions
| Group 1 Severe Sexual and Physical Abuse |
Group 2 Severe Physical Abuse |
Group 3 Severe Sexual Abuse |
Group 4 Severe Emotional Abuse |
|
|---|---|---|---|---|
| PAST HISTORY & DEMOGRAPHICS | ||||
| Few years with family before entry | + | – | 0 | + |
| Many years in institution | – | – | 0 | + |
| Entry reason | ||||
| Through courts for petty crime | – | – | + | 0 |
| Institution management | ||||
| Nuns | – | – | 0 | + |
| Religious brothers & priests | – | – | + | 0 |
| Mixed feelings leaving | – | – | 0 | + |
| Gender | ||||
| Male | – | – | + | 0 |
| Female | – | – | 0 | + |
| AGE | ||||
| Older (60s) | 0 | + | 0 | – |
| Lower educational achievement | 0 | + | – | 0 |
| Parent-child living arrangements | ||||
| Children spent time living with other parent | + | – | + | 0 |
| Children put up for adoption | – | + | – | – |
| INSTITUTIONAL ABUSE | ||||
| Physical institutional abuse | + | – | – | 0 |
| Sexual institutional abuse | + | – | + | – |
| Worst thing began at an early age | – | – | 0 | + |
| Worst thing lasted a long time | – | + | 0 | + |
| ADULT PSYCHOLOGICAL ADJUSTMENT | ||||
| Psychological disorders | ||||
| Posttraumatic stress disorder, current | + | – | + | – |
| Alcohol & Substance use, lifetime | – | – | + | 0 |
| Antisocial personality disorder | – | – | + | 0 |
| Multiple trauma symptoms | + | – | + | 0 |
| Multiple life problems | – | 0 | + | 0 |
Note: +=the feature was a significant feature of the group profile. 0=the feature was not a significant element of the group profile. – a moderate level of the feature characterized the groups profile.
Part 5 Profiles of groups with different patterns of psychological disorders
Summary of Part 5
3.217There was an association between having psychological disorders and reporting both institutional and family-based child abuse and neglect. Certain patterns of psychological disorders were associated with institutional abuse alone, and other patterns were associated with institutional family-based child abuse and neglect. For participants with multiple co-morbid diagnoses, and for those with mood disorders, greater institutional, but not family-based physical, sexual and emotional abuse was reported. Participants with PTSD, alcohol and substance use disorders, avoidant and antisocial personality disorder reported both institutional and family-based abuse or neglect. Participants with multiple diagnoses had the poorest adult psychological adjustment and those with no diagnoses were the best adjusted. Subgroups selected by diagnosis showed an intermediate level of adult psychological adjustment between these extremes. What follows are brief profiles of groups with different patterns or types of psychological disorders.
3.218Multiple comorbid diagnoses. Participants with 4 or more diagnoses reported greater institutional sexual and emotional abuse (but not more family-based abuse) than participants with fewer diagnoses. Participants with 4 or more diagnoses had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with 1-3 diagnoses, who in turn were less well adjusted than participants with no diagnoses. More participants with 4 or more diagnoses had a fearful adult attachment style, and fewer had secure or dismissive adult attachment styles. On average more participants with 4 or more diagnoses were in their 50s compared with those with no diagnoses who where were in their 60s. Also, more participants with 4 or more diagnoses were unemployed and of lower SES than participants with fewer diagnoses.
3.219Mood disorders. Participants with mood disorders, more than half of whom had co-morbid anxiety disorders, reported greater institutional sexual and emotional abuse and greater institutional severe physical and sexual abuse (but not family-based child abuse) than participants with no diagnoses. Participants with mood disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. More participants with mood disorders had a fearful adult attachment style, and fewer had a secure adult attachment style. On average participants with mood disorders were in their late 50s while those with no diagnoses were in their 60s. Also, on average, participants with mood disorders had had their first child in their mid-20s, while those with no diagnoses had their first children a couple of years later.
3.220Posttraumatic stress disorder. Participants with PTSD, more than half of whom had other co-morbid anxiety disorders and alcohol or substance use disorders, reported greater institutional physical, sexual and emotional abuse, and greater institutional severe physical and sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based emotional abuse. Participants with PTSD had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Fewer participants with PTSD had a dismissive adult attachment style. On average participants with PTSD were in their 50s while those with no disorders were in their 60s.
3.221Alcohol and substance use disorders. Participants with alcohol and substance use disorders, more than half of whom had a co-morbid anxiety disorder, reported greater institutional sexual and emotional abuse, and greater institutional severe sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based physical and emotional abuse. Participants with alcohol and substance use disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Compared with those with no diagnoses, participants with alcohol and substance use disorders were younger (in their 50s not their 60s); had had their first children at a younger age (in early, not their late 20s); were of lower SES; and fewer had entered an institution because their parents had died.
3.222Avoidant personality disorder. Participants with avoidant personality disorders reported greater institutional and family-based emotional abuse than those with no diagnoses. Almost all participants with an avoidant personality disorder had a co-morbid anxiety, mood or substance use disorder. Participants with avoidant personality disorder had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Compared to those with no diagnoses, more participants with an avoidant personality disorder had a fearful adult attachment style and fewer had a secure adult attachment style. Compared to participants with no diagnoses, participants with avoidant personality disorder were younger (in their 50s, not their 60s) and more had been placed in institutions run by nuns because their parents could not care for them.
3.223Antisocial personality disorder. Participants with antisocial personality disorder reported greater institutional sexual abuse than participants with no diagnoses. All participants with antisocial personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with antisocial personality disorder had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and lower parental satisfaction than participants with no diagnoses. Compared to those with no diagnoses, participants with antisocial personality disorder were younger (in their 50s, not their 60s); had spent fewer years in institutions (5 1/2 not nearly 10 years); more were unemployed; and more were of low SES.
3.224Borderline personality disorder. Participants with borderline personality disorder and those with no diagnoses, did not differ in their reported levels of institutional or family-based child abuse, although both reported a high level of child abuse. All participants with borderline personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with borderline personality disorders had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and more had a fearful adult attachment style than participants with no diagnoses. Compared to those with no diagnoses, participants with borderline personality disorder were younger (in their 50s, not 60s), more were unemployed, and on average reported being abused from an earlier age.
Introduction
3.225Recollections of both institutional and family-based child abuse by adult survivors of institutional living with varying patterns of psychological disorders are the main focus of this Part. In addition, profiles of subgroups of cases with varying patterns of psychological disorders are presented with respect to their trauma symptoms, life problems, quality of life, global functioning, relationships, adult attachment styles and demographic characteristics. A number of specific questions were addressed:
1.Do adult survivors of institutional living with many co-morbid diagnoses report more institutional and family-based child abuse compared to those with few or no diagnoses and what are the profiles of groups with many, few and no diagnoses?
2.Do adult survivors of institutional living with mood disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with mood disorders?
3.Do adult survivors of institutional living with posttraumatic stress disorder (PTSD) report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with PTSD?
4.Do adult survivors of institutional living with alcohol and substance use disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with alcohol and substance use disorders?
5.Do adult survivors of institutional living with personality disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with personality disorders?
Statistical analysis strategy
3.226The results of analyses conducted to address these questions will be presented in five sections, corresponding to the five questions. There are sections on multiple disorders, mood disorders, PTSD, substance use disorders and personality disorders. In answering the questions addressed in this Part, the following strategy was used in all statistical analyses. For categorical variables, chi square tests were conducted with p values set conservatively at p<.01 to reduce the probability of type 1 error (misinterpreting spurious group differences as significant). Where chi square tests were significant at p<.01, group differences were interpreted as significant if standardised residuals in table cells exceeded an absolute value of 2. For continuous variables, to control for type 1 error, where possible multivariate analyses of variance (MANOVAs) were conducted on groups of conceptually related variables. Where MANOVAs were significant at p<.05, specific variables on which groups differed at a significance level of p<.01 were identified by conducting one-way analyses or variance (ANOVAs) or t-tests. t-tests were used where only two groups were compared and ANOVAs were used where comparisons involved more than two groups. Scheffe post-hoc comparison tests for designs with unequal cell sizes were conducted to identify significant intergroup differences in those instances where ANOVAs yielded significant F values. Dunnett’s test was used instead of Scheffe’s, where the assumption of homogeneity of variance was violated. In addition to these parametric analyses of continuous variables, in those instances where dependent variables were not normally distributed, non-parametric Kruskall Wallace (for 3 groups) or Mann Whitney (for two groups) tests were conducted as well as ANOVAs. If these non-parametric tests yielded results that differed from those of the ANOVAs, these were reported. For continuous variables where MANOVAs were not conducted, because there were no grounds for conceptually grouping variables, to control for type 1 error, t-tests or ANOVAs were interpreted as statistically significant if p<.01. For the TSI and the WHOQOL, which are multiscale instruments, unless the pattern of subscale scores differed greatly from that of total scores, for brevity, only analyses of total scores are reported. To facilitate interpretation of profiles of tabulated means, all psychological variables on continuous scales were transformed to T-scores (with means of 50 and standard deviations of 10) before analyses were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X.
Multiple co-morbid psychological diagnoses
3.227In this section results are presented of analyses which address the question: Do adult survivors of institutional living, with many co-morbid diagnoses report more institutional and family-based child abuse compared to those with few or no diagnoses and what are the profiles of groups with many, few and no diagnoses? To address this question cases were classified into three groups. Group 1 contained 83 cases with four or more current or lifetime diagnoses as assessed with the SCID I and SCID II, while none of the 45 cases in group 3 had any current or lifetime diagnoses. 119 participants with 1 to 3 current or lifetime diagnoses were assigned to group 2.
3.228From Table 5.1. it may be seen that compared with groups 2 and 3, group 1 obtained significantly higher mean scores on the IAS; the total, sexual and emotional abuse scales of the institutional version of the CTQ; and on the total and sexual severe abuse scales of the institutional version of the SPSA.
3.229The MANOVA for the scales and subscales of the family versions of the CTQ and SPSA was not significant, so it was concluded that there were no significant differences between scores of the three groups on family versions of the CTQ or SPSA.
3.230From Table 5.2 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2, which in turn were significantly higher than those of group 3. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2, which in turn were significantly lower than those of group 3. These results show that, participants with 4 or more diagnoses had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with 1-3 diagnoses, who in turn were less well adjusted than participants with no diagnoses.
3.231From Table 5.3 it may be seen that on the ECRI compared with groups 2 and 3, significantly more members of group 1 had a fearful adult attachment style, and significantly fewer had secure or dismissive adult attachment styles.
3.232On demographic variables, significant group differences occurred for age (Group 1: M= 57.64; Group 2: M = 60.37; Group 3: = 63.67; F (2, 244) = 8.26, p<.001; Group 3>Group 1); currently unemployed (Group 1: 36.4%; Group 2: 22.7%; Group 3: 11.10%; Chi Square (8, N=247) = 20.62, p<.01; Group 1>Group 2 & Group 3); achieving a skilled manual SES level (Group 1: 7.79%; Group 2: 12.39%; Group 3: 24.44%; Chi Square (8, N=247) = 20.37, p<.01; Group 3>Group 1 & Group 2); and achieving a lower professional or managerial SES level (Group 1: 6.49%; Group 2: 19.47%; Group 3: 24.44%; Chi Square (8, N=247) = 20.37, p<.01; Group 1< Group 2 & Group 3). These results show that group 1 was younger than group 3; more members of group 1 were unemployed; and their highest achieved SES level was lower than that of the other two groups.
3.233Summary. Participants with 4 or more diagnoses, reported greater institutional sexual and emotional abuse than participants with fewer diagnoses. However, those with 4 or more diagnoses did not report experiencing more family-based child abuse or neglect. Participants with 4 or more diagnoses had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with 1-3 diagnoses, who in turn were less well adjusted than participants with no diagnoses. More participants with 4 or more diagnoses had a fearful adult attachment style, and fewer had secure or dismissive adult attachment styles. On average more participants with 4 or more diagnoses were in their 50s compared with those with no diagnoses who where were in their 60s. Also, more participants with 4 or more diagnoses were unemployed and of lower SES than participants with fewer diagnoses.
Mood disorders
3.234In this section results are presented of analyses which address the question: Do adult survivors of institutional living with mood disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with mood disorders? To address this question 142 cases with a diagnosis of lifetime or current major depression or current dysthymia were compared with those with no current or lifetime anxiety, mood, substance use or personality disorders. Among the142 participants with mood disorders, comorbid disorders were common. More than half (57%) had a current anxiety disorder; 44% had a current or lifetime alcohol and substance use disorder; and 38% had a personality disorder.
3.235From Table 5.4 it may be seen that compared with group 2, group 1 obtained significantly higher mean scores on the total, sexual and emotional abuse scales of the institution version of the CTQ, and on the total, physical and sexual severe abuse scales of the institutional version of the SPSA. The MANOVA for the scales and subscales of the family versions of the CTQ and SPSA was not significant, so it was concluded that there were no significant differences between scores of the three groups on family versions of the CTQ or SPSA.
3.236From Table 5.5 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with mood disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses.
3.237From Table 5.6 it may be seen that on the ECRI compared with group 2, significantly more members of group 1 had a fearful adult attachment style, and significantly fewer had a secure adult attachment style.
3.238On demographic variables, significant group differences occurred for age (Group 1 M= 59.18, Group 2 M = 63.67, t(245) = 3.19, p<.01), and age when first child was born (Group 1 M= 24.90, Group 2 M = 27.71, t(159) = 2.69, p<.01). These results show that on average participants in group 1 were in their late 50s, while those in group 2 were in their 60s. Also, on average participants in group 1 had their first child in their mid-20s, while those in group 2 had their first children a couple of years later.
3.239Summary. Participants with mood disorders, more than half of whom had co-morbid anxiety disorders, reported greater institutional sexual and emotional abuse; and greater institutional severe physical and sexual abuse than participants with no diagnoses. However, those with mood disorders did not report experiencing more family-based child abuse or neglect. Participants with mood disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. More participants with mood disorders had a fearful adult attachment style, and fewer had a secure adult attachment style. On average participants with mood disorders were in their late 50s while those with no diagnoses were in their 60s. Also, on average participants with mood disorders had had their first child in their mid-20s, while those with no diagnoses had their first children a couple of years later.
Posttraumatic stress disorder
3.240In this section results are presented of analyses which address the question: Do adult survivors of institutional living with posttraumatic stress disorder (PTSD) report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with PTSD? To address this question 63 cases with a diagnosis of lifetime or current PTSD were compared with 45 cases with no current or lifetime mood, anxiety, substance use or personality disorders. Among the 63 participants with PTSD comorbid disorders were common. More than three quarters (77%) had another current anxiety disorder; 55% had a lifetime diagnosis of any anxiety disorder; 50% had a lifetime diagnosis of alcohol and substance use disorder; 47% had a lifetime diagnosis of a mood disorder; and 41% had a personality disorder.
3.241From Table 5.7 it may be seen that compared with group 2, group 1 obtained significantly higher mean scores on the IAS; the total, physical, sexual and emotional abuse scales of the institution version of the CTQ; and on the total, physical and sexual severe abuse scales of the institutional version of the SPSA. Compared with group 2, group 1 also obtained significantly higher mean scores on the emotional abuse scale of the family version of the CTQ and the total scale of the family version of the SPSA. However, cautious interpretation of scores from the family version of the SPSA is warranted because of the low reliability of the total and physical severe abuse scores from this instrument, mentioned in Part 3 and documented in Table 3.11.
3.242From Table 5.8 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with PTSD disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses.
3.243From Table 5.9 it may be seen that on the ECRI compared with group 2, significantly fewer members of group 1 had a dismissive adult attachment style.
3.244The only demographic variable on which the groups differed significantly was age (Group 1 M = 57.49, Group 2 M = 63.67, t(106) = 3.97, p<.01). On average participants with PTSD were in their 50s, while those with no diagnoses were in their 60s.
3.245Summary. Participants with PTSD, more than half of whom had other co-morbid anxiety disorders and alcohol or substance use disorders, reported greater institutional physical, sexual and emotional abuse; and greater institutional severe physical and sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based emotional abuse. Participants with PTSD had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Fewer participants with PTSD had a dismissive adult attachment style. On average participants with PTSD were in their 50s while those with no disorders were in their 60s.
Substance abuse
3.246In this section, results are presented of analyses which address the question: Do adult survivors of institutional living with alcohol and substance use disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with alcohol and substance use disorders? To address this question 99 cases with a current or lifetime diagnosis of an alcohol or substance use disorder were compared with 45 cases with no diagnosis. Among the 99 participants with alcohol or substance use disorders, comorbid disorders were common. More than half (54%) had a current anxiety disorder, 48% had a lifetime diagnosis of any anxiety disorder, 39% had a current or lifetime diagnosis of a mood disorder, and 39% had a personality disorder.
3.247From Table 5.10 it may be seen that compared with group 2, group 1 obtained significantly higher mean scores on the IAS; the total, sexual and emotional abuse scales of the institution version of the CTQ; and the total and sexual severe abuse scales of the institutional version of the SPSA. Compared with group 2, group 1 obtained significantly higher mean scores on the physical and emotional abuse scales of the family version of the CTQ, and on the total scale of the family version of the SPSA. However, cautious interpretation of scores from the family version of the SPSA is warranted because of the low reliability of the total and physical severe abuse scores from this instrument, mentioned in Part 3 and documented in Table 3.11.
3.248From Table 5.11 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with alcohol and substance use disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses.
3.249With respect to demographic and historical variables the groups differed significantly on age (Group 1: M = 58.25, Group 2: M = 63.67, t(106) = 3.94, p<.01); age when first child was born (Group 1 M= 24.73, Group 2 M = 27.71, t(142) = 2.80, p<.01); current membership of an SES group of skilled manual work or higher (Group 1: 6.30%, Group 2: 22.20%, Chi Square (4, N=144) = 15.37, p<.001); membership of an SES group higher than skilled manual work since leaving school (Group 1: 4.40%, Group 2: 24.40%, Chi Square (4, N=144) = 22.80, p<.0001); and entering an institution because their parents died (Group 1: 8.20%, Group 2: 25.60%, Chi Square (3, N=144) = 15.01, p<.01). These results show that compared with group 2, participants in group 1 were in their 50s (not their 60s); had had their first children in their early 20s (not their late 20s); were of lower SES; and fewer had entered an institution because their parents had died.
3.250Summary. Participants with alcohol and substance use disorders, more than half of whom had a co-morbid anxiety disorder, reported greater institutional sexual and emotional abuse; and greater institutional severe sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based physical and emotional abuse. Participants with alcohol and substance use disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Compared with those with no diagnoses, participants with alcohol and substance use disorders were younger (in their 50s not their 60s); had had their first children in their earlier (in early, not their late 20s); were of lower SES; and fewer had entered an institution because their parents had died.
Personality disorders
3.251In this section results are presented of analyses which address the question: Do adult survivors of institutional living with personality disorders report more institutional and family-based child abuse compared to those with no diagnoses and what is the profile of participants with personality disorders? A series of analyses were conducted to address this question in which cases with personality disorders were compared with cases with no diagnoses. 75 participants had a personality disorder; 52 had avoidant personality disorder; 17 had antisocial personality disorder; 14 had borderline personality disorder; and 4 had dependent personality disorder. 9 cases had two or more comorbid personality disorders. In the three larger groups, there were 48 with avoidant personality disorder only; 10 with antisocial personality disorder only; and 6 with borderline personality disorder only. In view of this pattern of single and co-morbid personality disorder diagnoses, it was decided that cell sizes would be too small to validly compare profiles of three largest groups with distinct personality disorders. Instead, three separate analyses were conducted. In the first of these, 52 cases with avoidant personality disorder were compared with 45 cases with no diagnosis. In the second, 17 cases with antisocial personality disorder were compared with 45 cases with no diagnosis. In the third, 14 cases with borderline personality disorder were compared with 45 cases with no diagnosis.
Avoidant personality disorder
3.252From Table 5.12 it may be seen that compared with group 2, group 1 obtained significantly higher mean scores on the emotional abuse scale of the institution and family versions of the CTQ.
3.253Among the 52 cases with avoidant personality disorder, comorbid disorders were common. Almost all cases (98%) had a co-morbid anxiety, mood or substance use disorder. Just over three quarters (78.8%) had a current anxiety disorder. Just over half had a current mood disorder (53.8%). And just over a third (36.5%) had a lifetime diagnosis of a substance use disorder.
3.254From Table 5.13 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with avoidant personality disorder had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses.
3.255From Table 5.14 it may be seen that on the ECRI compared with group 2, significantly more members of group 1 had a fearful adult attachment style and significantly fewer members of group 1 had a secure adult attachment style.
3.256With respect to demographic and historical variables, the groups differed significantly on age (Group 1: M = 57.90, Group 2: M = 63.67, t(95) = 2.31, p<.01); being placed in an institution because their parents could not provide care (Group 1: 64.00%, Group 2: 20.93%, Chi Square (3, N=97) = 18.08, p<.0001); and placement in an institution run by nuns (Group 1: 61.5%, Group 2: 42.2%, Chi Square (2, N=97) = 11.41, p<.01). These results show that compared with group 2, participants in group 1 were in their 50s (not their 60s); more had been placed in an institution because their parents could not care for them; and more were placed in an institution run by nuns.
3.257Summary. Participants with avoidant personality disorders reported greater institutional and family-based emotional abuse than those with no diagnoses. Almost all participants with an avoidant personality disorder had a co-morbid anxiety, mood or substance use disorder. Participants with avoidant personality disorder had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Compared to those with no diagnoses, more participants with an avoidant personality disorder had a fearful adult attachment style and fewer had a secure adult attachment style. Compared to participants with no diagnoses, participants with avoidant personality disorder were younger (in their 50s, not their 60s) and more had been placed in institutions run by nuns because their parents could not care for them.
Antisocial personality disorder
3.258From Table 5.15 it may be seen that compared with group 2, group 1 obtained significantly higher mean scores on the total and sexual abuse scales of the institution version of the CTQ, and on the severe sexual abuse scale of the institution version of the SPSA.
3.259All 17 participants with antisocial personality disorder had co-morbid anxiety, mood or substance use disorders. Just over three quarters (76.5%) had a lifetime diagnosis of substance use disorder. 70% had a current anxiety disorder and 64% had a lifetime diagnosis of an anxiety disorder. 41% had had a mood disorder at some point in their life. Just over a third (35.3%) had comorbid borderline personality disorder.
3.260From Table 5.16 it may be seen that for the total number of Trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL, the GAF, and the KPS the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with antisocial personality disorder had more trauma symptoms and life problems; and a lower quality of life, global level of functioning, and parental satisfaction than participants with no diagnoses.
3.261With respect to demographic variables, the groups differed on age (Group 1: M = 57.24, Group 2: M = 63.67, t(60) = 2.98, p<.01); number of years spent in an institution (Group 1: M = 5.56, Group 2: M = 9.86, t(60) = 3.28, p<.01); currently unemployed (Group 1: 56.30%, Group 2: 11.10%, Chi Square (4, N=62) = 15.17, p<.01); and membership of a higher SES group than skilled workers since leaving school (Group 1: 0%, Group 2: 24.44%, Chi Square (3, N=62) = 11.45, p<.01). These results show that compared to those with no diagnoses, participants with antisocial personality disorder were younger (in their 50s, not their 60s); had spent fewer years in institutions (five and a half, not nearly 10 years); more were unemployed; and more were of low SES.
3.262Summary. Participants with antisocial personality disorder reported greater institutional sexual abuse than participants with no diagnoses. All participants with antisocial personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with antisocial personality disorder had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and lower parental satisfaction than participants with no diagnoses. Compared to those with no diagnoses, participants with antisocial personality disorder were younger (in their 50s, not their 60s); had spent fewer years in institutions (5 1/2 not nearly 10 years); more were unemployed; and more were of low SES.
Borderline personality disorder
3.263When the significance of differences between scores of participants with borderline personality disorder and no diagnoses was evaluated with MANOVA on indices of both institutional and family-based child abuse, the two groups were found not to differ significantly. The MANOVA on all subscales of the institution versions of the IAS, CTQ, and SPSA was not significant nor was the MANOVA on all subscales of the family versions of the CTQ and SPSA. These results showed that participants with borderline personality disorder and those with no diagnoses, did differ in their reported levels of institutional or family-based child abuse.
3.264All 14 cases of borderline personality disorder had co-morbid anxiety, mood or substance use disorders. Just over three quarters (78.6%) had a current diagnosis of an anxiety disorder. Just over three quarters (78.0%) had a current diagnosis of a mood disorder and half had a lifetime diagnosis of a substance use disorder. 42.9% had comorbid antisocial personality disorder.
3.265From Table 5.17 it may be seen that for the total number of trauma symptoms on the TSI and the total number of life problems on the LPC, the mean scores for group 1 were significantly higher than those of group 2. For the total score on the WHOQOL and the GAF, the mean scores for group 1 were significantly lower than those of group 2. These results show that participants with borderline personality disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses.
3.266From Table 5.18 it may be seen that on the ECRI compared with group 2, significantly more members of group 1 had a fearful adult attachment style.
3.267With respect to demographic and historical variables, the groups differed on age (Group 1: M = 54.54, Group 2: M = 63.67, t(57) = 3.93, p<.0001); current unemployment (Group 1: 53.80%, Group 2: 11.10%, Chi Square (4, N=59) = 19.22, p<.01); and the age when the worst form of abuse began (Group 1: M = 7.04, Group 2: M = 10.42, t(57) = 3.06, p<.01). Compared to those with no diagnoses, participants with borderline personality disorder were younger (in their 50s, not 60s), more were unemployed, and on average reported being abused from an earlier age (from about 7, not 10 years).
3.268Summary. Participants with borderline personality disorder and those with no diagnoses, did not differ in their reported levels of institutional or family-based child abuse, although both reported a high level of child abuse. All participants with borderline personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with borderline personality disorders had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and more had a fearful adult attachment style than participants with no diagnoses. Compared to those with no diagnoses, participants with borderline personality disorder were younger (in their 50s, not 60s), more were unemployed, and on average reported being abused from an earlier age.
Conclusions
3.269Table 5.19 summarizes patterns of institutional and family-based child abuse and neglect reported by participants with multiple co-morbid diagnoses, mood disorders, PTSD, substance use disorders, and personality disorders. The table also profiles the adult psychological adjustment of participants in each of these groups.
3.270The first main conclusion that can be drawn from the table is that there was an association between having psychological disorders and reporting both institutional and family-based child abuse and neglect.
3.271The second conclusion is that certain patterns of psychological disorders were associated with institutional abuse alone, and other patterns were associated with institutional and family-based child abuse and neglect. For participants with multiple co-morbid diagnoses and mood disorders, greater institutional, but not family-based physical, sexual and emotional abuse was reported. Participants with PTSD, alcohol and substance use disorders, avoidant and antisocial personality disorder reported both institutional and family-based abuse or neglect.
3.272A remarkable finding, in this context, was that participants with borderline personality disorder reported similar levels of abuse to participants with no diagnosis, since the link between child abuse and personality disorder is well established. It should be emphasized that normatively the group with no diagnosis had experienced significant abuse, and the profile of the borderline personality disorder group (along with all other profiles in Table 5.19) is relative to the group with no diagnosis, not to a normal control group.
3.273The third main finding was that participants with multiple diagnoses had the poorest adult psychological adjustment and those with no diagnoses were the best adjusted. Subgroups selected by diagnosis showed an intermediate level of adult psychological adjustment between these extremes.
Table 5.1. Recollections of child abuse among participants with 4 or more diagnoses, 1-3 diagnoses and no diagnoses
| Variable | Group 1 4+ Diagnoses |
Group 2 1-3 Diagnoses |
Group 3 0 Diagnoses |
ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|---|
| N=83 | N=119 | N=45 | |||||
| INSTITUTIONAL ABUSE | |||||||
| IAS >(N=247) | Specific institutional abuse | M | 52.89 | 49.01 | 47.28 | 5.96** | 1>2,3 |
| SD | 9.65 | 9.91 | 9.80 | ||||
| CTQ-Institution >(N=247) | Total institutional abuse | M | 54.04 | 48.38 | 46.83 | 11.51*** | 1>2,3 |
| SD | 9.37 | 9.37 | 10.58 | ||||
| Physical abuse | M | 52.06 | 49.06 | 48.67 | 2.73 | NS | |
| SD | 9.66 | 10.21 | 9.66 | ||||
| Sexual abuse | M | 53.69 | 48.23 | 47.92 | 9.06*** | 1>2,3 | |
| SD | 11.25 | 8.92 | 8.42 | ||||
| Emotional abuse | M | 53.46 | 49.32 | 45.43 | 10.73*** | 1>2,3 | |
| SD | 7.46 | 9.75 | 12.48 | ||||
| Physical neglect | M | 51.23 | 49.06 | 50.14 | 1.16 | NS | |
| SD | 9.07 | 10.40 | 10.55 | ||||
| Emotional neglect | M | 51.21 | 49.73 | 48.51 | 1.14 | NS | |
| SD | 9.90 | 10.09 | 9.98 | ||||
| SPSA-Institution >(N=247) | Total severe institutional abuse | M | 51.87 | 49.43 | 48.07 | 7.55** | 1>2,3 |
| SD | 6.50 | 5.41 | 5.03 | ||||
| Severe institutional physical abuse | M | 51.87 | 49.81 | 46.97 | 3.62 | NS | |
| SD | 10.74 | 9.69 | 8.66 | ||||
| Severe institutional sexual abuse | M | 52.78 | 48.85 | 47.85 | 5.23** | 1>2,3 | |
| SD | 10.48 | 9.74 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | |||||||
| CTQ-family (N=121) | Total family abuse score | M | 50.46 | 51.31 | 46.31 | NS | |
| SD | 9.66 | 11.56 | 5.52 | ||||
| Physical abuse | M | 51.20 | 50.63 | 46.37 | NS | ||
| SD | 10.49 | 10.80 | 5.88 | ||||
| Sexual abuse | M | 48.58 | 52.47 | 47.44 | NS | ||
| SD | 5.48 | 14.15 | 1.91 | ||||
| Emotional abuse | M | 50.90 | 51.30 | 45.49 | NS | ||
| SD | 10.55 | 10.95 | 4.10 | ||||
| Physical neglect | M | 50.60 | 49.66 | 49.57 | NS | ||
| SD | 10.32 | 10.17 | 9.34 | ||||
| Emotional neglect | M | 50.28 | 50.72 | 47.91 | NS | ||
| SD | 10.72 | 10.24 | 7.97 | ||||
| SPSA-family >(N=121) | Total severe family abuse | M | 50.82 | 50.99 | 46.37 | NS | |
| SD | 8.78 | 11.94 | 6.64 | ||||
| Severe family physical abuse | M | 51.87 | 49.88 | 46.65 | NS | ||
| SD | 10.37 | 10.18 | 8.24 | ||||
| Severe family sexual abuse | M | 48.39 | 52.46 | 47.77 | NS | ||
| SD | 5.44 | 13.99 | 3.91 | ||||
Note: Group1 had four or more current or lifetime diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had 1-3 current or lifetime diagnoses. Group 3 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analyses of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. For the MANOVA on all subscales of the institution versions of the CTQ, SPSA & the IAS, F (14, 476) = 2.89, p<0.0001. For the MANOVA on all subscales of the family versions of the CTQ and SPSA, F (12, 226) = 1.30, NS. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.2. Current adjustment of participants with 4 or more diagnoses, 1-3 diagnoses and no diagnoses
| Group 1 4+ Diagnoses |
Group 2 1-3 Diagnoses |
Group 3 0 Diagnoses |
ANOVA F |
Group Diffs | ||
|---|---|---|---|---|---|---|
| N=83 | N=119 | N=45 | ||||
| Total trauma symptoms (TSI) | M | 57.74 | 48.51 | 39.66 | 84.28*** | 1>2>3 |
| (N=247) | SD | 7.89 | 8.21 | 5.83 | ||
| Total No of life problems (LPC) | M | 55.73 | 48.27 | 43.99 | 28.92*** | 1>2>3 |
| (N=247) | SD | 10.30 | 8.93 | 6.30 | ||
| Total quality of life (WHOQOL) | M | 42.74 | 52.12 | 57.79 | 54.86*** | 1<2<3 |
| (N=247) | SD | 8.69 | 8.45 | 7.32 | ||
| Global functioning (GAF) | M | 42.98 | 51.40 | 58.87 | 56.43*** | 1<2<3 |
| (N=235) | SD | 9.39 | 8.00 | 6.44 | ||
| Marital satisfaction (KMS) | M | 50.56 | 51.62 | 53.51 | 0.68 | NS |
| (N=136) | SD | 9.98 | 10.90 | 10.26 | ||
| Parental satisfaction (KPS) | M | 47.33 | 50.70 | 49.43 | 1.93 | NS |
| (N=212) | SD | 11.61 | 10.21 | 12.59 | ||
Note: Group1 had four or more current or lifetime diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had 1-3 current or lifetime diagnoses. Group 3 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before ANOVAs were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. F values are from one-way analysis of variance and inter-group differences are based on Scheffe post hoc tests for comparing groups with unequal Ns that were significant at p<.05. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.3. Adult attachment styles of participants with 4 or more diagnoses, 1-3 diagnoses and no diagnoses Table 5.3. Adult attachment styles of participants with 4 or more diagnoses, 1-3 diagnoses and no diagnoses
| Adult Attachment Style |
Group 1 4+ Diagnoses |
Group 2 1-3 Diagnoses |
Group 3 0 Diagnoses |
Group Differences | |
|---|---|---|---|---|---|
| N= 83 | N= 119 | N=45 | |||
| Secure | f | 6.00 | 22.00 | 13.00 | |
| % | 7.20 | 18.50 | 28.90 | 1<2<3 | |
| Dismissive | f | 10.00 | 39.00 | 17.00 | 1<2,3 |
| % | 12.00 | 32.80 | 37.80 | ||
| Fearful | f | 54.00 | 43.00 | 12.00 | |
| % | 65.10 | 36.10 | 26.70 | 1>2,3 | |
| Preoccupied | f | 13.00 | 15.00 | 3.00 | NS |
| % | 15.70 | 12.60 | 6.70 | ||
Note: Group1 had four or more current or lifetime diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had 1-3 current or lifetime diagnoses. Group 3 had no diagnoses. Cases were classified into the four adult attachment styles using the SPSS algorithm for the Experiences in Close Relationships Inventory in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Chi Square (6, N=247) =34.07, p<.001. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant where cell standardised residuals equalled or exceeded an absolute value of 2.00.
Table 5.4. Recollections of child abuse among participants with mood disorders and no diagnoses
| Variable | Group 1 Mood Disorder |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|---|
| N=142 | N=45 | |||||
| INSTITUTIONAL ABUSE | ||||||
| IAS >(N=187) | Specific institutional abuse | M | 51.49 | 47.28 | 2.50 | NS |
| SD | 9.87 | 9.80 | ||||
| CTQ- Institution >(N=187) | Total institutional abuse | M | 52.01 | 46.83 | 3.00** | 1>2 |
| SD | 9.95 | 10.58 | ||||
| Physical abuse | M | 51.04 | 48.67 | 1.37 | NS | |
| SD | 10.32 | 9.66 | ||||
| Sexual abuse | M | 52.07 | 47.92 | 2.71** | 1>2 | |
| SD | 10.45 | 8.42 | ||||
| Emotional abuse | M | 51.64 | 45.43 | 3.10** | 1>2 | |
| SD | 8.97 | 12.48 | ||||
| Physical neglect | M | 50.59 | 50.14 | 0.26 | NS | |
| SD | 10.16 | 10.55 | ||||
| Emotional neglect | M | 50.23 | 48.51 | 0.99 | NS | |
| SD | 10.18 | 9.98 | ||||
| SPSA-Institution >(N=187) | Total severe institutional abuse | M | 51.21 | 48.07 | 3.16** | 1>2 |
| SD | 6.03 | 5.03 | ||||
| Severe institutional physical abuse | M | 50.72 | 46.97 | 2.28** | 1>2 | |
| SD | 9.91 | 8.06 | ||||
| Severe institutional sexual abuse | M | 52.14 | 47.85 | 2.77** | 1>2 | |
| SD | 10.22 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | ||||||
| CTQ-family (N=92) | Total family abuse score | M | 51.88 | 46.31 | NS | |
| SD | 11.60 | 5.52 | ||||
| Physical abuse | M | 51.63 | 46.37 | NS | ||
| SD | 11.43 | 5.88 | ||||
| Sexual abuse | M | 50.70 | 47.44 | NS | ||
| SD | 11.19 | 1.91 | ||||
| Emotional abuse | M | 52.05 | 45.49 | NS | ||
| SD | 11.39 | 4.10 | ||||
| Physical neglect | M | 51.18 | 49.57 | NS | ||
| SD | 10.97 | 9.34 | ||||
| Emotional neglect | M | 51.28 | 47.91 | NS | ||
| SD | 11.06 | 7.97 | ||||
| SPSA-family >(N=92) | Total severe family >abuse | M | 51.41 | 46.37 | NS | |
| SD | 11.32 | 6.64 | ||||
| Severe family physical abuse | M | 51.64 | 46.65 | NS | ||
| SD | 10.77 | 8.24 | ||||
| Severe family sexual abuse | M | 50.19 | 47.77 | NS | ||
| 10.95 | 3.91 | |||||
Note: Group1 had current or lifetime mood disorder diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. For the MANOVA on the total scores of the institution versions of the CTQ, SPSA & the IAS, F (3, 183) = 4.22, p<0.01. For the MANOVA on total scores of the family versions of the CTQ and SPSA, F (2, 89) = 2.65, NS. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.5. Current adjustment of participants with mood disorders and no diagnoses
| Group 1 Mood Disorder |
Group 2 No Diagnosis |
t-value | Group Diffs | ||
|---|---|---|---|---|---|
| N=142 | N=45 | ||||
| Total trauma symptoms (TSI) >(N=187) | M | 53.77 | 39.66 | 12.19*** | 1>2 |
| SD | 9.09 | 5.83 | |||
| Total No of life problems (LPC) (N=187) | M | 52.37 | 43.99 | 6.71*** | 1>2 |
| SD | 9.80 | 6.60 | |||
| Total quality of life (WHOQOL) (N=187) | M | 46.21 | 57.79 | 8.61*** | 1<2 |
| SD | 9.35 | 7.32 | |||
| Global functioning (GAF) (N=180) | M | 46.78 | 58.88 | 7.76*** | 1<2 |
| SD | 9.77 | 6.44 | |||
| Marital satisfaction (KMS) (N=99) | M | 50.09 | 53.51 | 1.47 | NS |
| SD | 10.64 | 10.26 | |||
| Parental satisfaction (KPS) (N=159) | M | 48.49 | 51.50 | 1.58 | NS |
| SD | 10.45 | 9.03 | |||
Note: Group1 had current or lifetime mood disorders as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X.t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.6. Adult attachment styles of participants with mood disorders and no diagnoses Table 5.6. Adult attachment styles of participants with mood disorders and no diagnoses
| Adult Attachment Style |
Group 1 Mood Disorder |
Group 2 No Diagnosis |
Group Diffs | |
|---|---|---|---|---|
| N=142 | N=45 | |||
| Secure | f | 14.00 | 13.00 | 1<2 |
| % | 9.90 | 28.90 | ||
| Fearful | f | 76.00 | 12.00 | 1>2 |
| % | 53.50 | 26.70 | ||
| Preoccupied | f | 19.00 | 3.00 | NS |
| % | 13.40 | 6.70 | ||
| Dismissive | f | 33.00 | 17.00 | NS |
| % | 23.20 | 37.80 | ||
Note: Group1 had current or lifetime mood disorders as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. Cases were classified into the four adult attachment styles using the SPSS algorithm for the Experiences in Close Relationships Inventory in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Chi Square (3, N=187) =17.82, p<.001. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant where cell standardised residuals equalled or exceeded an absolute value of 2.00.
Table 5.7. Recollections of child abuse among participants with PTSD and no diagnoses
| Variable | Group 1 PTSD |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|---|
| N=63 | N=45 | |||||
| INSTITUTIONAL ABUSE | ||||||
| IAS >(N=108) | Specific institutional abuse | M | 52.23 | 47.28 | 2.74*** | 1>2 |
| SD | 8.88 | 9.80 | ||||
| CTQ-Institution >(N=108) | Total institutional abuse | M | 55.47 | 46.83 | 4.59*** | 1>2 |
| SD | 8.92 | 10.58 | ||||
| Physical abuse | M | 54.46 | 48.67 | 3.47** | 1>2 | |
| SD | 7.86 | 9.66 | ||||
| Sexual abuse | M | 54.61 | 47.92 | 3.55** | 1>2 | |
| SD | 11.18 | 8.42 | ||||
| Emotional abuse | M | 53.46 | 45.43 | 3.91*** | 1>2 | |
| SD | 6.95 | 12.48 | ||||
| Physical neglect | M | 51.58 | 50.14 | 0.72 | NS | |
| SD | 9.97 | 10.55 | ||||
| Emotional neglect | M | 52.12 | 48.51 | 1.83 | NS | |
| SD | 10.14 | 9.98 | ||||
| SPSA-Institution >(N=108) | Total severe institutional abuse | M | 52.87 | 48.07 | 4.32*** | 1>2 |
| SD | 6.12 | 5.03 | ||||
| Severe institutional physical abuse | M | 52.80 | 46.97 | 3.25** | 1>2 | |
| SD | 9.54 | 8.06 | ||||
| Severe institutional sexual abuse | M | 54.33 | 47.85 | 3.42** | 1>2 | |
| SD | 10.40 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | ||||||
| CTQ-family (N=57) | Total family abuse score | M | 51.53 | 46.31 | 2.56 | NS |
| 9.75 | 5.52 | |||||
| Physical abuse | M | 51.93 | 46.37 | 2.62 | NS | |
| SD | 10.06 | 5.88 | ||||
| Sexual abuse | M | 50.31 | 47.44 | 1.61 | NS | |
| SD | 10.02 | 1.91 | ||||
| Emotional abuse | M | 51.48 | 45.49 | 2.97** | 1>2 | |
| SD | 10.54 | 4.10 | ||||
| Physical neglect | M | 51.02 | 49.57 | 0.51 | NS | |
| SD | 11.47 | 9.34 | ||||
| Emotional neglect | M | 51.46 | 47.91 | 1.39 | NS | |
| SD | 11.31 | 7.97 | ||||
| SPSA-family >(N=57) | Total severe family abuse | M | 52.67 | 46.37 | 2.85** | 1>2 |
| SD | 10.03 | 6.64 | ||||
| Severe family physical abuse | M | 53.32 | 46.65 | 2.65 | NS | |
| SD | 10.74 | 8.24 | ||||
| Severe family sexual abuse | M | 49.99 | 47.77 | 1.30 | NS | |
| SD | 8.71 | 3.91 | ||||
Note: Group1 had current or lifetime PTSD diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. For the MANOVA on the total scores of the institution versions of the CTQ, SPSA & the IAS, F (3, 104) = 8.04, p<0.001. For the MANOVA on total scores of the family versions of the CTQ and SPSA, F (2, 54) = 3.84, p<0.05. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.8. Current adjustment of participants with PTSD and no diagnoses
| Group 1 PTSD |
Group 2 No Diagnosis |
t-value | Group Diffs | ||
|---|---|---|---|---|---|
| N=63 | N=45 | ||||
| Total trauma symptoms (TSI) (N=108) | M | 55.32 | 39.66 | 11.37*** | 1>2 |
| SD | 8.48 | 5.83 | |||
| Total No of life problems (LPC) (N=108) | M | 52.63 | 43.99 | 5.28*** | 1>2 |
| SD | 5.28 | 6.30 | |||
| Total quality of life (WHOQOL) (N=108) | M | 45.25 | 57.79 | 7.66*** | 1<2 |
| SD | 9.06 | 7.32 | |||
| Global functioning (GAF) (N=103) | M | 45.27 | 58.88 | 8.07*** | 1<2 |
| SD | 9.79 | 6.44 | |||
| Marital satisfaction (KMS) (N=66) | M | 53.05 | 53.51 | 0.18 | NS |
| SD | 9.78 | 10.26 | |||
| Parental satisfaction (KPS) (N=90) | M | 48.72 | 51.50 | 1.27 | NS |
| SD | 10.99 | 9.03 | |||
Note: Group1 had current or lifetime PTSD as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.9. Adult attachment styles of participants with PTSD and no diagnoses Table 5.9. Adult attachment styles of participants with PTSD and no diagnoses
| Adult Attachment Style |
Group 1 PTSD |
Group 2 No Diagnosis |
Group Diffs | |
|---|---|---|---|---|
| N=63 | N=45 | |||
| Secure | f | 9.00 | 13.00 | NS |
| % | 14.30 | 28.90 | ||
| Fearful | f | 36.00 | 12.00 | NS |
| % | 57.10 | 26.70 | ||
| Preoccupied | f | 10.00 | 3.00 | NS |
| % | 15.90 | 6.70 | ||
| Dismissive | f | 8.00 | 17.00 | 1<2 |
| % | 12.70 | 37.80 | ||
Note: Group1 had current or lifetime PTSD as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. Cases were classified into the four adult attachment styles using the SPSS algorithm for the Experiences in Close Relationships Inventory in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Chi Square (3, N=108) =17.22, p<.001. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant where cell standardised residuals equalled or exceeded an absolute value of 2.00.
Table 5.10. Recollections of child abuse among participants with alcohol and substance use disorders and no diagnoses
| Variable | Group 1 Alcohol and Substance use Disorders |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|---|
| N=99 | N=45 | |||||
| INSTITUTIONAL ABUSE | ||||||
| IAS >(N=144) | Specific institutional abuse | M | 51.83 | 47.28 | 2.65** | 1>2 |
| SD | 9.49 | 9.80 | ||||
| CTQ-Institution >(N=144) | Total institutional abuse | M | 52.71 | 46.83 | 3.21** | 1>2 |
| SD | 10.03 | 10.58 | ||||
| Physical abuse | M | 51.43 | 48.67 | 1.55 | NS | |
| SD | 10.00 | 9.66 | ||||
| Sexual abuse | M | 53.53 | 47.92 | 3.39** | 1>2 | |
| SD | 10.69 | 8.42 | ||||
| Emotional abuse | M | 51.15 | 45.43 | 2.76** | 1>2 | |
| SD | 9.10 | 12.48 | ||||
| Physical neglect | M | 50.80 | 50.14 | 0.38 | NS | |
| SD | 9.40 | 10.55 | ||||
| Emotional neglect | M | 49.89 | 48.51 | 0.77 | NS | |
| SD | 10.00 | 9.98 | ||||
| SPSA-Institution >(N=144) | Total severe institutional abuse | M | 51.66 | 48.07 | 3.40** | 1>2 |
| SD | 6.22 | 5.03 | ||||
| Severe institutional physical abuse | M | 49.62 | 46.97 | 1.50 | NS | |
| SD | 10.29 | 8.06 | ||||
| Severe institutional sexual abuse | M | 53.90 | 47.85 | 3.57*** | 1>2 | |
| SD | 9.75 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | ||||||
| CTQ-family | Total family abuse score† >(N=87) | M | 50.80 | 46.31 | 2.70** | |
| SD | 9.70 | 5.52 | Z=1.8 | NS | ||
| Physical abuse | M | 52.18 | 46.37 | 3.15** | 1>2 | |
| SD | 11.15 | 5.88 | ||||
| Sexual abuse | M | 50.10 | 47.44 | 2.10 | NS | |
| SD | 9.58 | 1.91 | ||||
| Emotional abuse | M | 50.39 | 45.49 | 3.27** | 1>2 | |
| SD | 9.84 | 4.10 | ||||
| Physical neglect | M | 50.20 | 49.57 | 0.28 | NS | |
| SD | 9.48 | 9.34 | ||||
| Emotional neglect | M | 50.59 | 47.91 | 1.15 | NS | |
| SD | 10.26 | 7.97 | ||||
| SPSA-family >(N=87) | Total severe family abuse | M | 51.80 | 46.37 | 2.91** | 1>2 |
| SD | 10.18 | 6.64 | ||||
| Severe family physical abuse | M | 52.18 | 46.65 | 2.57 | NS | |
| SD | 10.70 | 8.24 | ||||
| Severe family sexual abuse | M | 50.08 | 47.77 | 1.62 | NS | |
| SD | 9.31 | 3.91 | ||||
Note: Group1 had current or lifetime diagnoses of alcohol or substance use disorders as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. For the MANOVA on the total scores of the institution versions of the CTQ, SPSA & the IAS, F (3, 140) = 4.63, p<0.01. For the MANOVA on total scores of the family versions of the CTQ and SPSA, , F (2, 141) =3.77, p<0.05. †Scores on the family version of the CTQ total scale violated the t-test assumption of normality and a Mann Whitney indicated that the intergroup differences on this variable were not statistically significant (Z=1.8, p>.05), so the significant t-test result may be disregarded. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.11. Current adjustment of participants with alcohol and substance use and no diagnoses
| Group 1 Alcohol and Substance use Disorders |
Group 2 No Diagnosis |
t-value | Group Diffs | ||
|---|---|---|---|---|---|
| N=99 | N=45 | ||||
| Total trauma symptoms (TSI) (N=144) | M | 54.93 | 39.66 | 12.23*** | 1>2 |
| SD | 8.93 | 5.83 | |||
| Total No of life problems (LPC) (N=144) | M | 56.41 | 43.99 | 8.95*** | 1>2 |
| SD | 10.17 | 6.30 | |||
| Total quality of life (WHOQOL) (N=144) | M | 46.64 | 57.79 | 7.48*** | 1<2 |
| SD | 10.09 | 7.32 | |||
| Global functioning (GAF) (N=136) | M | 46.59 | 58.88 | 8.73*** | 1<2 |
| SD | 9.82 | 6.44 | |||
| Marital satisfaction (KMS) (N=83) | M | 52.31 | 53.51 | 0.52 | NS |
| SD | 9.75 | 10.26 | |||
| Parental satisfaction (KPS) >(N=123) | M | 47.92 | 51.50 | 1.73 | NS |
| SD | 11.09 | 9.03 | |||
Note: Group1 had current or lifetime alcohol or substance use disorders as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169).To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.12. Recollections of child abuse among participants with avoidant personality disorder and no diagnoses
| Variable |
Group 1 Avoidant Personality Disorder |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|---|
| N=52 | N=45 | |||||
| INSTITUTIONAL ABUSE | ||||||
| IAS >(N=97) | Specific institutional abuse | M | 51.76 | 47.28 | 2.28 | NS |
| SD | 9.58 | 9.80 | ||||
| CTQ-Institution >(N=97) | Total institutional abuse | M | 50.41 | 46.83 | 1.89 | NS |
| SD | 8.12 | 10.58 | ||||
| Physical abuse | M | 50.86 | 48.67 | 1.15 | NS | |
| SD | 9.13 | 9.66 | ||||
| Sexual abuse | M | 49.50 | 47.92 | 0.83 | NS | |
| SD | 10.05 | 8.42 | ||||
| Emotional abuse | M | 51.58 | 45.43 | 2.84** | 1>2 | |
| SD | 7.96 | 12.48 | ||||
| Physical neglect | M | 48.25 | 50.14 | 0.99 | NS | |
| SD | 8.36 | 10.55 | ||||
| Emotional neglect | M | 51.38 | 48.51 | 1.42 | NS | |
| SD | 9.93 | 9.98 | ||||
| SPSA-Institution >(N=97) | Total severe institutional abuse | M | 49.95 | 48.07 | 1.71 | NS |
| SD | 5.67 | 5.03 | ||||
| Severe institutional physical abuse | M | 51.40 | 46.97 | 2.40 | NS | |
| SD | 9.38 | 8.66 | ||||
| Severe institutional sexual abuse | M | 48.87 | 47.85 | 0.52 | NS | |
| SD | 10.35 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | ||||||
| CTQ-family (N=45) | Total family abuse score | M | 53.36 | 46.31 | 2.66 | NS |
| SD | 46.31 | 5.52 | ||||
| Physical abuse | M | 50.63 | 46.37 | 1.67 | NS | |
| SD | 10.31 | 5.88 | ||||
| Sexual abuse | M | 50.06 | 47.44 | 1.49 | NS | |
| SD | 7.88 | 1.91 | ||||
| Emotional abuse | M | 54.32 | 45.49 | 3.33** | 1>2 | |
| SD | 11.53 | 4.10 | ||||
| Physical neglect | M | 52.90 | 49.57 | 1.02 | NS | |
| SD | 12.46 | 9.34 | ||||
| Emotional neglect | M | 55.61 | 47.91 | 2.51 | NS | |
| SD | 11.91 | 7.97 | ||||
| SPSA-family >(N=45) | Total severe family abuse | M | 49.87 | 46.37 | 1.49 | NS |
| SD | 8.78 | 6.64 | ||||
| Severe family physical abuse | M | 50.37 | 46.65 | 1.34 | NS | |
| SD | 10.13 | 8.24 | ||||
| Severe family sexual abuse | M | 48.98 | 47.77 | 0.78 | NS | |
| SD | 6.37 | 3.91 | ||||
Note: Group1 had avoidant personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. For the MANOVA on all subscales of the institution versions of the CTQ, SPSA & the IAS, F (7, 89) = 2.63, p<0.05. For the MANOVA on all subscales of the family versions of the CTQ and SPSA, F (6, 38) = 3.83, p<0.01. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.13. Current adjustment of participants with avoidant personality disorder and no diagnoses
| Group 1 Avoidant Personality Disorder |
Group 2 No Diagnosis |
t-value | Group Diffs | ||
|---|---|---|---|---|---|
| N=52 | N=45 | ||||
| Total trauma symptoms (TSI) (N=97) | M | 56.29 | 39.66 | 11.37*** | 1>2 |
| SD | 8.48 | 5.83 | |||
| Total No of life problems (LPC) (N=97) | M | 50.25 | 43.99 | 4.01*** | 1>2 |
| SD | 8.67 | 6.30 | |||
| Total quality of life (WHOQOL) (N=97) | M | 44.19 | 57.79 | 8.60*** | 1<2 |
| SD | 8.13 | 7.32 | |||
| Global functioning (GAF) (N=93) | M | 43.17 | 58.87 | 10.42*** | 1>2 |
| SD | 7.97 | 6.44 | |||
| Marital satisfaction (KMS) (N=55) | M | 49.12 | 53.51 | 1.10 | NS |
| SD | 8.88 | 10.26 | |||
| Parental satisfaction (KPS) (N=80) | M | 49.03 | 51.50 | 1.10 | NS |
| SD | 10.82 | 9.03 | |||
Note: Group1 had avoidant personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.14. Adult attachment styles of participants with avoidant personality disorder and no diagnoses Table 5.14. Adult attachment styles of participants with avoidant personality disorder and no diagnoses
| Adult Attachment Style |
Group 1 Avoidant Personality Disorder |
Group 2 No Diagnosis |
Group Diffs | |
|---|---|---|---|---|
| N=52 | N=45 | |||
| Secure | f | 3.00 | 13.00 | 1<2 |
| % | 5.80 | 28.90 | ||
| Fearful | f | 35.00 | 12.00 | 1>2 |
| % | 67.30 | 26.70 | ||
| Preoccupied | f | 4.00 | 3.00 | NS |
| % | 7.70 | 6.70 | ||
| Dismissive | f | 10.00 | 17.00 | NS |
| % | 19.20 | 37.80 | ||
Note: Group1 had avoidant personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. Cases were classified into the four adult attachment styles using the SPSS algorithm for the Experiences in Close Relationships Inventory in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Chi Square (3, N=97) =19.06, p<.001. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant where cell standardised residuals equalled or exceeded an absolute value of 2.00.
Table 5.15. Recollections of child abuse among participants with antisocial personality disorder and no diagnoses
| Variable | Group 1 Antisocial Personality Disorder |
>Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|---|
| N=17 | N=45 | |||||
| INSTITUTIONAL ABUSE | ||||||
| IAS | Specific institutional abuse >(N=62) | M | 52.08 | 47.28 | 1.72 | NS |
| SD | 9.86 | 9.80 | ||||
| CTQ-Institution | Total institutional abuse >(N=62) | M | 55.17 | 46.83 | 2.87** | 1>2 |
| SD | 9.10 | 10.58 | ||||
| Physical abuse | M | 50.94 | 48.67 | 0.85 | NS | |
| SD | 8.62 | 9.66 | ||||
| Sexual abuse | M | 59.23 | 47.92 | 4.63*** | 1>2 | |
| SD | 9.00 | 8.42 | ||||
| Emotional abuse | M | 51.72 | 45.43 | 1.93 | NS | |
| SD | 8.00 | 12.48 | ||||
| Physical neglect | M | 49.11 | 50.14 | 0.37 | NS | |
| SD | 9.07 | 10.55 | ||||
| Emotional neglect | M | 50.18 | 48.51 | 0.58 | NS | |
| SD | 10.52 | 9.98 | ||||
| SPSA-Institution >(N=62) | Total severe institutional abuse | M | 51.15 | 48.07 | 1.98 | NS |
| SD | 6.53 | 5.03 | ||||
| Severe institutional physical abuse | M | 44.27 | 46.97 | 1.03 | NS | |
| SD | 10.54 | 8.66 | ||||
| Severe institutional sexual abuse | M | 56.55 | 47.85 | 3.80** | 1>2 | |
| SD | 7.79 | 8.66 | ||||
| CHILD ABUSE IN FAMILY | ||||||
| CTQ-family (N=38) | Total family abuse score | M | 52.97 | 46.31 | 2.18 | NS |
| SD | 10.64 | 5.52 | ||||
| Physical abuse | M | 55.38 | 46.37 | 2.57 | NS | |
| SD | 12.33 | 5.88 | ||||
| Sexual abuse | M | 50.73 | 47.44 | 1.23 | NS | |
| SD | 9.88 | 1.91 | ||||
| Emotional abuse | M | 54.28 | 45.49 | 2.91 | NS | |
| SD | 10.86 | 4.10 | ||||
| Physical neglect | M | 49.38 | 49.57 | 0.06 | NS | |
| SD | 9.49 | 9.34 | ||||
| Emotional neglect | M | 52.25 | 47.91 | 1.21 | NS | |
| SD | 11.93 | 7.97 | ||||
| SPSA-family >(N=38) | Total severe family abuse | M | 54.54 | 46.37 | 2.85 | NS |
| SD | 9.44 | 6.64 | ||||
| Severe family physical abuse | M | 54.47 | 46.65 | 2.30 | NS | |
| SD | 11.09 | 8.24 | ||||
| Severe family sexual abuse | M | 52.17 | 47.77 | 1.50 | NS | |
| SD | 10.59 | 3.91 |
Note: Group1 had antisocial personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. CTQ=Childhood Trauma Questionnaire (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale. SPSA=Most severe forms of physical and sexual abuse. To aid profiling, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. For the MANOVA on all subscales of the institution versions of the CTQ, SPSA & the IAS, F (10,51) = 10.98, p<0.0001. For the MANOVA on all subscales of the family versions of the CTQ and SPSA, , F (6, 31) = 3.00, p<0.05. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.16. Current adjustment of participants with antisocial personality disorder and no diagnoses
| Group 1 Antisocial Personality Disorder |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|
| N=17 | N=45 | ||||
| Total trauma symptoms (TSI) (N=62) | M | 56.62 | 39.66 | 6.00*** | 1>2 |
| SD | 11.09 | 5.83 | |||
| Total No of life problems (LPC) (N=62) | M | 69.28 | 43.99 | 14.06*** | 1>2 |
| SD | 6.37 | 6.30 | |||
| Total quality of life (WHOQOL) (N=62) | M | 44.25 | 57.79 | 5.54*** | 1<2 |
| SD | 11.36 | 7.32 | |||
| Global functioning (GAF) (N=60) | M | 42.45 | 58.87 | 5.32*** | 1<2 |
| SD | 11.37 | 6.44 | |||
| Marital satisfaction (KMS) (N=36) | M | 53.74 | 53.51 | 0.06 | NS |
| SD | 9.59 | 10.26 | |||
| Parental satisfaction (KPS) (N=51) | M | 35.84 | 51.50 | 5.07*** | 1<2 |
| SD | 11.83 | 9.03 | |||
Note: Group1 had antisocial personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.17. Current adjustment of participants with borderline personality disorder and no diagnoses
| Group 1 Borderline Personality Disorder |
Group 2 No Diagnosis |
t | Group Diffs | ||
|---|---|---|---|---|---|
| N=14 | N=45 | ||||
| Total trauma symptoms (TSI) (N=59) | M | 61.79 | 39.66 | 11.12*** | 1>2 |
| SD | 8.38 | 5.83 | |||
| Total No of life problems (LPC) (N=59) | M | 61.16 | 43.99 | 5.50*** | 1>2 |
| SD | 11.13 | 6.30 | |||
| Total quality of life (WHOQOL) (N=59) | M | 41.27 | 57.79 | 6.85*** | 1<2 |
| SD | 9.53 | 7.32 | |||
| Global functioning (GAF) (N=59) | M | 38.07 | 58.87 | 6.04*** | 1<2 |
| SD | 12.38 | 6.44 | |||
| Marital satisfaction (KMS) (N=34) | M | 48.12 | 53.51 | 0.93 | NS |
| SD | 15.16 | 10.26 | |||
| Parental satisfaction (KPS) (N=47) | M | 46.21 | 51.50 | 1.50 | NS |
| SD | 12.93 | 9.03 | |||
Note: Group1 had borderline personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). LPC=Life Problems Checklist. WHOQOL= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath). GAS=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169). To aid profiling across variables, all variables were transformed to T-scores with means of 50 and standard deviations of 10 before t-tests were conducted. T-score for variable X = ((X-M)/SD)X10)+50), where X is the score of a case on variable X; M is the mean for all cases on variable X and SD is the standard deviation for all cases on variable X. t values are from t-tests for independent samples. **p<0.01 ***p<0.001. NS=Not significant.
Table 5.18. Adult attachment styles of participants with borderline personality disorder and no diagnoses Table 5.18. Adult attachment styles of participants with borderline personality disorder and no diagnoses
| Adult Attachment Style |
Group 1 Borderline Personality Disorder |
Group 2 No Diagnosis |
Group Diffs | |
|---|---|---|---|---|
| N=14 | N=45 | |||
| Secure | f | 1.00 | 13.00 | NS |
| % | 7.10 | 28.90 | ||
| Fearful | f | 11.00 | 12.00 | 1>2 |
| % | 78.60 | 26.70 | ||
| Preoccupied | f | 1.00 | 3.00 | NS |
| % | 7.10 | 6.70 | ||
| Dismissive | f | 1.00 | 17.00 | NS |
| % | 7.10 | 37.80 | ||
Note: Group1 had borderline personality disorder as assessed with the SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had no diagnoses. Cases were classified into the four adult attachment styles using the SPSS algorithm for the Experiences in Close Relationships Inventory in Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press. Chi Square (3, N=59) =12.80, p<.01. Within each group the percentages sum to approximately 100. Minor deviations from 100 are due to rounding of decimals to two places. Percentages across rows do not sum to 100. Group differences were interpreted as significant where cell standardised residuals equalled or exceeded an absolute value of 2.00.
Table 5.19. Institutional and family child abuse and neglect reported by participants with multiple co-morbid diagnoses, mood disorders, PTSD, substance use disorders, and personality disorders; and profiles of adult psychological adjustment
|
Multiple Co-morbid Diagnoses (4+) |
Mood Disorders |
PTSD |
Alcohol and Substance Use Disorders |
Avoidant Personality Disorder |
Antisocial Personality Disorder |
Borderline Personality disorder |
No Diagnosis | |
|---|---|---|---|---|---|---|---|---|
| Institutional child abuse & neglect | ||||||||
| Physical institutional abuse | + | + | + | – | – | – | – | – |
| Sexual institutional abuse | + | + | + | + | – | + | – | – |
| Emotional institutional abuse | + | + | + | + | + | – | – | – |
| Physical institutional neglect | – | – | – | – | – | – | – | – |
| Emotional institutional neglect | – | – | – | – | – | – | – | – |
| Family-based child abuse & neglect | ||||||||
| Physical family abuse | – | – | – | + | – | – | – | – |
| Sexual family abuse | – | – | – | – | – | – | – | – |
| Emotional family abuse | – | – | + | + | + | – | – | – |
| Physical family neglect | – | – | – | – | – | – | – | – |
| Emotional family neglect | – | – | – | – | – | – | – | – |
| Adult psychological adjustment | ||||||||
| >50% comorbid anxiety disorder | + | + | + | + | + | + | + | – |
| >50% co-morbid mood disorder | + | + | – | – | + | – | + | – |
| >50% comorbid substance use disorder | + | – | + | – | – | + | + | – |
| >50% comorbid personality disorder | + | – | – | – | – | – | – | – |
| Multiple trauma symptoms | + | + | + | + | + | + | + | – |
| Multiple life problems | + | + | + | + | + | + | + | – |
| Low quality of life | + | + | + | + | + | + | + | – |
| Low parenting satisfaction | – | – | – | – | – | + | – | – |
| Fearful adult attachment style | + | + | – | – | + | – | + | – |
| Low socio economic status | + | – | – | + | – | + | – | – |
Note: +=the feature was a significant element of the group profile. – the feature was not a significant element of the group profile.
Part 6 Psychological processes and coping strategies associated with institutional abuse
Summary of Part 6
3.274Six scales were developed to measure past and present psychological processes theoretically purported to arise from the experience of institutional abuse, and associated functional and dysfunctional coping strategies. The scales were (1) traumatization which assesses negative emotions arising from abuse, betrayal and loss of trust, stigmatization, shame, guilt, and disrespect of authority; (2) re-enactment which assesses re-enactment of abuse, powerlessness, coping by opposing and coping by using alcohol and drugs; (3) spiritual disengagement which assesses disengagement from religious practice and not using spiritual coping strategies; (4) positive coping which assesses coping through planning, skill mastery and social support; (5) coping by complying which assesses coping by complying with the wishes of people in authority; and (6) avoidant coping which assesses coping by avoiding thoughts and situations associated with abuse.
3.275All participants reported a reduction in traumatization and re-enactment and an increase in spiritual disengagement from childhood to adult life. They also reported an increase in the use of positive coping strategies and a reduction in the use of coping by complying and avoidant coping.
3.276The psychological processes of traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of institutional abuse, but not family-based child abuse.
3.277Time spent living with one’s family in childhood was a protective factor and was associated with reduced traumatization in adulthood, whereas severe family-based child abuse was associated with avoidant coping in adulthood.
3.278Participants for whom severe physical and sexual abuse, or severe sexual abuse alone were the worst things that happened to them in institutions, reported greater past re-enactment of abusive experiences, than those for whom worst experiences involved severe physical or emotional abuse.
3.279Traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of adult adjustment including the presence of multiple trauma symptoms, multiple adult life problems, global functioning, quality of life, interpersonal anxiety and interpersonal avoidance.
3.280Participants with four or more psychological disorders reported greatest past and present traumatization and re-enactment; greatest current use of avoidant coping; and least current use of positive coping. Participants with no diagnoses, reported least present traumatization, re-enactment and use of avoidant coping; and the greatest reduction in traumatization from past to present. However, they showed a negligible increase in the use of positive coping strategies from past to present.
3.281Positive coping was associated with marital satisfaction and quality of life. Participants who spent 5-11 years in an institution and placement occurred through the courts reported greater use of positive coping strategies in the past, than those who spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. These in turn reported greater use of these strategies than participants who spent more than 12 years in an institution and entered before age 5.
3.282Participants who reported that severe physical abuse was the worst thing that happened to them in institutions, reported greatest coping by complying, and lowest levels of coping by complying occurred among those that reported that severe sexual abuse was the worst thing that happened to them in institutions. For present coping by complying, intermediated between these extremes was the group that reported that severe emotional abuse was the worst thing that happened to them in institutions.
3.283A model was developed which shows how childhood institutional abuse is associated with the processes of traumatization, re-enactment and spiritual disengagement, which in turn are associated with adult mental health and quality of life. The model also shows how childhood years within the family and current use of positive coping strategies are associated with quality of life.
Introduction
3.284In this Part an account is given of the development of a set of 6 scales to measure past and present psychological processes theoretically purported to arise from the experience of institutional abuse, and associated functional and dysfunctional coping strategies. These scales are then used to address a series of five questions about the association between abuse processes and coping strategies on the one hand and the following variables (1) recollections of institutional abuse and family-based child abuse; (2) adult adjustment; (3) duration of time spent in institutions and circumstances of entry to institutions; (4) types of worst abusive experiences in institutions (5) number of psychological disorders. The Part closes with the presentation of a model which links childhood experiences of institutional abuse with adult adjustment, via psychological processes and coping strategies.
Theoretical basis for development of scales to measure abuse processes and coping strategies
3.285Professor David Wolfe has argued that the long-term outcomes of child abuse are probably mediated by distinctive psychological processes (Wolfe et al., 2003) including traumatization, betrayal , disrespect for authority, stigmatization, powerlessness, avoidance of reminders of abuse, and re-enactment of abuse on self or others. The research literature on clerical abuse indicates that in addition to the processes identified by Wolfe, survivors of clerical abuse may also disengage from religious and spiritual beliefs and practices (e.g. Bottoms et al., 1995; Fater & Mullaney, 2000; Farrell & Taylor, 2000; McLaughlin, 1994, Wolfe et al., 2006). The research literature on stress and coping in children exposed to early childhood adversity suggests that children may use both functional and dysfunctional coping strategies to deal with institutional abuse (Luthar, 2003; Rutter et al., 1990). Functional coping strategies include social support, skill mastery, planning and spiritual support. Dysfunctional coping strategies may include either fully complying with the abusive regime or aggressively opposing it without due regard to the risks of further abuse entailed by this. Excessive consumption of alcohol, drugs and food are other potentially dysfunctional coping strategies.
Rational subscales included in the Institutional Abuse Processes and Coping Inventory (IAPCI)
3.286In light of these insights from the broad literature on child abuse and coping, the Institutional Abuse Processes and Coping Inventory (IAPCI) was developed for the present study, to facilitate investigation of psychological processes and coping strategies in survivors of institutional abuse. The IAPCI contained rational subscales to assess the following processes: (1) traumatization, (2) betrayal, (3) disrespect of authority, (4) religious disengagement, (5) stigmatization, (6) powerlessness, (7) avoidance, and (8) re-enactment. The following functional coping strategies were assessed with the IAPCI: (1) social support, (2) skill mastery, (3) planning, and (4) spiritual support. The inventory also assessed these dysfunctional coping strategies: (1) overcomplying, (2) aggressively opposing, and (3) substance abuse. Two versions the IACPI were developed for the present study. The first inquired about processes and coping strategies used while living in an institution and the second inquired about the same processes and coping strategies in the person’s present life. The IAPCI is part of the protocol contained in Appendix 1, which was completed by the 247 participants in this study.
Development of IAPCI factor scales
3.287A series of analyses were conducted on the IAPCI with the aim of developing a set of factorially valid and psychometrically reliable factor scales which contained the same items for past and present versions.
3.288Initially, principal component analyses (PCA) of total scores from rational scales for past and present versions of the IAPCI were conducted. These PCAs each yielded similar, although not identical, five factor solutions. The five factors were named traumatization; re-enactment; spiritual disengagement; positive coping; and coping by complying.
3.289The next step involved conducting factor analyses on items from past and present versions of the IAPCI. These each yielded very similar (though not identical) 5 factor solutions The five factors were very similar to those identified through principal components analysis of total scores from rational scales. The five factors were named in a similar manner, i.e., traumatizaiton, re-enactment, spiritual disengagement, positive coping, and coping by complying.
3.290Internal consistency alpha reliability co-efficients were obtained for rational scales and factor scales from the factor analyses of items. The reliability analyses pointed to a number of significant problems. Few of the narrowband rational scales were reliable for both past and present versions. Not all of the factor scales were reliable. Past and present versions had different item compositions, so past and present scores could not be compared. Also avoidant coping, which is a clinically and theoretically important coping strategy did not emerge in a coherent way in the PCA or factor analysis solutions.
3.291To design the final 6 IAPCI factor scales, in 4 instances rational scales were combined in coherent ways consistent with the results of PCAs of rational scale totals, factor analyses of items, and trauma theory. Items were dropped if they keyed differently for past and present versions of the IAPCI or detracted from scale internal consistency reliability in alpha reliability analyses. The four scales constructed in this way were named traumatization, re-enactment, spiritual disengagement, and positive coping. The remaining two scales were each rational scales: coping by complying and avoidant coping. What follows are brief descriptions of the six IAPCI factor scales.
3.292Traumatization is a 14 item scale which assesses truamatization; betrayal and loss of trust; stigmatization, shame and guilt; and disrespect of authority.
3.293Re-enactment is an 9 item scale which assesses re-enactment of abuse, powerlessness, coping by opposing and coping by using alcohol and drugs.
3.294Spiritual disengagement is a 5 item scale which assesses disengagement from religious practice and not using spiritual coping strategies.
3.295Positive coping is a 9 item scale which assesses coping through planning, skill mastery and social support.
3.296Coping by complying is a 3 item scale which assesses coping by complying with the wishes of people in authority.
3.297Avoidant coping is a 3 item scale which assesses coping by avoiding thoughts and situations associated with abuse.
Confirmatory factor analyses
3.298The item composition of past and present versions of the 6 IAPCI factor scales is presented in Table 6.1. Two confirmatory factor analyses were conducted to evaluate the factorial validity of past and present versions of the 6 IAPCI factor scales. Two confirmatory factor models, using the structure in Table 6.1, were specified and estimated using LISREL 8.72 (Jöreskog & Sörbom, 2005a). Model 1 was the Present IAPCI and Model 2 was the Past IAPCI. Analyses were based on a covariance matrix and an asymptotic weight matrix (the distribution of all IAPCI items deviated significantly from normality in terms of skewness and kurtosis) computed using PRELIS 2.72 (Jöreskog & Sörbom, 2005b) and the parameters estimated using maximum likelihood. The use of an asymptotic weight matrix allows for weaker assumptions regarding the distribution of the observed variables and results in improved fit and test statistics (Satorra, 1992; Curran, West, & Finch, 1996). All models were specified to allow the factors to correlate, have no cross-factor loadings, and initially have no correlated errors.
3.299Following the guidelines suggested by Hoyle and Panter (1995) the goodness of fit for each model was assessed using the Sattora–Bentler scaled chi-square (S-Bχ2), the Incremental Fit Index (IFI: Bollen, 1989), and the Comparative Fit Index (CFI: Bentler, 1990). A non-significant chi-square, and values greater than .90 for the IFI and CFI are considered to reflect acceptable model fit. In addition, the Root Mean Square Error of Approximation (RMSEA: Steiger, 1990) with 90% confidence intervals (90%CI) were reported, where a value less than .05 indicates close fit and values up to .08 indicating reasonable errors of approximation in the population (Jöreskog & Sörbom, 1993). The standardized root-mean-square residual (SRMR: Jöreskog & Sörbom, 1981) has been shown to be sensitive to model mis-specification and its use recommended by Hu and Bentler (1999). Values less than .08 are considered to be indicative of acceptable model fit (Hu & Bentler, 1998).
3.300Model 1 was considered to be an reasonable description of the sample data (S-Bχ2=1767, df=845, p=.00; RMSEA=.07 (90%CI .06-.07); CFI=.86; IFI=.86; SRMR=.08) although the residuals indicated that the Institutional Traumatization factor was not adequately explaining the covariation between two item pairs (DC2 &DC3 and SC2 &SC3), and the Positive Coping factor was not adequately explaining the covariation between items CTC1 and CTC2. The inclusion of three correlated errors improved the fit of the model (S-Bχ2=1544, df=842, p=.00; RMSEA=.06 (90%CI .05-.06); CFI=.90; IFI=.90; SRMR=.08). The improvement in model fit was statistically significant (S-Bχ2=223, df=3, p=.00). The standardized factor loading are reported in Table 6.2. All factor loading are statistically significant (p<.05). The factor correlations are reported below in Table 6.3.
3.301Model 2 was considered to be an reasonable description of the sample data (S-Bχ2=1383, df=845, p=.00; RMSEA=.05 (90%CI .05-.06); CFI=.86; IFI=.86; SRMR=.08) although the residuals indicated that the Powerless Re-enactment factor was not adequately explaining the covariation between two item pairs (XP1 & XP2 and XP3 & XP4). The inclusion of two correlated errors improved the fit of the model (S-Bχ2=1292, df=843, p=.00; RMSEA=.05 (90%CI .04-.05); CFI=.90; IFI=.90; SRMR=.08). The improvement in model fit was statistically significant (S-Bχ2=223, df=2, p=.00). The standardized factor loading are reported in Table 6.2. With the exception of two items (BP1 and PP3) all factor loading are statistically significant (p<.05). The factor correlations are reported in Table 6.3.
3.302Thus, the confirmatory factor analyses supported the factorial validity of the six factor scales of the past and present versions of the IAPCI shown in Table 6.1
Reliability analyses
3.303Internal consistency alpha reliability coefficients were calculated for past and present versions of each of the 6 IACPI factor scales. Also, for 52 cases inter-rater reliability was evaluated using the split-half method, treating ratings by each rater as two halves of the same scale. From Table 6.4 it may be seen that alpha reliabilities ranged from .51 to .87 (with 7 of the 12 alpha coefficients close to, or above .7) indicating moderate to good internal consistency reliability for all IAPCI scales. 11 of the 12 inter-rater reliability coefficients were above .7 indicating good inter-rater reliability for 11 scales and moderate inter-rater reliability for one scale (past coping by complying).
Questions investigated with the IAPCI
3.304Having developed a set of IAPCI factor scales to measure past and present psychological processes theoretically purported to arise from the experience of institutional abuse, and associated functional and dysfunctional coping strategies, a series of analyses were conducted to answer the questions listed below.
3.305The first question was: Are past and present institutional abuse processes and coping strategies (as evaluated by the IAPCI factor scales) associated with recollections of institutional abuse but not family-based child abuse?
3.306The second question was: Are past and present institutional abuse processes and coping strategies (as evaluated by the IAPCI factor scales) associated with indices of adult adjustment?
3.307The third question was: Do participants who had spent different amounts of time in institutions and entered under different circumstances differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales?
3.308The fourth question was: Do participants who had different types of worst abusive experiences in institutions differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales?
3.309The fifth question was: Do participants who with multiple co-morbid psychological disorders, fewer disorders and no disorders differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales?
The IAPCI scales and institutional and family abuse
3.310The following analyses were carried out to address the first question which was: Are past and present institutional abuse processes and coping strategies (as evaluated by the IAPCI factor scales) associated with recollections of institutional abuse but not family-based child abuse? First, Pearson product moment correlations were conducted between IAPCI scales on the one hand, and indices of institutional abuse on the other. These analyses are summarized in Table 6.5. Next, Pearson product moment correlations were conducted between IAPCI scales on the one hand, and indices of family-based child abuse on the other. These analyses are summarized in Table 6.6. In these analyses, the indices of institutional and family-based abuse were: the number of years spent living in an institution; the total, severe physical and severe sexual abuse scale scores of the institution and family versions of the Severe Physical and Sexual Abuse scale (SPSA); the total score on the Institutional Abuse Scale (IAS); and the total, physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect scale scores of the institution and family versions of the Childhood Trauma Questionnaire (CTQ). Correlations with an absolute value above .3 and significant at p<.01 were interpreted as indicating a moderate association between variables.
3.311From Table 6.5 it may be seen that 16 correlations with an absolute value above .3 and significant at p<.01 occurred when IAPCI scales were correlated with indices of institutional abuse and neglect. In contrast only two such correlation occurred between IAPCI scales and indices of family-based child abuse and neglect. Thus, IAPCI scale scores were far more strongly associated with recollections of institutional abuse than family-based child abuse.
3.312From Table 6.5, it may be seen that both past and present versions of the traumatization scale, and the past version of the re-enactment scale had large significant correlations with multiple indices of institutional abuse. Specifically, the past and present version of the IAPCI traumatization scale correlated with the total, physical and emotional abuse scales of the institution version of the CTQ. The past version of the IAPCI traumatization scale also correlated with the SPSA severe institutional physical abuse scale, the IAS total scale, and the physical neglect scale of the institution version of the CTQ. The present version of the IAPCI traumatization scale also correlated with the SPSA total severe institutional abuse scale. The past version of the IAPCI re-enactment scale correlated with the SPSA total and severe institutional sexual abuse scales; the IAS total scale; and the total, physical and sexual abuse scales of the institution version of the CTQ.
3.313From Table 6.6 it may be seen that the present IAPCI traumatization scale correlated negatively with the number of years spent living with the family before 16. The present IAPCI avoidant coping scale correlated with SPSA total severe family-based abuse scale. Thus children who lived longer with their families as children reported less current traumatization as adults; and children who experienced severe child abuse within the family used greater avoidant coping as adults.
3.314The analysis reported in this section provided an answer to the question about the association between past and present abuse processes and coping strategies on the one hand and recollections of institutional abuse but not family-based child abuse on the other. Collectively the results show that the psychological processes of traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of institutional abuse, but not family-based child abuse. Time spent living with one’s family in childhood was a protective factor and was associated with reduced traumatization in adulthood, whereas severe family-based child abuse was associated with avoidant coping in adulthood.
The IAPCI scales and adult adjustment
3.315The following analyses were carried out to address the second question which was: Are past and present institutional abuse processes and coping strategies (as evaluated by the IAPCI factor scales) associated with indices of adult adjustment? Pearson product moment correlations were conducted between IAPCI scales on the one hand and indices of adult adjustment on the other. These analyses are summarized in Table 6.7. In these analyses the indices of adjustment were: total number of current and lifetime psychological disorders; the total score on the Life Problems Checklist (LPC); the score on the Global Assessment of Functioning (GAF) scale; the total score on the Trauma Symptom Inventory (TSI); Socio economic status (SES); the number of failed marital or cohabiting relationships in a participants life; the total score on the Kansas Marital Satisfaction scale (KMS); scores on the interpersonal anxiety and avoidance scales of the Experiences in Close Relationships Inventory (ECRI); the total score on the Kansas Parent Satisfaction scale; and the total score on the World health Organization Quality of Life Scale. Correlations with an absolute value above .3 and significant at p<.01 were interpreted as indicating a moderate association between variables.
3.316From table 6.7 it may be seen that 17 correlations with an absolute value above .3 and significant at p<.01 occurred and 15 of these involved the traumatization and re-enactment scales.
3.317Past and present versions of the traumatization and re-enactment scales correlated with the total number of trauma symptoms on the TSI. Past and present versions of the re-enactment scale correlated with the total number of life problems on the LPC. The present version of the traumatization and re-enactment scales correlated positively with the total number of disorders and negatively with global functioning on the GAF and the total quality of life score of the WHOQOL 100 UK. The present version of the traumatization scale correlated with the ECRI interpersonal anxiety and avoidance scales. The present version of the re-enactment scale correlated with the ECRI interpersonal anxiety scale. The present version of the positive coping scale correlated with the KMS marital satisfaction score and the total quality of life score of the WHOQOL 100 UK.
3.318The analysis reported in this section provided an answer to the question about the association between past and present abuse processes and coping strategies on the one hand and adult adjustment on the other. Collectively the results show that the psychological processes of traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of adult adjustment including the presence of multiple co-morbid psychological disorders, multiple trauma symptoms, multiple adult life problems, global functioning, quality of life, interpersonal anxiety and interpersonal avoidance. Positive coping was associated with marital satisfaction and quality of life.
IAPCI profiles of groups of participants who had spent different amounts of time in institutions and entered under different circumstances
3.319The following analyses were carried out to address the third question which was: Do participants who had spent different amounts of time in institutions and entered under different circumstances differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales? The four groups included in this set of analyses, were those referred to in the main analysis in Part 4. Group 1 contained 110 participants who spent more than 12 years in an institution and entered before age 5. Group 2 contained 67 participants who spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 contained 22 participants who spent 5-11 years in an institution and placement occurred through the courts, in most instances for petty crime. Group 4 contained 48 participants who spent 4 or fewer years in institution. To aid profiling, all IAPCI scales were scored so they each had a range of 1-5. This was obtained for each scale by summing items and dividing by the number of items. A series of twelve one-way analyses of variance (ANOVAs) were used to test for significant (p<.05) variation between groups on either past or present versions of each IAPCI scales, and Scheffe post hoc tests for comparing groups with unequal Ns were used to identify significant (p<.05) intergroup differences. Dunnett’s post hoc tests were used where the assumption of homogeneity was violated. In addition to the one-way ANOVAs, a series of six 4X2, Groups X Time repeated measures ANOVAs were used to identify significant changes from past to present on each IAPCI scale.
3.320From Table 6.8 it may be seen that in the one-way ANOVAs, past positive coping was the only IAPCI scale on which the four groups differed significantly, with group 3 obtaining higher scores than group 2, who in turn obtained higher scores than group 1. There were no significant Group X Time interactions in the repeated measures ANOVAs, indicating that there were no significant intergroup differences in the pattern of past and present scores. All four of the groups showed the same pattern of change. In all of the repeated measures ANOVAs significant time effects occurred. For traumatization and re-enactment, mean scores decreased from the past to the present, but for spiritual disengagement, they increased. Positive coping mean scores increased from past to present, but coping by complying and avoidant coping mean scores decreased.
3.321The analysis reported in this section provided an answer to the question about differences in IAPCI profiles of participants who had spent different amounts of time in institutions and entered under different circumstances. Participants who spent 5-11 years in an institution and placement occurred through the courts reported greater use of positive coping strategies in the past, than those who spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. These in turn reported greater use of these strategies than participants who spent more than 12 years in an institution and entered before age 5. Participants from all four groups reported a reduction in traumatization and re-enactment and an increase in spiritual disengagement from childhood to adult life. They also reported an increase in the use of positive coping strategies and a reduction in the use of coping by complying and avoidant coping.
IAPCI profiles of groups of participants who reported different types of worst abusive experiences in institutions
3.322The following analyses were carried out to address the fourth question which was: Do participants who reported different types of worst abusive experiences in institutions differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales? The four groups included in this set of analyses, were those referred to in the second analysis in Part 4. Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where the worst thing they had experienced was severe physical abuse. Group 3 contained 40 cases where the worst thing they had experienced was severe sexual abuse. Group 4 contained 85 cases where the worst thing they had experienced was severe emotional abuse. Participant’s statements were classified as severe physical abuse if the person reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. To aid profiling, all IAPCI scales were scored so they each had a range of 1-5. This was obtained for each scale by summing items and dividing by the number of items. A series of twelve one-way analyses of variance (ANOVAs) were used to test for significant (p<.05) variation between groups on either past or present versions of each IAPCI scales, and Scheffe post hoc tests for comparing groups with unequal Ns were used to identify significant (p<.05) intergroup differences. Dunnett’s post hoc tests were used where the assumption of homogeneity was violated. In addition to the one-way ANOVAs, a series of six 4X2, Groups X Time repeated measures ANOVAs were used to identify significant changes from past to present on each IAPCI scale.
3.323From Table 6.9 it may be seen that in the one-way ANOVAs, past re-enactment and both past and present coping by complying were the only IAPCI scales on which the four groups differed significantly. Mean past re-enactment scores for groups 1 and 3 were significantly greater than those for groups 2 and 4. Group 2’s mean past and present coping by complying scores were significantly greater that those of group 3, with group 4 obtaining a mean score between these extremes for present, but not past, coping by complying.
3.324There were no significant Group X Time interactions in the repeated measures ANOVAs, indicating that there were no significant intergroup differences in the pattern of past and present scores.
3.325The analysis reported in this section provided an answer to the question about differences in IAPCI profiles of participants who reported different types of worst abusive experiences in institutions. Participants for whom severe physical and sexual abuse, or severe sexual abuse alone were the worst things that happened to them in institutions, reported greater past re-enactment of abusive experiences, than those for whom worst experiences involved severe physical or emotional abuse. Participants who reported that severe physical abuse was the worst thing that happened to them in institutions, reported greatest past and present coping by complying, and lowest levels of coping by complying occurred among those that reported that severe sexual abuse was the worst thing that happened to them in institutions. For present coping by complying, intermediate between these extremes was the group that reported that severe emotional abuse was the worst thing that happened to them in institutions.
IAPCI profiles of groups of participants who groups of participants who had different numbers of psychological diagnoses
3.326The following analyses were carried out to address the fifth question which was: Do participants who had different numbers of psychological diagnoses differ in their experience of past and present institutional abuse processes and coping strategies as evaluated by the IAPCI factor scales? The three groups included in this set of analyses, were those referred to in the first analysis in Part 5. Group 1 contained 83 participants who had four or more current or lifetime diagnoses as assessed with the SCID I and SCID II. Group 2 contained 119 participants who had 1-3 current or lifetime diagnoses. Group 3 contained 45 participants who had no diagnoses. To aid profiling, all IAPCI scales were scored so they each had a range of 1-5. This was obtained for each scale by summing items and dividing by the number of items. A series of twelve one-way analyses of variance (ANOVAs) were used to test for significant (p<.05) variation between groups on either past or present versions of each IAPCI scales, and Scheffe post hoc tests for comparing groups with unequal Ns were used to identify significant (p<.05) intergroup differences. Dunnett’s post hoc tests were used where the assumption of homogeneity was violated. In addition to the one-way ANOVAs, a series of six 4X2, Groups X Time repeated measures ANOVAs were used to identify significant changes from past to present on each IAPCI scale.
3.327From Table 6.10 it may be seen that in the one-way ANOVAs, the three groups differed significantly in their mean scores on the past and present versions of the traumatization and re-enactment scales, and on the present versions of the positive and avoidant coping scales. On the past and present versions of the traumatization and re-enactment scales, group 1 obtained a significantly higher mean scores than groups 2 and 3. On the present versions of the traumatization and re-enactment scales, group 2 obtained a significantly higher mean score than groups 3. On the present version of the positive coping scale, group 1 obtained a significantly lower mean score than group 2. On the present version of the avoidant coping scale, group 1 obtained a significantly higher mean score than group 3.
3.328On the repeated measures ANOVAs there were significant Group X Time interactions for traumatization and positive coping. From the first panel in Figure 6.1 it may be seen that group 3 with no disorders showed a greater reduction in traumatization from past to present, than the other two groups, who had multiple co-morbid psychological disorders. From the second panel in Figure 6.1 it may be seen that for positive coping, group 3 with no disorders showed a negligible increase in the use of positive coping strategies from past to present, compared with the other two groups who showed a marked increase in positive coping from past to present.
3.329The analysis reported in this section provided an answer to the question about differences in IAPCI profiles of participants who had different numbers of psychological diagnoses. Participants with four or more disorders reported greatest past and present traumatization and re-enactment; greatest current use of avoidant coping and least current use of positive coping. Participants with no diagnoses, reported least present traumatization, re-enactment and use of avoidant coping; and the greatest reduction in traumatization from past to present. However, they showed a negligible increase in the use of positive coping strategies from past to present.
Model of childhood institutional abuse, psychological processes, and adult adjustment
3.330A theoretical model of childhood institutional abuse, psychological processes, and adult adjustment is presented in Figure 6.2. The model shows how childhood institutional abuse is associated with the processes of truamatization, re-enactment and spiritual disengagement, which in turn are associated with mental health and quality of life. The model also shows how childhood years within the family and current use of positive coping strategies are associated with quality of life. The reliabilities of the composite scores used in the model were incorporated using the method suggested by Jöreskog and Sörbom (1993).The model presented in Figure 6.2 was specified and estimated using LISREL8.52 (Jöreskog & Sörbom, 2002). A covariance matrix and an asymptotic weight matrix were computed using PRELIS2.3 (Jöreskog & Sörbom, 1999) and the parameters estimated using maximum likelihood. Following the guidelines suggested by Hoyle and Panter (1995) the goodness of fit for each model was assessed using the chi-square, the Goodness of Fit Index (GFI: Jöreskog & Sörbom, 1981), the Incremental Fit Index (IFI: Bollen, 1989), and the Comparative Fit Index (CFI: Bentler, 1990). A non-significant chi-square, and values greater than 0.90 for the GFI, IFI and CFI, are considered to reflect acceptable model fit. In addition, the Root Mean Square Error of Approximation (RMSEA: Steiger, 1990) with 90% confidence intervals (90%CI) were reported, where a value less than 0.05 indicates close fit and values up to 0.08 indicating reasonable errors of approximation in the population (Jöreskog & Sörbom, 1993). The standardised root-mean-square residual (SRMR: Jöreskog & Sörbom, 1981) has been shown to be sensitive to model mis-specification and its use recommended by Hu and Bentler (1999). Values less than .08 are considered to be indicative of acceptable model fit. The fit indices are reported in Table 6.11. On the basis of the RMSEA, IFI, CFI, SRMR and the GFI the model is judged to be an acceptable description of the sample data. Although the chi-square for this model is large relative to the degrees of freedom, and statistically significant, this should not lead to the rejection of the model as the large sample size increases the power of the test (Tanaka, 1987). The standardized model parameters are presented in Table 6.12.
Conclusions
3.331Six scales were developed to measure past and present psychological processes theoretically purported to arise from the experience of institutional abuse, and associated functional and dysfunctional coping strategies. The scales were (1) traumatization, (2) re-enactment, (3) spiritual disengagement, (4) positive coping, (5) coping by complying, and (6) avoidant coping.
3.332All participants reported a reduction in traumatization and re-enactment and an increase in spiritual disengagement from childhood to adult life. They also reported an increase in the use of positive coping strategies and a reduction in the use of coping by complying and avoidant coping.
3.333The psychological processes of traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of institutional abuse, but not family-based child abuse.
3.334Time spent living with one’s family in childhood was a protective factor and was associated with reduced traumatization in adulthood, whereas severe family-based child abuse was associated with avoidant coping in adulthood.
3.335Participants for whom severe physical and sexual abuse, or severe sexual abuse alone were the worst things that happened to them in institutions, reported greater past re-enactment of abusive experiences, than those for whom worst experiences involved severe physical or emotional abuse.
3.336Traumatization and re-enactment as experienced now or remembered from childhood were associated multiple indices of adult adjustment including the presence of multiple trauma symptoms, multiple adult life problems, global functioning, quality of life, interpersonal anxiety and interpersonal avoidance.
3.337Participants with four or more psychological disorders reported greatest past and present traumatization and re-enactment; greatest current use of avoidant coping; and least current use of positive coping. Participants with no diagnoses, reported least present traumatization, re-enactment and use of avoidant coping; and the greatest reduction in traumatization from past to present. However, they showed a negligible increase in the use of positive coping strategies from past to present.
3.338Positive coping was associated with marital satisfaction and quality of life. Participants who spent 5-11 years in an institution and placement occurred through the courts reported greater use of positive coping strategies in the past, than those who spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. These in turn reported greater use of these strategies than participants who spent more than 12 years in an institution and entered before age 5.
3.339Participants who reported that severe physical abuse was the worst thing that happened to them in institutions, reported greatest coping by complying, and lowest levels of coping by complying occurred among those that reported that severe sexual abuse was the worst thing that happened to them in institutions. For present coping by complying, intermediated between these extremes was the group that reported that severe emotional abuse was the worst thing that happened to them in institutions.
3.340A model was developed which shows how childhood institutional abuse is associated with the processes of traumatization, re-enactment and spiritual disengagement, which in turn are associated with adult mental health and quality of life. The model also shows how childhood years within the family and current use of positive coping strategies are associated with quality of life.
Table 6.1. Item composition of the 6 factor scales from the Institutional Abuse Process and Coping Inventory.
| ITEM CODE | PAST VERSION | ITEM CODE | PRESENT VERSION |
|---|---|---|---|
| PAST TRAUMATIZATION | PRESENT TRAUMATIZATION | ||
| Traumatization | Traumatization | ||
| 1TP1 | I felt hurt then | 2TC1 | I feel hurt now |
| 3TP2 | I felt frightened then | 4TC2 | I feel frightened now |
| 5TP3 | I felt sad then | 6TC3 | I feel sad now |
| 7TP4 | I felt humiliated then | 8TC4 | I feel humiliated now |
| Betrayal and loss of trust | Betrayal and loss of trust | ||
| 9BP1 | I trusted everyone then (-) | 10BC1 | I trust everyone now (-) |
| 11BP2 | I felt betrayed then | 12BC2 | I feel betrayed now |
| 13BP3 | I cut myself off from other people then | 14BC3 | I cut myself off from other people now |
| Stigmatization shame and guilt | Stigmatization shame and guilt | ||
| 29SP1 | I felt I was worthless then | 30SC1 | I feel I am worthless now |
| 31SP2 | I felt I was dirty then | 32SC2 | I feel I am dirty now |
| 33SP3 | I felt ashamed then | 34SC3 | I feel ashamed now |
| 35SP4 | I felt guilty and believed the abuse was my fault then | 36SC4 | I feel guilty and believe the abuse was my fault now |
| Disrespect of authority | Disrespect of authority | ||
| 15DP1 | I was angry at everyone in authority then | 16DC1 | I am angry with everyone in authority now |
| 17DP2 | I liked people in authority then (-) | 18DC2 | I like people in authority now (-) |
| 19DP3 | I respected everyone in authority then (-) | 20DC3 | I respect everyone in authority now (-) |
| PAST RE-ENACTMENT | PRESENT RE-ENACTMENT | ||
| Re-enactment | Re-enactment | ||
| 49XP1 | I felt the urge to attack or abuse other people then | 50XC1 | I feel the urge to attack or abuse other people now |
| 51XP2 | I hurt other people then | 52XC2 | I hurt other people now |
| 53XP3 | I felt the urge to harm or injure myself then | 54XC3 | I feel the urge to harm or injure myself now |
| 55XP4 | I harmed or injured myself then | 56XC4 | I harm or injure myself now |
| Powerlessness | Powerlessness | ||
| 39PP2 | I believed that my life was controlled by others then | 40PC2 | I believe that my life is controlled by others now |
| 41PP3 | I thought I could do nothing to change my situation then | 42PC3 | I think I can do nothing to change my situation now |
| Coping by opposing | Coping by opposing | ||
| 71COP3 | I planned revenge on my abusers then | 72COC3 | I am planning revenge on my abusers now |
| Coping by alcohol, drugs and food | Coping by alcohol, drugs and food | ||
| 91CDP1 | I drank alcohol to cope then | 92CDC1 | I drink alcohol to cope now |
| 93CDP2 | I took other drugs to cope then | 94CDC2 | I take other drugs to cope now |
| PAST SPIRITUAL DISENGAGEMENT. | PRESENT SPIRITUAL DISENGAGEMENT. | ||
| Religious Disengagement | Religious Disengagement | ||
| 21RP1 | I had faith in God then (-) | 22PC1 | I have faith in God now (-) |
| 23RP2 | I had faith in the church then (-) | 24RC2 | I have faith in the church now (-) |
| 25RP3 | I stopped praying then | 26RC3 | I do not pray now |
| 27RP4 | I only went mass then because I would be punished if I did not to | 28RC4 | I do not go to mass now |
| Coping through spiritual support | Coping through spiritual support | ||
| 57CSP1 | I prayed to God then, and that made the abuse bearable (-) | 58CSPC1 | I pray to God now, and that makes the abuse bearable (-) |
| PAST POSITIVE COPING. | PRESENT POSITIVE COPING | ||
| Coping through planning | Coping through planning | ||
| 85CLP1 | Then I planned each day very carefully to avoid abuse and make good things happen (like having a laugh, getting well fed, and keeping warm) | 86CLC1 | Now I plan each day very carefully to avoid bad feelings and make good things happen (like having a laugh, getting well fed, and keeping warm) |
| 87CLP2 | When I was leaving school I followed a plan to get a job that would suit me and make my situation better | 88CLC2 | Now I still follow a plan to make sure my job suits me and makes my situation better |
| 89CLP3 | When I was settling down with my partner, I waited for at least 6 months to make sure we were well suited to live together | 90CLC3 | When my partner and I are planning something important we take time to plan it very carefully |
| Coping though skill mastery | Coping though skill mastery | ||
| 79CMP1 | I put my energy into my school work and that made me feel better then | 80CMC1 | I put my energy into my work and that makes me feel better now |
| 81CMP2 | I put my energy into sports or music and that made me feel better then | 82CMC2 | I put my energy into sport or music and that makes me feel better now |
| 83CMP3 | I put my energy into a skill that I could do well that made me feel better then | 84CMC3 | I put my energy into a skill that I can do well that makes me feel better now |
| Coping through social support | Coping through social support | ||
| 73CTP1 | I had a good friendship with a close friend I could trust and this made the abuse bearable then | 74CTC1 | I have a good friendship with a close friend I can trust and this made the abuse bearable now (This friend is not my partner, husband or wife) |
| 75CTP2 | I had a good friendship with an adult I could trust and this made the abuse bearable then | 76CTC2 | I have a good friendship with a person I trust and look up to and this makes the abuse bearable now (this could be doctor or counsellor but not a partner) |
| 77CTP3 | I reminded my self that my mother or father was still alive, cared about me, and this made the abuse bearable then | 78CTC3 | I have a good relationship with my partner who I know cares about me and who I can tell my troubles to now and this makes the abuse bearable ( A partner is a wife /husband/ cohabitee /lover) |
| PAST COPING BY COMPLYING | PRESENT COPING BY COMPLYING | ||
| Coping by complying | Coping by complying | ||
| 61CCP1 | I tried to behave well for the teachers /nuns /brothers /priests so I would not be punished then | 62CCC1 | I try to behave well and fit in with people at work and in my family now to avoid conflict and arguments |
| 63CCP2 | I was careful never to break a rule then | 64CCC2 | I am careful never to break a rule now |
| 65CCP3 | I was careful always to show respect to the brothers, priests, nuns and teachers then (even if I didn’t feel respect) | 66CCC3 | I am careful always to show respect to people in authority now (even if I do not feel respect) |
| PAST AVOIDANT COPING | PRESENT AVOIDANT COPING | ||
| Avoidance of reminders of abuse | Avoidance of reminders of abuse | ||
| 43AP1 | I avoided thinking about the abuse then | 44AC1 | I avoid thinking about the abuse now |
| 45AP2 | I avoided situations that reminded me of abuse then | 46AC2 | I avoid situations that reminded me of abuse now |
| 47AP3 | I avoided people who reminded me of the abuse then | 48AC3 | I avoid people who remind me of the abuse now |
Note: Headings in bold lowercase are the names of IAPCI rational scales containing the items beneath them. Headings in bold uppercase are the name of the six factor scales supported by confirmatory factor analyses.
Table 6.2. Factor loadings for confirmatory factor analysis of the past and present forms of the Institutional Abuse Processes and Coping Inventory
| Past version | Present version | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Item | Trauma | Reinact | Disengag | PosCope | ComCope | AvCope | Item | Trauma | Reinact | Disengag | PosCope | ComCope | AvCope |
| TP1 | 0.62 | TC1 | 0.56 | ||||||||||
| TP2 | 0.52 | TC2 | 0.70 | ||||||||||
| TP3 | 0.62 | TC3 | 0.72 | ||||||||||
| TP4 | 0.73 | TC4 | 0.77 | ||||||||||
| BP1 | 0.04 | BC1 | 0.41 | ||||||||||
| BP2 | 0.56 | BC2 | 0.65 | ||||||||||
| BP3 | 0.43 | BC3 | 0.52 | ||||||||||
| SP1 | 0.60 | SC1 | 0.65 | ||||||||||
| SP2 | 0.56 | SC2 | 0.52 | ||||||||||
| SP3 | 0.65 | SC3 | 0.61 | ||||||||||
| SP4 | 0.37 | SC4 | 0.37 | ||||||||||
| DP1 | 0.46 | DC1 | 0.60 | ||||||||||
| DP2 | 0.19 | DC2 | 0.42 | ||||||||||
| DP3 | 0.14 | DC3 | 0.30 | ||||||||||
| XP1 | 0.55 | XC1 | 0.42 | ||||||||||
| XP2 | 0.31 | XC2 | 0.47 | ||||||||||
| XP3 | 0.46 | XC3 | 0.79 | ||||||||||
| XP4 | 0.33 | XC4 | 0.71 | ||||||||||
| PP2 | 0.19 | PC2 | 0.46 | ||||||||||
| PP3 | 0.09 | PC3 | 0.35 | ||||||||||
| COP3 | 0.59 | COC3 | 0.28 | ||||||||||
| CDP1 | 0.57 | CDC1 | 0.34 | ||||||||||
| CDP2 | 0.41 | CDC2 | 0.40 | ||||||||||
| RP1 | 0.83 | RC1 | 0.42 | ||||||||||
| RP2 | 0.77 | RC2 | 0.47 | ||||||||||
| RP3 | 0.35 | RC3 | 0.79 | ||||||||||
| TP4 | 0.33 | TC4 | 0.71 | ||||||||||
| CSP1 | 0.51 | CSPC1 | 0.46 | ||||||||||
| CLP1 | 0.38 | CLC1 | 0.35 | ||||||||||
| CLP2 | 0.53 | CLC2 | 0.49 | ||||||||||
| CLP3 | 0.32 | CLC3 | 0.49 | ||||||||||
| CMP1 | 0.43 | CMC1 | 0.61 | ||||||||||
| CMP2 | 0.51 | CMC2 | 0.51 | ||||||||||
| CMP3 | 0.52 | CMC3 | 0.60 | ||||||||||
| CTP1 | 0.16 | CTC1 | 0.21 | ||||||||||
| CTP2 | 0.30 | CTC2 | 0.17 | ||||||||||
| CTP3 | 0.39 | CTC3 | 0.32 | ||||||||||
| CCP1 | 0.68 | CCC1 | 0.67 | ||||||||||
| CCP2 | 0.78 | CCC2 | 0.60 | ||||||||||
| CCP3 | 0.57 | CCC3 | 0.41 | ||||||||||
| AP1 | 0.45 | AC1 | 0.34 | ||||||||||
| AP2 | 0.73 | AC2 | 0.77 | ||||||||||
| AP3 | 0.74 | AC3 | 0.68 | ||||||||||
Note. N=247. Trauma=Traumatization; Reinact= Re-enactment; Disengag= Spititual Disengagement; PosCope=Positive Coping; ComCope=Coping by Complying; AvCope=Avoidant Coping.
Table 6.3. Factor correlations for confirmatory factor analysis of the past and present forms of the Institutional Abuse Processes and Coping Inventory
| Past version | Present version | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Scale | Trauma | Reinact | Disengag | PosCope | ComCope | AvCope | Scale | Trauma | Reinact | Disengag | PosCope | ComCope | AvCope |
| Reinact | .39 | 1.00 | Reinact | .58 | 1.00 | ||||||||
| Disengag | .05 | .07 | 1.00 | Disengag | .17 | .11 | 1.00 | ||||||
| PosCope | .05 | .33 | -.30 | 1.00 | PosCope | -.28 | -.29 | -.27 | 1.00 | ||||
| ComCope | .24 | -.06 | -.21 | .09 | 1.00 | ComCope | .19 | .04 | -.13 | .32 | 1.00 | ||
| AvCope | .35 | .33 | .02 | .30 | .07 | 1.00 | AvCope | .38 | .17 | .02 | .12 | .25 | 1.00 |
Note. N=247. Trauma=Traumatization; Reinact=Re-enactment; Disengag= Spiritual Disengagement; PosCope=Positive Coping; ComCope=Coping by Complying; AvCope=Avoidant Coping. Correlations significant at p<.01 and greater than an absolute value of .3 are in bold.
Table 6.4. Reliability of 6 factor scales from past and present versions of the Institutional Abuse Processes and Coping Inventory
| Instrument | Constructs and variables | No. of items in the scale | Possible range | M | SD | Internal consistency Reliability Alpha |
Inter-rater reliability |
|---|---|---|---|---|---|---|---|
| IAPCI-Past version | Traumatization | 14 | 1-5 | 4.19 | 0.65 | .75 | .97 |
| Re-enactment | 9 | 1-5 | 2.50 | 0.70 | .62 | .95 | |
| Spiritual disengagement | 5 | 1-5 | 2.93 | 0.78 | .69 | .80 | |
| Positive coping | 9 | 1-5 | 2.43 | 0.82 | .62 | .99 | |
| Coping by complying | 3 | 1-5 | 4.58 | 0.78 | .71 | .51 | |
| Avoidant coping | 3 | 1-5 | 3.90 | 1.24 | .59 | .91 | |
| IAPCI-Present version | Traumatization | 14 | 1-5 | 3.23 | 0.89 | .87 | .90 |
| Re-enactment | 9 | 1-5 | 1.69 | 0.67 | .70 | .94 | |
| Spiritual disengagement | 5 | 1-5 | 3.22 | 0.80 | .78 | .85 | |
| Positive coping | 9 | 1-5 | 3.11 | 0.89 | .68 | .96 | |
| Coping by complying | 3 | 1-5 | 3.66 | 1.06 | .56 | .98 | |
| Avoidant coping | 3 | 1-5 | 3.65 | 1.15 | .51 | .98 | |
Note. N=247.
Table 6.5. Correlations between IAPCI scales and adverse institutional living experiences
| IAPCI Scales | Years in Institution | SPSA-I Total severe institutional abuse |
SPSA-I Severe institutional physical abuse |
SPSA-I Severe institutional sexual abuse |
IAS Specific Institutional abuse |
CTQ-I Total |
CTQ-I Physical abuse |
CTQ-I Sexual abuse |
CTQ-I Emotional abuse |
CTQ-I Physical neglect |
CTQ-I Emotional neglect |
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Past | Traumatization | .05 | .26 | .32 | .11 | .42 | .47 | .45 | .12 | .59 | .38 | .09 |
| Re-enactment | -.06 | .40 | .19 | .39 | .37 | .39 | .31 | .35 | .28 | .15 | .06 | |
| Spiritual disengagement | -.08 | .21 | .19 | .14 | .23 | .21 | .24 | .10 | .17 | .16 | .02 | |
| Positive coping | -.24 | -.13 | -.23 | .00 | .12 | -.07 | .02 | .04 | -.03 | -.09 | -.26 | |
| Coping by complying | -.09 | -.16 | -.06 | -.17 | -.02 | -.09 | -.01 | -.14 | -.01 | -.04 | -.03 | |
| Avoidant coping | -.05 | .09 | .01 | .11 | .18 | .14 | .13 | .10 | .15 | .03 | .00 | |
| Present | Traumatization | .11 | .30 | .27 | .20 | .29 | .41 | .32 | .23 | .38 | .23 | .13 |
| Re-enactment | .04 | .24 | .10 | .24 | .10 | .27 | .13 | .28 | .15 | .13 | .04 | |
| Spiritual disengagement | -.03 | .15 | .04 | .17 | .15 | .22 | .15 | .15 | .16 | .21 | .01 | |
| Positive coping | -.09 | -.08 | -.11 | -.03 | .13 | -.04 | -.01 | .00 | .03 | .04 | -.21 | |
| Coping by complying | -.10 | -.17 | -.12 | -.14 | -.00 | -.10 | -.11 | -.14 | -.02 | -.01 | -.05 | |
| Avoidant coping | .01 | .08 | .06 | .06 | .19 | .13 | .12 | .07 | .22 | .04 | -.08 | |
Note: N=247. Pearson correlations significant at p<.01 and greater than an absolute value of .3 are in bold. CTQ-I=Childhood Trauma Questionnaire , institutional version (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A Retrospective Self-report. Manual. San Antonio, TX: The Psychological Cooperation). IAS=Institutional abuse scale . SPSA=Most severe forms of physical and sexual abuse, intuition version. IAPCI=Institutional Abuse Processes and Coping Inventory.
Table 6.6. Correlations between IAPCI scales and child abuse and neglect within the family
| IAPCI Scales | Years living with family before 16y |
SPSA-F Total severe family abuse |
SPSA-F Severe family physical abuse |
SPSA-F Severe family sexual abuse |
CTQ-F Total |
CTQ-F Physical abuse |
CTQ-F Sexual abuse |
CTQ-F Emotional abuse |
CTQ-F Physical neglect |
CTQ-F Emotional neglect |
|
|---|---|---|---|---|---|---|---|---|---|---|---|
| N=246 | N=121 | N=121 | N=121 | N=121 | N=121 | N=121 | N=121 | N=121 | N=121 | ||
| Past | Traumatization | -.15 | .04 | .01 | .07 | .05 | .01 | .07 | .13 | .02 | -.08 |
| Re-enactment | .02 | .01 | .06 | -.10 | .01 | .07 | -.07 | -.12 | .01 | -.00 | |
| Spiritual disengagement | .06 | -.02 | -.03 | .01 | -.05 | -.01 | .00 | -.08 | -.12 | -.02 | |
| Positive coping | .17 | -.14 | -.14 | -.06 | -.15 | -.23 | -.03 | -.13 | -.10 | -.18 | |
| Coping by complying | -.04 | -.22 | -.14 | -.25 | -.13 | -.22 | -.19 | -.14 | -.01 | -.10 | |
| Avoidant coping | -.22 | -.13 | -.20 | .07 | .05 | -.02 | .10 | .05 | .02 | .04 | |
| Present | Traumatization | -.33 | .14 | .09 | .16 | .27 | .17 | .18 | .29 | .18 | .21 |
| Re-enactment | -.22 | .11 | .10 | .07 | .16 | .16 | .06 | .14 | .13 | .10 | |
| Spiritual disengagement | -.12 | .07 | .10 | -.04 | .08 | .13 | -.06 | .10 | .03 | .01 | |
| Positive coping | .04 | -.14 | -.16 | -.03 | -.07 | -.08 | -.03 | -.01 | -.09 | -.07 | |
| Coping by complying | -.09 | -.04 | -.09 | .08 | .10 | .04 | .11 | .13 | .13 | .02 | |
| Avoidant coping | -.26 | .40 | .02 | .05 | .13 | .11 | .09 | .13 | .08 | .08 | |
Note: Pearson correlations significant at p<.01 and greater than .3 are in bold. CTQ-F=Childhood Trauma Questionnaire, family version (Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A Retrospective Self-report. Manual. San Antonio, TX: The Psychological Cooperation). SPSA-F=Most severe forms of physical and sexual abuse, family version. IAPCI=Institutional Abuse Processes and Coping Inventory.
Table 6.7. Correlations between IAPCI scales and indices of adult adjustment
| IAPCI Scales | Total number of current and lifetime psychological disorders | LPC Total number of life problems |
GAF Global Functioning |
Total trauma symptoms on TSI |
SES | Number of failed relationships | KMS Marital satisfaction |
ECRI Anxiety |
ECRI Avoidance |
KPS Parental satisfaction |
WHOQOL 100 UK Total QoL |
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N=247 | N=247 | N=235 | N=247 | N=241 | N=217 | N=136 | N=247 | N=247 | N=212 | N=247 | ||
| Past | Traumatization | .19 | .10 | -.15 | .32 | -.08 | .04 | .01 | .24 | .12 | .04 | -.21 |
| Re-enactment | .19 | .50 | -.18 | .40 | -.13 | -.02 | .05 | .20 | .19 | .12 | -.23 | |
| Spiritual disengagement | .01 | .10 | -.03 | .10 | -.02 | .04 | .05 | .06 | .01 | .05 | -.05 | |
| Positive coping | -.05 | .03 | .15 | -.03 | .13 | -.05 | .14 | -.03 | -.19 | .16 | .19 | |
| Coping by complying | -.01 | -.03 | -.10 | .07 | .01 | .03 | -.09 | .07 | -.02 | -.05 | -.01 | |
| Avoidant coping | .14 | -.08 | -.09 | .09 | -.08 | -.06 | .07 | .11 | .06 | .08 | .03 | |
| Present | Traumatization | .32 | .18 | -.38 | .64 | -.06 | .09 | -.20 | .44 | .30 | -.07 | -.57 |
| Re-enactment | .32 | .39 | -.44 | .63 | -.09 | .15 | -.10 | .34 | .16 | -.17 | -.57 | |
| Spiritual disengagement | .09 | .11 | -.25 | .20 | -.11 | .07 | -.08 | .06 | .14 | -.02 | -.19 | |
| Positive coping | .03 | -.04 | .14 | -.07 | .14 | -.16 | .30 | .04 | -.26 | .08 | .36 | |
| Coping by complying | -.01 | -.17 | .01 | .01 | .16 | -.08 | -.01 | .09 | -.09 | .10 | -.03 | |
| Avoidant coping | .17 | .09 | -.19 | .23 | .02 | -.02 | -.07 | .16 | .12 | .00 | -.15 | |
Note: Pearson correlations significant at p<.01 and greater than .3 are in bold. LPC=Life problems checklist. GAF=Global assessment of functioning scale (Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417).TSI=Trauma Symptom Inventory (Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources). SES=Socio Economic Status (O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156). KMS=Kansas Marital Satisfaction Scale (Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387). ECRI=Experiences in Close Relationships Inventory (Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press). KPS=Kansas Parenting Satisfaction Scale (James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169. WHOQOL 100 UK= World Health Organization Quality of Life 100 UK (Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath).
Table 6.8. Scale scores from past and present versions of the IAPCI of 4 groups of participants who had spent different amounts of time in institutions and entered under different circumstances.
| One way ANOVA |
4X2 ANOVA |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Group 1 12+y |
Group 2 5-11y Fam |
Group 3 5-11y Court |
Group 4 <4y |
F | Group Diffs | Groups X Time |
Time | Groups | ||
| N=110 | N=67 | N=22 | N=48 | |||||||
| Past traumatization | M | 4.23 | 4.17 | 3.86 | 4.19 | 2.26 | NS | 2.07 | 213.60*** | 1.49 |
| SD | 0.59 | 0.70 | 0.92 | 0.49 | ||||||
| Present traumatization | M | 3.30 | 3.29 | 3.10 | 3.02 | 1.36 | NS | |||
| SD | 0.90 | 0.91 | 0.76 | 0.90 | ||||||
| Past re-enactment | M | 2.42 | 2.50 | 2.76 | 2.56 | 1.62 | NS | 0.81 | 187.41*** | 1.07 |
| SD | 0.62 | 0.78 | 0.76 | 0.70 | ||||||
| Present re-enactment | M | 1.70 | 1.65 | 1.80 | 1.67 | 0.27 | NS | |||
| SD | 0.65 | 0.62 | 0.70 | 0.75 | ||||||
| Past spiritual disengagement | M | 2.88 | 2.91 | 2.89 | 3.09 | 0.85 | NS | 0.74 | 17.59*** | 0.38 |
| SD | 0.76 | 0.86 | 0.63 | 0.78 | ||||||
| Present spiritual disengagement | M | 3.19 | 3.20 | 3.37 | 3.22 | 0.31 | NS | |||
| SD | 0.84 | 0.77 | 0.78 | 0.78 | ||||||
| Past positive coping | M | 2.22 | 2.53 | 2.89 | 2.59 | 5.79*** | 3>2>1 | 3.41 | 79.91*** | 2.88* |
| SD | 0.72 | 0.75 | 0.99 | 0.93 | ||||||
| Present positive coping | M | 3.03 | 3.15 | 3.07 | 3.26 | 0.79 | NS | |||
| SD | 0.90 | 0.77 | 1.15 | 0.90 | ||||||
| Past coping by complying | M | 4.53 | 4.61 | 4.56 | 4.63 | 0.19 | NS | 0.40 | 120.86*** | 0.81 |
| SD | 0.85 | 0.74 | 0.68 | 0.76 | ||||||
| Present coping by complying | M | 3.58 | 3.78 | 3.48 | 3.78 | 0.92 | NS | |||
| SD | 1.09 | 1.03 | 0.99 | 1.06 | ||||||
| Past avoidant coping | M | 3.82 | 4.18 | 3.52 | 3.90 | 2.11 | NS | 0.43 | 7.81** | 2.08 |
| SD | 1.28 | 1.02 | 1.51 | 1.18 | ||||||
| Present avoidant coping | M | 3.61 | 3.78 | 3.29 | 3.71 | 1.08 | NS | |||
| SD | 1.11 | 1.14 | 1.34 | 1.16 | ||||||
Note: Group 1 spent more than 12 years in an institution and entered before age 5. Group 2 spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. Group 3 spent 5-11 years in an institution and placement occurred through the courts. Group 4 spent 4 or fewer years in institutions. To aid profiling all scales have a possible range of 1-5 which was obtained for each scale by summing items and dividing by the number of items. One-way ANOVAs were used to compare groups on either past or present versions of each scale and Scheffe post hoc tests for comparing groups with unequal Ns were used to identify significant (p<.05) intergroup differences. 4X2, Groups X Time repeated measures ANOVAs were used to test the significance of changes from past to present on each scale. *p<.05. **p<.01. ***p<.001.
Table 6.9. Scale scores from past and present versions of the IAPCI of 4 groups of participants who reported different types of worst abusive experiences in institutions.
| One way ANOVA |
4X2 ANOVA |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Group 1 P+S |
Group 2 P |
Group 3 S |
Group 4 E |
F | Group Diffs | Groups X Time |
Time | Groups | ||
| N=23 | N=99 | N=40 | N=85 | |||||||
| Past traumatisation | M | 4.45 | 4.19 | 4.19 | 4.11 | 1.68 | NS | 0.45 | 209.81*** | 2.74* |
| SD | 0.52 | 0.65 | 0.78 | 0.60 | ||||||
| Present traumatisation | M | 3.58 | 3.29 | 3.21 | 3.07 | 2.20 | NS | |||
| SD | 0.80 | 0.88 | 0.88 | 0.92 | ||||||
| Past re-enactment | M | 2.93 | 2.43 | 2.76 | 2.34 | 7.07*** | 1,3>2,4 | 1.70 | 199.26*** | 5.81** |
| SD | 0.70 | 0.62 | 0.80 | 0.66 | ||||||
| Present re-enactment | M | 1.91 | 1.67 | 1.76 | 1.62 | 1.33 | NS | |||
| SD | 0.60 | 0.66 | 0.81 | 0.60 | ||||||
| Past spiritual disengagement | M | 3.17 | 2.95 | 3.02 | 2.80 | 1.75 | NS | 0.19 | 15.70*** | 2.38 |
| SD | 0.68 | 0.80 | 0.77 | 0.78 | ||||||
| Present spiritual disengagement | M | 3.41 | 3.19 | 3.37 | 3.12 | 1.37 | NS | |||
| SD | 0.78 | 0.78 | 0.77 | 0.85 | ||||||
| Past positive coping | M | 2.24 | 2.42 | 2.66 | 2.40 | 1.47 | NS | 0.37 | 111.99*** | 1.85 |
| SD | 0.74 | 0.78 | 1.04 | 0.76 | ||||||
| Present positive coping | M | 2.99 | 3.13 | 3.34 | 3.01 | 1.45 | NS | |||
| SD | 0.83 | 0.81 | 1.01 | 0.93 | ||||||
| Past coping by complying | M | 4.39 | 4.74 | 4.38 | 4.54 | 2.83* | 2>3 | 1.30 | 116.27*** | 5.86** |
| SD | 1.07 | 0.47 | 0.95 | 0.87 | ||||||
| Present coping by complying | M | 3.61 | 3.96 | 3.38 | 3.46 | 4.89** | 2>4>3 | |||
| SD | 0.76 | 0.89 | 1.15 | 1.18 | ||||||
| Past avoidant coping | M | 4.46 | 3.91 | 3.87 | 3.78 | 1.94 | NS | 0.44 | 8.88** | 2.45 |
| SD | 0.84 | 1,30 | 1.32 | 1.16 | ||||||
| Present avoidant coping | M | 4.03 | 3.69 | 3.74 | 3.45 | 1.85 | NS | |||
| SD | 1.02 | 1.17 | 1.11 | 1.16 | ||||||
Note: Group 1 contained 23 cases where the worst thing reported was severe physical and sexual abuse. Group 2 contained 99 cases where the worst thing they had experienced was severe physical abuse. Group 3 contained 40 cases where the worst thing they had experienced was severe sexual abuse. Group 4 contained 85 cases where the worst thing they had experienced was severe emotional abuse. Participant’s statements were classified as severe physical abuse if the person reported physical violence, beating, slapping, or being physically injured, but not having medical attention withheld. Statements were classified as severe sexual abuse if the person reported the words sexual abuse or mentioned rape; genital, anal or oral sex; masturbation; or other coercive sexual activities involving either staff or older pupils. Statements were classified as severe physical and sexual abuse if they involved both severe physical abuse and severe sexual abuse as defined earlier. Statements of actions involving humiliation, degradation, severe lack of care, withholding medical treatment, witnessing the traumatization of other pupils and adverse experiences that were not clearly classifiable as severe sexual or physical abuse were classified as severe emotional abuse. Inter-rater agreement greater than 90% was achieved for a sample of 10% of statements. To aid profiling all scales have a possible range of 1-5 which was obtained for each scale by summing items and dividing by the number of items. One-way ANOVAs were used to compare groups on either past or present versions of each scale and Scheffe post hoc tests for comparing groups with unequal Ns were used to identify significant (p<.05) intergroup differences. 4X2, Groups X Time repeated measures ANOVAs were used to test the significance of changes from past to present on each scale. *p<.05. **p<.01. ***p<.001.
Table 6.10. Scale scores from past and present versions of the IAPCI of 3 groups of participants who had different numbers of psychological diagnoses.
| One way ANOVA |
3X2 ANOVA |
||||||||
|---|---|---|---|---|---|---|---|---|---|
| Group 1 4+ Diagnoses |
Group 2 1-3 Diagnoses |
Group 3 0 Diagnoses |
F | Group Diffs | Groups X Time |
Time | Groups | ||
| N=83 | N=119 | N=45 | |||||||
| Past traumatization | M | 4.39 | 4.16 | 3.90 | 9.39*** | 1>2,3 | 9.19*** | 297.35*** | 29.82*** |
| SD | 0.52 | 0.63 | 0.78 | ||||||
| Present traumatization | M | 3.73 | 3.12 | 2.60 | 30.91*** | 1>2>3 | |||
| SD | 0.68 | 0.83 | 0.91 | ||||||
| Past re-enactment | M | 2.87 | 2.35 | 2.21 | 21.74*** | 1>2,3 | 1.58 | 214.63*** | 61.31*** |
| SD | 0.78 | 0.57 | 0.57 | ||||||
| Present re-enactment | M | 2.16 | 1.53 | 1.23 | 48.90*** | 1>2>3 | |||
| SD | 0.75 | 0.49 | 0.32 | ||||||
| Past spiritual disengagement | M | 3.01 | 2.86 | 2.95 | 0.87 | NS | 1.12 | 14.16*** | 1.05 |
| SD | 0.77 | 0.78 | 0.80 | ||||||
| Present spiritual disengagement | M | 3.29 | 3.22 | 3.06 | 1.28 | NS | |||
| SD | 0.75 | 0.78 | 0.95 | ||||||
| Past positive coping | M | 2.31 | 2.49 | 2.52 | 1.57 | NS | 3.10* | 113.41*** | 4.31* |
| SD | 0.90 | 0.76 | 0.81 | ||||||
| Present positive coping | M | 2.88 | 3.31 | 3.01 | 6.14** | 1<2 | |||
| SD | 0.89 | 0.85 | 0.91 | ||||||
| Past coping by complying | M | 4.64 | 4.54 | 4.56 | 0.38 | NS | 2.49 | 140.28*** | 0.31 |
| SD | 0.73 | 0.80 | 0.84 | ||||||
| Present coping by complying | M | 3.50 | 3.73 | 3.78 | 1.48 | NS | |||
| SD | 1.01 | 1.08 | 1.06 | ||||||
| Past avoidant coping | M | 3.94 | 3.99 | 3.62 | 1.52 | NS | 1.11 | 11.43** | 3.97* |
| SD | 1.32 | 1.15 | 1.22 | ||||||
| Present avoidant coping | M | 3.82 | 3.70 | 3.17 | 5.14** | 1>3 | |||
| SD | 1.10 | 1.06 | 1.35 | ||||||
Note: Group 1 had four or more current or lifetime diagnoses as assessed with the SCID I (First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-I). Washington, DC: American Psychiatric Press) and SCID II (First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press). Group 2 had 1-3 current or lifetime diagnoses. Group 3 had no diagnoses. To aid profiling all scales have a possible range of 1-5, which was obtained for each scale by summing items and dividing by the number of items. One-way ANOVAs were used to compare groups on either past or present versions of each scale and Scheffe post hoc tests for comparing groups with unequal Ns were used (except where otherwise stated) to identify significant (p<.05) inter-group differences except for 3X2, Groups X Time repeated measures ANOVAs were used to test the significance of changes from past to present on each scale. *p<.05. **p<.01. ***p<.001.
Table 6.11. Fit indices for the model of institutional abuse
| Index | Model |
|---|---|
| χ2 df p |
31.25 11 .00 |
| RMSEA – Root Mean Square Error of Approximation 90% Confidence Interval |
.08 (.05-.12) |
| IFI – Incremental Fit Index | .96 |
| CFI – Comparative Fit Index | .97 |
| SRMR – Standardized Root-Mean-Square Residual | .07 |
| GFI – Goodness of fit index | .97 |
Table 6.12. Standardised regression coefficients from the model of institutional abuse.
| Total CTQ-I | Years living with family before 16 | Present traumatization | Present re-enactment | Present spiritual disengagement | Present positive coping |
Total current and lifetime diagnoses | |
|---|---|---|---|---|---|---|---|
| Traumatization | .38* | -.22* | |||||
| Re-enactment | .11 | .63* | |||||
| Spiritual Disengagement | -.07 | ||||||
| Positive Coping | -.07 | .15 | |||||
| Total Current and Present Diagnoses | .15* | .00 | .59* | ||||
| Total WHO-QoL 100 | -.02 | -.19* | -.34* | .03 | .31* | -.26* | |
Note: *p<.05
Figure 6.1. Changes in traumatization and positive coping from past to present in three groups of survivors of institutional living with differing numbers of psychological disorders.
Figure 6.2. A path diagram of the model of institutional abuse
Part 7 Conclusions
3.341Past research on child abuse, institutional living, institutional abuse and clerical abuse suggests that children brought up in institutions and abused as children may show a range of problems as adults. These include anxiety, mood, substance use and personality disorders, relationship and parenting problems, occupational and health difficulties, self-harm and an impoverished quality of life, as detailed in Part 1. The negative effects of such early adversity is probably related to the variety, severity, frequency, and duration of abusive experiences. The long-term outcomes of child abuse may be mediated by critical psychological processes such as traumatization, betrayal, disrespect for authority, stigmatization, powerlessness, avoidance of reminders of trauma and re-enactment of negative experiences on self or others. If the negative childhood experiences occur within the context of a religious institution, religious disengagement may also occur. The negative effects of adversity may be attenuated by the use of functional coping strategies such as developing social support, mastering skills, and effectively planning escape from adversity. In contrast, the adverse effects of negative experiences may be exacerbated by the use of dysfunctional coping strategies such as overcompliance. However, in Ireland no large-scale studies have been conducted to investigate whether or not these tentative findings from the international literature reflect the experiences of survivors of institutional living in Ireland.
Aims of the current study
3.342The overarching aim of the present study was to profile subgroups of adult survivors of institutional child abuse on demographic, historical and psychological variables with a view to detecting associations between recollections of institutional living and current adjustment. In particular the aim was to profile subgroups of survivors defined by: (1) the number of years spent in institutions and the circumstances under which admission occurred; (2) the worst type of institutional abuse experienced; and (3) the number and type of psychological disorders displayed. An additional aim was to develop a way to assess psychological processes and coping strategies associated with institutional abuse, and establish the correlates of these processes and coping strategies.
Methodology
3.343Between May 2005 and February 2006 just under 250 adult survivors of institutional living recruited through CICA were interviewed in Ireland and the UK by a team which included 29 trained interviewers, all of whom had degrees in psychology. The overall exclusion rate was 26% (326 of 1267). The participation rate was 20% (246 of 1267). The response rate for the study was 26% (246 of 941). (This low response rate is not unusual. A response rate of 9% was obtained in the Time to Listen Report on Confronting Child Sexual Abuse by Catholic Clergy (Goode, McGee & O’Boyle, 2003)).
3.344The sample of participants interviewed was not representative of all CICA attenders, or indeed of adult survivors of institutional living. It is probable that participants were better adjusted than CICA attenders who did not take part, because the old and the ill were excluded from the study. The interview protocol covered demographic characteristics, history of family and institutional living, recollections of child abuse within the family and institutions, psychological processes associated with institutional life, coping strategies used to deal with institutional life, current trauma symptoms, current and past diagnoses of psychological and personality disorders, relationships with partners and children, adult attachment style, main life problems, current quality of life, and global level of functioning. Interviews were conducted in an ethical way that safeguarded participants’ wellbeing. Data were managed in a way to safeguard participants’ anonymity.
Summary of main results
Profile of overall sample
3.345Demographic characteristics. The 247 participants in this study included roughly equal numbers of men and women of about 60 years of age, who had entered institutions run by nuns or religious brothers due to family adversity or petty criminality. Participants had spent an average of 5.4 years living with their families before entering an institution and on average spent 10 years living in an institution. The majority were of lower socioeconomic status and low educational attainment. The majority had been, or were currently married or in a long-term relationships, with a high rate of relationship stability. Most married participants had children, with three children being the average, and most had brought up their own children.
3.346Institutional abuse. On the institutional version of the Childhood Trauma Questionnaire, more than 90% of participants were classified as having experienced institutional physical and emotional child abuse and about half as having experienced institutional child sexual abuse. More than 90% were classified as having experienced physical and emotional neglect within institutions. For about 40% of participants, severe physical abuse was the worst thing that happened to them in an institution. For a further third it was humiliation and degradation. For 16% it was sexual abuse and for about a tenth it was combined physical and sexual abuse. Worst institutional abusive experiences began at about 9 years and lasted for 5 about years.
3.347Family-based child abuse. On the family version of the Childhood Trauma Questionnaire just over a third of those who had memories of having lived with their families reported family-based child abuse or neglect.
3.348Life problems. All participants had experienced one or more significant life problems. Mental health problems, unemployment and substance use were the three most common difficulties and were reported by a third to three quarters of participants.
3.349Strengths. Self-reliance, optimism, work and skills were the most frequently reported sources of personal strength and factors that helped participants face life challenges.
3.350Psychological disorders. About four fifths of participants at some point in their life had had a psychological disorder and only a fifth had never had any psychological disorder. Anxiety disorders were the most common, followed by mood disorders, followed by substance use disorders, and personality disorders were the least common.
3.351Trauma symptoms. The majority of participants showed clinically significant post-traumatic symptomatology on the Trauma Symptom Inventory, indicative of continuing post-traumatic adjustment difficulties.
3.352Adult attachment styles. On the Experiences in Close Relationships Inventory more than four fifths of participants were classified as having an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships. A fearful attachment style characterized by high interpersonal anxiety and avoidance was by far the most common. Less than a fifth of cases were classified as having a secure adult attachment style.
Comparison of CICA survivors and normal populations
3.353The overall rates of psychological disorders among survivors of institutional living in the present study, were far higher, and in most cases double those found in normal community populations in major international epidemiological studies.
Correlates of institutional abuse
3.354Institutional sexual abuse was associated with current post-traumatic symptomatology and major life problems.
Heterogeneity among survivors
3.355Adult survivors of institutional living were not a homogenous group, and subgroups had distinctive profiles.
Males and females
3.356Male and female participants had different profiles. Male participants spent longer living with their families before entering institutions and fewer years in institutions. More entered institutions run by religious brothers or priests for petty crime and left because their sentence was over, while more females lived in institutions run by nuns. Male participants achieved a higher SES than females and more had children who spent time living separately from them with the child’s other parent. While worst abusive experiences began at an older age, for male participants, they reported more institutional sexual abuse. While female participants had significantly more current panic disorder with agoraphobia, significantly more male participants had lifetime diagnoses of alcohol and substance use disorders, especially alcohol dependence. Male participants had significantly higher numbers of life problems, but also higher levels of global functioning and marital satisfaction than females.
Older and younger participants
3.357Older participants in their 60s and younger participants in their 50s had distinct profiles. More older participants left their institutions because they were too old to stay on and more were now retired. They had longer relationships with their current partners and were older when their first children were born. Younger participants reported greater institutional, physical, sexual and emotional abuse. More had current anxiety, mood and personality disorders, especially PTSD, generalized anxiety disorder and avoidant personality disorder. Younger participants had more trauma symptoms, adult life problems, a lower quality of life and lower level of global functioning compared with older participants.
Participants from the CICA confidential and investigation committees
3.358Participants from the confidential and investigation committees had distinct profiles. Participants from the confidential committee had spent fewer years with their families before entering an institution and more years in institutions run by nuns. More entered because they were illegitimate and left because they were too old to stay on. They were younger when their worst experiences began. More had maintained stable long-term relationships with their partners and provided their own children with a stable family in which to grow up. More participants from the investigation committee entered intuitions run by religious brothers or priests through the courts for petty crime and left because their sentences were over. They reported greater institutional sexual abuse than participants from the confidential committee. More participants from the investigation committee had a current diagnosis of major depression.
Subgroups defined by duration of time in an institution and circumstances of entry
3.359In the analysis of four groups of participants who had spent different amounts of time in institutions and entered under different circumstances, the most poorly adjusted as adults were not those who had spent longest living in institutions (more than 12 years), but rather those who had spent less time in institutions (under 11 years), entered institutions through the courts and reported institutional sexual abuse, in addition to physical abuse within their families. These had more anti-social personality disorders, substance use disorders and life problems such as unemployment and criminality. What follows is a summary of the profiles of the four groups from this analysis.
3.360Group 1 included those who had spent more than 12 years in an institution and entered before 5 years of age. They had spent the least time with their families (under one and a half years) and the longest time living in institutions (about fifteen years) of any of the four groups. Compared to groups 3 and 4, more were girls placed in orphanages run by nuns because they were illegitimate, or because their parents had died or could not look after them. More left because they were too old to stay on, and more had mixed feelings about leaving. More had experienced physical abuse which began at a younger age and persisted longer than in group 4. Severe emotional abuse was most commonly cited as the worst thing that happened to this group and it began at an earlier age and lasted longer than worst experiences of other groups. Compared with groups 3 and 4, this group reported fewer psychological disorders and life problems. They identified relationships with friends, self-reliance, optimism, and their work and skills as the sources of their strength.
3.361Group 2 included participants who had spent 5-11 years in institutions because of family problems. Participants in this group entered institutions run predominantly by nuns because their parents could not cope or died, and left when they were too old to stay. Compared with groups 3 and 4, more members of group 2 were female, younger when their most severe form of sexual abuse began, and more identified severe emotional abuse as the worst thing that had happened to them. Compared with group 4 more identified self-reliance, optimism, and their work and skills as the source of their strength.
3.362Group 3 included participants who had spent 5-11 years in institution and entered through the courts. Compared with groups 1 and 2, more members of this group were male, lived in institutions run by religious brothers or priests, and were survivors of institutional sexual abuse. Compared to the other three groups they identified sexual abuse as the worst thing that had happened to them, and more had experienced physical abuse within their families. Compared with groups 1 and 2, this group had more alcohol and substance use disorders, antisocial personality disorders, violent and non-violent crime, imprisonment for violent and non-violent crime, and unemployment. For this group, their self-reliance, optimism, and their work and skills were identified as the main sources of their strength in adulthood, compared with group 4.
3.363Group 4 included participants who had spent 4 or fewer years in institution. Participants in this group spent the most time with their families (more than ten and a half years) and the shortest time living in an institution (just under three years) compared with the other three groups. Most were boys placed in institutions run by religious brothers or priests because of petty crime and left because their short sentences were over, or because their families wanted them back, and few had mixed feelings about leaving. Institutional sexual abuse was the form of maltreatment that distinguished this group, and compared with groups 1 and 2, they showed more alcohol and substance use disorders, antisocial personality disorders, non-violent crime, imprisonment for non-violent crime and unemployment. Their relationships with their partners was identified as the main source of their strength in adulthood.
Subgroups defined by worst form of institutional abuse
3.364In the analysis of groups of participants who reported suffering differing types of worst abusive experiences in institutions, the most poorly adjusted as adults were not those who reported severe combined physical and sexual abuse, but rather, those who pinpointed severe sexual abuse as the worst thing that had happened to them while living in an institution. In this analysis, the best adjusted were those who had suffered severe emotional abuse. What follows is a summary of the profiles of the four groups from this analysis.
3.365Group 1 included participants for whom severe sexual and physical abuse was the worst thing they had experienced. Participants in this group had experienced more physical and sexual institutional abuse than at least two of the other 3 groups (in this analysis). They had spent less time with their families before entering an institution than group 3. Like members of group 3, more had children who spent some time living separately with the child’s other parent. Compared with groups 2 and 4, more had a current diagnosis of post-traumatic stress disorder (PTSD) and multiple trauma symptoms.
3.366Group 2 included participants for whom severe physical abuse was the worst thing they had experienced. Participants in this group had the lowest educational achievement, were older than groups 1 and 3 (in this analysis), and more had put their own children up for adoption. Compared with group 3, their worst abusive experience had lasted longer. Like group 4, fewer had PTSD than groups 1 and 3, and they had fewer life problems than group 3.
3.367Group 3 included participants for whom severe sexual abuse was the worst thing they had experienced. Compared with group 4 (in this analysis), more participants in group 3 were male and were admitted through the courts to institutions run by religious brothers for petty crime. Like group 1, more had children who spent time with their other parent who lived separately compared to group 4. Also, compared to group 4, more had PTSD, multiple trauma symptoms, lifetime alcohol and substance use disorders, antisocial personality disorders and multiple life problems.
3.368Group 4 included participants for whom severe emotional abuse was the worst thing they had experienced. Compared to group 3 (in this analysis), more participants in this group were female and on average had spent the longer living in institutions run by nuns. Their worst experiences began at an earlier age than any other group and more had mixed feelings about leaving.
The association between sexual abuse and outcome
3.369In the analysis of groups of participants who had spent different amounts of time in institutions and entered under different circumstances, the most poorly adjusted as adults were those who had spent a moderate amount of time in institutions and who had suffered institutional sexual abuse. In the analysis of groups of participants who reported suffering differing types of worst abusive experiences in institutions, the most poorly adjusted included those who pinpointed severe sexual abuse as the worst thing that had happened to them while living in an institution. Thus, institutional sexual abuse was associated in both analyses with a particularly poor outcome.
Profiles associated with patterns of adult psychological disorders
3.370There was an association between having psychological disorders and reporting both institutional and family-based child abuse and neglect. Certain patterns of psychological disorders were associated with institutional abuse alone, and other patterns were associated with institutional family-based child abuse and neglect. For participants with multiple co-morbid diagnoses, and for those with mood disorders, greater institutional, but not family-based physical, sexual and emotional abuse was reported. Participants with PTSD, alcohol and substance use disorders, avoidant and antisocial personality disorder reported both institutional and family-based abuse or neglect. Participants with multiple diagnoses had the poorest adult psychological adjustment and those with no diagnoses were the best adjusted. Subgroups selected by diagnosis showed an intermediate level of adult psychological adjustment between these extremes. What follows are brief profiles of groups with different patterns or types of psychological disorders.
3.371Multiple comorbid diagnoses. Participants with 4 or more diagnoses reported greater institutional sexual and emotional abuse (but not more family-based abuse) than participants with fewer diagnoses. Participants with 4 or more diagnoses had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with 1-3 diagnoses, who in turn were less well adjusted than participants with no diagnoses. More participants with 4 or more diagnoses had a fearful adult attachment style, and fewer had secure or dismissive adult attachment styles. On average more participants with 4 or more diagnoses were in their 50s compared with those with no diagnoses who where were in their 60s. Also, more participants with 4 or more diagnoses were unemployed and of lower SES than participants with fewer diagnoses.
3.372Mood disorders. Participants with mood disorders, more than half of whom had co-morbid anxiety disorders, reported greater institutional sexual and emotional abuse and greater institutional severe physical and sexual abuse (but not family-based child abuse) than participants with no diagnoses. Participants with mood disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. More participants with mood disorders had a fearful adult attachment style, and fewer had a secure adult attachment style. On average participants with mood disorders were in their late 50s while those with no diagnoses were in their 60s. Also, on average, participants with mood disorders had had their first child in their mid-20s, while those with no diagnoses had their first children a couple of years later.
3.373Posttraumatic stress disorder. Participants with PTSD, more than half of whom had other co-morbid anxiety disorders and alcohol or substance use disorders, reported greater institutional physical, sexual and emotional abuse, and greater institutional severe physical and sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based emotional abuse. Participants with PTSD had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Fewer participants with PTSD had a dismissive adult attachment style. On average participants with PTSD were in their 50s while those with no disorders were in their 60s.
3.374Alcohol and substance use disorders. Participants with alcohol and substance use disorders, more than half of whom had a co-morbid anxiety disorder, reported greater institutional sexual and emotional abuse, and greater institutional severe sexual abuse than participants with no diagnoses. They also reported having experienced greater family-based physical and emotional abuse. Participants with alcohol and substance use disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Compared with those with no diagnoses, participants with alcohol and substance use disorders were younger (in their 50s not their 60s); had had their first children at a younger age (in early, not their late 20s); were of lower SES; and fewer had entered an institution because their parents had died.
3.375Avoidant personality disorder. Participants with avoidant personality disorders reported greater institutional and family-based emotional abuse than those with no diagnoses. Almost all participants with an avoidant personality disorder had a co-morbid anxiety, mood or substance use disorder. Participants with avoidant personality disorder had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Compared to those with no diagnoses, more participants with an avoidant personality disorder had a fearful adult attachment style and fewer had a secure adult attachment style. Compared to participants with no diagnoses, participants with avoidant personality disorder were younger (in their 50s, not their 60s) and more had been placed in institutions run by nuns because their parents could not care for them.
3.376Antisocial personality disorder. Participants with antisocial personality disorder reported greater institutional sexual abuse than participants with no diagnoses. All participants with antisocial personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with antisocial personality disorder had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and lower parental satisfaction than participants with no diagnoses. Compared to those with no diagnoses, participants with antisocial personality disorder were younger (in their 50s, not their 60s); had spent fewer years in institutions (5 1/2 not nearly 10 years); more were unemployed; and more were of low SES.
3.377Borderline personality disorder. Participants with borderline personality disorder and those with no diagnoses, did not differ in their reported levels of institutional or family-based child abuse, although both reported a high level of child abuse. All participants with borderline personality disorder had co-morbid anxiety, mood or substance use disorders. Participants with borderline personality disorders had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and more had a fearful adult attachment style than participants with no diagnoses. Compared to those with no diagnoses, participants with borderline personality disorder were younger (in their 50s, not 60s), more were unemployed, and on average reported being abused from an earlier age.
Changes in institutional abuse processes from childhood to adult hood
3.378All participants reported a reduction in the psychological processes of traumatization and re-enactment and an increase in spiritual disengagement from childhood to adult life. The three multi-item scales developed in this study to measure these constructs were: (1) the traumatization scale which assessed negative emotions arising from abuse, betrayal and loss of trust, stigmatization, shame, guilt, and disrespect of authority; (2) the re-enactment scale which assessed re-enactment of abuse, powerlessness, coping by opposing and coping by using alcohol and drugs; and (3) the spiritual disengagement scale which assessed disengagement from religious practice and not using spiritual coping strategies. Two versions of these scales were developed. The first assessed participants’ memories of these processes from childhood. The second assessed the current experience of these processes in adulthood.
Changes in coping strategies from childhood to adulthood
3.379Participants reported an increase in the use of positive coping strategies and a reduction in the use of coping by complying and avoidant coping strategies from childhood to adulthood. The three multi-item scales developed in this study to measure these constructs were: (1) the positive coping scale which assessed coping through planning, skill mastery and social support; (2) the coping by complying scale which assessed coping by complying with the wishes of people in authority; and (3) the avoidant coping scale which assessed coping by avoiding thoughts and situations associated with abuse. Two versions of these scales were developed. The first assessed participants’ memories of using these coping strategies in childhood. The second assessed their current use of these coping strategies in adulthood.
Institutional abuse and the processes of traumatization and re-enactment
3.380The psychological processes of traumatization and re-enactment as experienced in adulthood or remembered from childhood were associated with multiple indices of institutional abuse, but not family-based child abuse. Participants for whom severe physical and sexual abuse, or severe sexual abuse alone were the worst things that happened to them in institutions, reported greater past re-enactment of abusive experiences, than those for whom worst experiences involved severe physical or emotional abuse.
Adult adjustment, abuse processes and coping strategies
3.381Traumatization and re-enactment as experienced in adulthood or remembered from childhood were associated multiple indices of adult adjustment including the presence of multiple trauma symptoms, multiple adult life problems, global functioning, quality of life, interpersonal anxiety and interpersonal avoidance. Participants with four or more psychological disorders reported greatest past and present traumatization and re-enactment; greatest current use of avoidant coping; and least current use of positive coping. Participants with no psychological disorders, reported least current traumatization, re-enactment and use of avoidant coping, and the greatest reduction in traumatization from childhood to adulthood. However, they showed a negligible increase in the use of positive coping strategies from childhood to adulthood, probably because they were using these strategies throughout their lives.
Correlates of positive coping and time spent living with family
3.382Positive coping in adulthood was associated with marital satisfaction and a good quality of life. Participants who spent 5-11 years in an institution and placement occurred through the courts reported greater use of positive coping strategies in childhood, than those who spent 5-11 years in an institution and placement occurred because parents couldn’t cope or died. These in turn reported greater use of these strategies than participants who spent more than 12 years in an institution and entered before age 5. Time spent living with one’s family in childhood was a protective factor and was associated with reduced traumatization in adulthood, whereas severe family-based child abuse was associated with avoidant coping in adulthood.
Correlates of dysfunctional coping
3.383Participants who reported that severe physical abuse was the worst thing that happened to them in institutions reported greatest coping by complying. Lowest levels of coping by complying occurred among those that reported that severe sexual abuse was the worst thing that happened to them in institutions. For present coping by complying, intermediate between these extremes was the group that reported that severe emotional abuse was the worst thing that happened to them in institutions.
A model of institutional abuse, psychological processes and adult adjustment
3.384A model was developed which shows how childhood institutional abuse is associated with the processes of traumatization, re-enactment and spiritual disengagement, which in turn are associated with adult mental health and quality of life. The model also shows how childhood years within the family and current use of positive coping strategies are associated with quality of life
Strengths and limitations
3.385This study had three main limitations: (1) there was a high exclusion rate and a low response rate; (2) there was no control group; and (3) the study used a crossectional not a longitudinal design. There were also four main strengths: (1) it was the largest study of its kind conducted to date; (2) an extensive reliable and valid interview protocol was used; (3) data were collected by psychologists trained in using the interview protocol and (4) in the statistical analyses, steps were taken to reduce type 1 error (interpreting non-significant results as significant)
High exclusion rate and low response rate
3.386About a quarter of all potential participants were excluded for various practical reasons, and only about a quarter of the remaining survivors participated in the study. Because of these two factors, the group of participants was not a representative sample of either typical CICA attenders or the broader population of adult survivors of institutional living. This limits the generalizability of the results. We cannot say that an identical pattern of results would occur if all CICA attenders, or all survivors of institutional living were interviewed.
3.387However, we can make an informed judgment. Those, too old, or too ill, or too disabled or without fixed addresses were excluded. Thus, on balance, it is probable that the participants in the study may have been slightly better adjusted than those excluded. We have no basis on which to make a similar judgement about non-responders or survivors who did not attend CICA. They may be better or more poorly adjusted.
3.388It is worth commenting on the response rate within the context of other studies. The response rate for the study of adult survivors of clerical child abuse in the Time to Listen Report on Confronting Child Sexual Abuse by Catholic Clergy was only 9%, and only 7 survivors were interviewed face to face (Goode, McGee & O’Boyle, 2003). The response rate in our study was almost three times this, and 240 more survivors were interviewed. Within this context, although the exclusion and response rates were limitations, the current study has made a significant contribution to our knowledge about institutional abuse in Ireland.
No control group
3.389The aim of the study was to determine if there were associations between adult adjustment and recollections of institutional abuse, an aim that could be achieved by exploring profiles of subgroups and correlations between variables within a single group cross-sectional design.
3.390However, a more powerful design involving a demographically matched control group, members of which had grown up in families (not institutions), would have allowed other important questions to be answered. For example, a control group design would have allowed us to answer questions about whether rates of psychological disorders and levels of life problems, quality of life and so forth were different in survivors and matched normal controls. Such a study would have been beyond the resources available for the investigation, and no such studies have been published in the Irish or international scientific literature.
3.391In an attempt to overcome some of the limitations of a single group study, we included some standardized assessment instruments for which normative data were available, such as the Childhood Trauma Questionnaire and the Trauma Symptom Checklist and data from epidemiological studies of normal populations. Using the norms for standardized instruments we could conclude that across a range of trauma symptom scales 12-59% of cases scored above clinical cut-off scores of a normative group; over 90% of cases scored above cut-off scores of a normative group for physical and emotional child abuse; and just under 50% scored above the cut-off score of a normative group for child sexual abuse. Data from major international epidemiological studies allowed us to conclude that the prevalence of current anxiety, mood and personality disorders among participants in our study was more than twice that found in normal European, North American or British populations; and the prevalence of lifetime diagnoses of anxiety, mood, and substance use among our participants exceeded those found in normal European, North American or British populations by between 5 and 30%.
Cross-sectional design
3.392We used a cross-sectional design, with all variables being assessed at one point in time. This design has major limitations. Where two variables are found to correlate significantly or where two groups are found to differ significantly on a variable, the strongest inference that can validly be made is that variables in these statistical analyses are associated. We cannot validly infer causality. That is, we cannot say, for example, that institutional abuse caused adult adjustment problems. To make such an inference, a longitudinal design is required, in which cases abused in institutions and a normal control group are assessed before the onset of the abuse, and later in life. Such a design was clearly not viable. From our cross-sectional design, all that can be concluded is that some of the variables that assessed abuse and some of the variables that assessed adult adjustment were associated. Furthermore, there are at least three possible explanations that could account for this association. The abusive experiences may have caused the adjustment problems. Another possibility is that adults with adjustment problems selectively and inadvertently over-reported abusive experiences. A third possibility, is that some other factor of which we are unaware, caused both the reporting of abusive experiences and the reporting of adult adjustment problems.
3.393Our informed judgement, in which we have a moderate degree of confidence, is that the abusive experiences caused the adult adjustment problems. But of course, we are cautious about making a definitive statement in this regard. Our confidence is based partly on the similarity between our findings and those from the large international literature on child abuse referred to in Part 1 (Berliner & Elliott, 2002; Carr, 2006; Carr & O’Reilly, 2004; Kolko, 2002; NCCANI & NAIC, 2004; Wekerle & Wolfe, 2003).
Largest study of its kind
3.394A major strength of this study is that it is the largest study of its kind ever to be conducted. The only comparable study, conducted in Canada, included 76 men aged 23-54 years (Wolfe et al. 2006). Our study involved 247 males and females ranging in age from 40-83 years.
Extensive reliable and valid interview protocol
3.395An extensive reliable and valid interview protocol was used, which allowed data on a range of important constructs to be collected. The protocol included multiple indices of institutional and family-based child abuse and neglect, along with multiple indices of adult adjustment including psychological diagnoses, trauma symptoms, life problems, adult attachment style, marital and parenting relationships, quality of life and global functioning.
Qualified interviewers
3.396Data were collected in face-to-face interviews, not by questionnaire, and these interviews were conducted by a team of psychologists all of whom had been trained in using the interview protocol. Interviews were conducted in an ethical and sensitive manner. Furthermore, a subsidiary study of 52 cases confirmed that good inter-rater reliability was achieved for all variables. The interviewer training, they style of the interviews, the and the fact that a reliable and valid protocol was used, allows us to place a high level of confidence in the quality of the data collected.
Reduction of type 1 error
3.397In the statistical analyses in Parts 3-5, steps were taken to reduce type 1 error (interpreting non-significant results as significant). In any set of statistical analyses where a p value is set at .05 for each single test, and if 100 tests are conducted, it may be expected that 5 significant results will be obtained by chance, through type 1 error. To avoid such spurious results, for single items or variables, p-values for t-tests, analyses of variance (ANOVAs) and Chi Square tests were set conservatively at p<.01 (not p<.05). For continuous variables assessing child abuse multivariate analyses of variance (MANOVAs) were conducted, before proceeding to ANOVAs or t-tests, since this also controls for type 1 error. In MANOVAs an overall test is conducted to check if groups differ significantly on all variables, before checking whether they differ significantly on each individual variable (using ANOVA or t-tests).
Recommendations
3.398Recommendations arising from this research fall into four broad categories: prevention, treatment, training and research.
Prevention
3.399The first recommendation is that legislation, policies, practices and procedures be regularly reviewed and revised to maximize protection of children and adolescents in institutional care in Ireland from all forms of abuse and neglect. Specifically the Children First: National Guidelines for the Protection and Welfare of Children (Department of Health and Children, 1999) require regular review and revision to insure that they are being properly implemented and that children and adolescents in institutional care, and other forms of substitutive care in Ireland are being adequately protected.
Treatment
3.400The second recommendation is that evidence-based psychological treatment continue to be made available to adult survivors of Irish institutional abuse. Specifically the National Counselling Service for adult survivors of child abuse in Ireland and similar appropriate services in the UK should continue to be accessible to Irish survivors of institutional abuse. Staff in such services should be appropriately qualified and trained to offer services to clients with complex difficulties, such as multiple co-morbid disorders including anxiety disorders, mood disorders, substance use disorders and personality disorders. It is important the these services be evidence-based (Carr, 2006).
Staff training
3.401The third recommendation is that staff at centres which provide psychological treatment for adult survivors of Irish institutional abuse have regular continuing professional education and training to keep them abreast of developments in the field of evidence-based treatment of survivors of childhood trauma.
Research
3.402The fourth recommendation is that research be conducted to evaluate the effectiveness of psychological treatment for adult survivors of institutional abuse. The report of Survivors’ Experiences of the National Counselling Service for Adults who Experienced Childhood Abuse (Leigh et al., 2003) was an important first step in evaluating client satisfaction with the National Counselling Service. However, it did not address the critical issue of the effectiveness of the service provided. Such research is urgently required. Research is also required on levels of child abuse among looked after children (including all categories of children in care and children living in a variety of health, educational, correctional and social services institutions).
References
Alonso, J., Angermeyer, M., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., de Girolamo, G., de Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J.M., Katz, S., Kessler, R.C., Kovess, V., Lépine, J.P., Ormel, J., Polidori, G., Vilagut, G. (2004). Prevalence of Mental Disorders in Europe: Results from the European Study of Epidemiology of Mental Disorders (ESEMeD) Project. Acta Psychiatrica Scandninavica, 109 (suppl 420), 21-27.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of the Mental Disorders (Fourth Edition-Text Revision, DSM –IV-TR). Washington, DC: APA.
Battle, C., Shea, M., Johnson, D. et al., (2004) Childhood maltreatment associated with adult personality disorders: findings from the collaborative longitudinal personality disorders study. Journal of Personality Disorders, 18 (2). 193-211.
Bentler, P.M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238-246.
Berliner, L. & Elliott, D. (2002). Sexual abuse of children. In J. Myers, L. Berliner, J. Briere, C. Hendrix, C. Jenny & T. Reid (Ed.), APSAC Handbook on Child Maltreatment (Second Edition, pp. 55-78). Thousand Oaks, CA: Sage.
Bernstein, D. & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report. Manual. San Antonio, TX: The Psychological Cooperation.
Bierer, L. Yehuda, R., Schmeidler, J., Mitropoulou, V. Antonia, S., Silverman, J. & Siever, L. (2003). Abuse and neglect in childhood: relationship to personality disorder diagnoses. CNS Spectrums, 8(10), 737-740, 749-754.
Bollen, K.A. (1989). Structural Equations with Latent Variables. New York: Wiley.
Bottoms, B. L., Shaver, P. R., Goodman, G. S. & Qin, J. (1995). In the name of God: A profile of religion-related child abuse. Journal of Social Issues, 51, 85-111.
Brennan, K., Clark, C., & Shaver, P. (1998). Self-report measure of adult attachment: An integrative overview. In J. Simpson & W. Rholes (Eds.), Attachment Theory and Close Relationships (pp. 46-76). New York: Guilford Press.
Briere, J. (1996). Trauma Symptom Inventory. Odessa, FL: Psychological Assessment Resources.
Brodsky, B. S., Oquendo, M., Ellis, S. P., Haas, G. L., Malone, K. M. & Mann, J. J. (2001). The relationship of childhood abuse to impulsivity and suicidal behaviour in adults, with major depression. American Journal of Psychiatry. 2001, 158, 1871-1877.
Carr, A. & O’Reilly, G. (Eds.) (2004) Clinical Psychology in Ireland Volume 5: Empirical Studies of Child Sexual Abuse. Wales: Edwin Mellen Press.
Carr, A. (2006a). Handbook of Clinical Child and Adolescent Psychology: A Contextual Approach (Second Edition, Chapters 19, 20, 21). London: Routledge.
Carr, A. (2006b). The Effects of Psychotherapy: A Review of Research Prepared for the Irish Council for Psychotherapy. Dublin, Ireland: Irish Council for Psychotherapy.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46.
Colman, R. & Widom, C. (2004). Childhood abuse and neglect and adult intimate relationships: A prospective study. Child Abuse & Neglect, 28, 1133-1151.
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika. 16, 297-334.
Curran, P. J., West, S. G., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16-29.
Davis, J. & Petretic-Jackson, P. (2000). The impact of child sexual abuse on adult interpersonal functioning: A review and synthesis of the empirical literature. Aggression and Violent Behaviour, 5, 291-323.
Department of Health and Children (1999). Children First: National Guidelines for the Protection and Welfare of Children. Dublin: Stationary Office.
DiLillo, D. & Damashek, A. (2003). Parenting characteristics of women reporting a history of childhood sexual abuse. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children, 8(4), 319-333.
Farrell, D. & Taylor, M. (2000). Silenced by God–an examination of unique characteristics within sexual abuse by clergy. Counselling Psychology Review, 15, 22-31.
Fater, K. & Mullaney, J. (2000). The lived experience of adult male survivors who allege childhood sexual abuse by clergy. Health Nursing, 21(3), 281-295.
First, M., Spitzer, R., Gibbon M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV Personality Disorders, (SCID-II). Washington, DC: American Psychiatric Press.
First, M., Spitzer, R., Gibbon, M., and Williams, J. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.
Gallagher, B. (1999). The abuse of children in public care. Child Abuse Review, 8(6), 357-365.
Gilligan, R. (2000). The developmental implications for children of life in public care – Irish and international perspectives. Irish Journal of Psychology, 21, 3-4, 138-15.
Goode, H., McGee, H., & O’Boyle, C. (2003). Time to Listen. Confronting Child Sexual Abuse by Catholic Clergy in Ireland. Dublin, Ireland: Liffey Press.
Grant, B., Hasin, D., Stinson, F., Dawson, D., Chou, S. & Ruan, W. J. et al. (2004). Prevalence, correlates, and disability of personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 65, 948-58.
Hardt, J. & Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry, 45, 260–273.
Hoyle, R.H., & Panter, A.T. (1995). Writing about structural equation models. In R.H. Hoyle (Ed.) Structural equation modelling: Concepts, issues and applications (pp. 158-198). London: Sage.
Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modelling: sensitivity to underparameterized model misspecification. Psychological Methods ,4 ,424-453.
Hu, L., & Bentler, P. M. (1999). Cut-off criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling, 6, 1-55.
James, D. E., Schumm, W. R., Kennedy, C. E., Grigsby, C. C., Shectman, K. L., Nichols, C. W. (1985). Characteristics of the Kansas Parental Satisfaction Scale among two samples of married parents. Psychological Reports, 57, 163-169.
Jöreskog, K., & Sörbom, D. (1981). LISREL V: Analysis of Linear Structural Relationships by the Method of Maximum Likelihood. Chicago: National Educational Resources.
Jöreskog, K. G., & Sörbom, D. (1993). Structural Equation Modelling with the SIMPLIS Command Language. Chicago: Scientific Software Inc.
Jöreskog, K. & Sörbom, D. (1999). PRELIS 2.30. Chicago: Scientific Software Inc.
Jöreskog, K. & Sörbom, D. (2002). LISREL 8.52. Chicago: Scientific Software Inc.
Jöreskog, K., & Sörbom, D. (2005a). LISREL 8.72. Chicago: Scientific Software Inc.
Jöreskog, K., & Sörbom, D. (2005b). PRELIS 2.72. Chicago: Scientific Software Inc.
Kendall-Tackett, K. (2002). The health effects of childhood abuse: Four pathways by which abuse can influence health. Child Abuse & Neglect, 26, 715-729.
Kennedy, E. (1970). Reformatory and Industrial Schools Systems Report. Dublin: Stationary Office.
Kessler, R., Berglund, P., Demler, O., Jin, R. & Walters, E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 593-602.
Kessler, R., Chiu, W., Demler, O. & Walters, E.E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 617-627.
Kolko, D. (2002). Child physical abuse. In J. Myers, L. Berliner, J. Briere, C. Hendrix, C. Jenny & T. Reid (Ed.), APSAC Handbook on Child Maltreatment Second Edition, pp. 21-54). Thousand Oaks, CA: Sage.
Leigh, C., Rundle, K., McGee, H. & Garavan R. (2003). SENCS: Survivors’ Experiences of the National Counselling Service for Adults who Experienced Childhood Abuse. Dublin: National Counselling Service
Luborsky, L. (1962). Clinicians’ Judgements of Mental Health. Archives of General Psychiatry, 7, 407–417.
Luthar, S. (2003). Resilience and Vulnerability : Adaptation in the Context of Childhood Adversities. Cambridge: Cambridge University Press.
MacMillan, H. L., Fleming, J. E. & Streiner, D. L. et al. (2001). Childhood abuse and lifetime psychopathology in a community sample. American Journal of Psychiatry. 2001, 158, 1878-1883.
McGee, H. Garavan, R., deBarra, M., Byrne, J. & Conroy, R. (2002). The SAVI Report. Sexual Abuse and Violence in Ireland. A National Study of Irish Experiences, Beliefs and Attitudes Concerning Sexual Violence. Dublin, Ireland: Liffey Press.
McLaughlin, B. (1994). Devastated spirituality: The impact of clergy sexual abuse on the survivor’s relationship with God and the church. Sexual Addiction & Compulsivity, 1(2), 145-158.
- NCCANI & NAIC – National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse (2004). Long-Term Consequences of Child Abuse and Neglect. http://nccanch.acf.hhs.gov
Newcomb, M. & Locke, T. (2001). Intergenerational cycle of maltreatment: a popular concept obscured by methodological limitations. Child Abuse and Neglect, 25(9)1219-1240.
O’Hare, A., Whelan, C.T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135-156.
Perez, C. & Wodom, C. (1994). Childhood victimization and long-term intellectual and academic outcomes. Child Abuse & Neglect, 18(8),. 617-633.
Powers, J. L., Mooney, A. & Nunno, M. (1990). Institutional abuse: A review of the literature. Journal of Child and Youth Care, 4, 81-95.
Quinton, D., & Rutter, M. (1988). Parenting Breakdown: The Making and Breaking of Inter-Generational Links. Aldershot, England: Avebury.
Rossetti, S. (1997). The effects of priest-perpetration of child sexual abuse on the trust of Catholics in the priesthood, Church and God. Journal of Psychology and Christianity, 16, 3, 197-209.
Rutter, M. (2002). Maternal deprivation. In M. Bornstein (Ed.) Handbook of Parenting: Vol. 4: Social Conditions and Applied Parenting (Second Edition, pp. 181-202). Mahwah, NJ: Lawrence Erlbaum.
Rutter, M., Kreppner, J. K., O’Connor, T. G. & the ERA Research Team. (2001). Specificity and heterogeneity in children’s responses to profound privation. British Journal of Psychiatry, 179, 97-103.
Rutter, M., Quinton, D. & Hill, J. (1990). Adult outcome of institution-reared children: Males and females compared. In L. Robins, & M. Rutter, Michael (Ed). Straight and Devious Pathways From Childhood to Adulthood (pp. 135-157). New York,: Cambridge University Press.
Satorra, A. (1992). Asymptotic robust inferences in the analysis of mean and covariance structures. Sociological Methodology, 22, 249-278.
Satorra, A., & Bentler, P. (2001). A scaled difference chi-square test statistic for moment structure analysis. Psychometrika, 66, 507-514.
Scher, C., Stein, M., Asmundson, G., McCreary, D. & Forde, D. (2001). The Childhood Trauma Questionnaire in a Community Sample: Psychometric properties and normative data. Journal of Traumatic Stress, 14 (4), 843- 857.
Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., Bugaighis, M.A. (1986) Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage & the Family, 48, 381-387.
Singleton, N., Bumpstead, R., O’Brien, M., Lee, A. & Meltzer, H. (2001). Psychiatric Morbidity Among Adults Living in Private Households, 2000. London, UK: Stationary Office.
Skevington, S. (2005). World Health Organization Quality of Life 100 UK Version. Bath, UK: WHO Centre for the Study of Quality of Life, University of Bath.
Slep, A. & Heyman, R. (2004). Severity of partner and child maltreatment: reliability of scales used in America’s largest child and family protection agency. Journal of Family Violence, 19 (2), 95 – 106.
Soloff, P., Lynch, K. & Kelly, T. (2002). Childhood abuse as a risk factor for suicidal behaviour in borderline personality disorder. Journal of Personality Disorders, 16 (3), 201-214.
Steiger, J.H. (1990). Structural model evaluation and modification: An interval approach. Multivariate Behavioural Research, 25, 173–180.
Tanaka, J.S. (1987). “How big is big enough?” Sample size and goodness off fit in structural equation models with latent variables. Child Development, 58, 134-146.
Torgersen, S., Kringlen, E. & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590-596.
Wekerle, C. & Wolfe, D. (2003). Child maltreatment. In E. Mash & R. Barkley (Eds.), Child Psychopathology (Second Edition, pp. 632-684). New York: Guilford.
White, H. & Widom, C. (2003). Intimate partner violence among abused and neglected children in young adulthood: The mediating effects of early aggression, antisocial personality, hostility, and alcohol problems. Aggressive Behaviour, 29, 332-345.
Wolfe, D. Jaffe, P., Jette, J. & Poisson, S. (2003). The impact of child abuse in community institutions and organizations: Advancing professional and scientific understanding. Clinical Psychology: Science & Practice, 10(2), 179-191.
Wolfe, D., Francis, K., & Straatman, A. (2006). Child abuse in religiously-affiliated institutions: long-term impact on men’s mental health. Child Abuse and Neglect, 30, 205-212
Appendix 1. Interview Protocol
I consent to participate in this study which is being conducted by Professor Alan Carr, University College Dublin at the invitation of the Child Abuse Commission.
I understand that the study will involve an interview; that participation is voluntary; that the interview will be fully confidential, that I may withdraw at any time; and that I may be invited to participate in a follow-up interview.
| Signature of participant | Witnessed by interviewer | Date |
| Demographic Questionnaire | |||
|---|---|---|---|
| Thank you for agreeing to do this interview. We will start with some fairly straightforward questions. | |||
| D1 | Name | Put case number in box | |
| Address | |||
| Phone Number | |||
| D2 | Gender | Male 0 Female 1 |
|
| D3 | What age are you now? | Record in years | |
| D4 | In what year were your born? | Record year | |
| D5 | How long did you live with your family before you lived in an institution? | Record in years with 0 if never lived in family | |
| D6 | What institution did you enter? |
Name____________ 1. Orphanage 2. Reformatory 3. Industrial school 4. Children’s home 5. Boarding school 6. Hospital |
|
| D7 | Who ran the institution? | 1. Nuns 2. Brothers 3. Priests 4. Other |
|
| D8 | Now long did you live in an institution? | Record in years | |
| D9 | Why did you enter an institution? | 1. I was illegitimate and given to the orphanage 2. My mother died in childbirth 3. Put in by authorities for petty crime (theft, truancy or misdemeanour) 4. Put in by parents because they could not look after me 5. Put in by parent because other parent died 6. I was sick or disabled |
|
| D10 | Why did you leave the institution? | 1. I was too old to stay on 2. The institution closed down 3. My short sentence was over 4. My family wanted to take me home 5. I ran away 7. Other specify |
|
| D11 | Were you happy to leave the institution? | 2. Yes 1. Mixed feelings 0. No |
|
| D12 | Code group | Group 1. Raised in institution from birth and left when too old to stay Group 2. Raised by parents and put in institution because parents couldn’t cope or died and left when too old to stay Group 3. Raised by parents and put in institution by authorities because of petty crime and left when too old to stay Group 4. Raised by parents, put in institution and escaped or taken out within 1-4 years Other: specify. |
|
| D13 | What is your current job ? | Name of job and put SES rating in box | |
| D14 | What was the best job you had since leaving school? | Name of job and put SES rating in box | |
| SES Rating scale | Unemployed | 0 | |
| Unskilled manual | 1 | ||
| Semi-skilled manual and farmers owning less than 30 acres | 2 | ||
| Skilled manual and farmers owning 30-49 acres | 3 | ||
| Other non-manual and farmers owning 50-99 acres | 4 | ||
| Lower professional and lower managerial; farmers owning 100-199 acres | 4 | ||
| Higher professional and higher managerial; farmers owning 200 or more acres | 6 | ||
| D15 | What was the highest exam | None | 0 |
| you passed? (circle number) | Junior school exam in 5th or 6th class (e.g. primary cert) | 1 | |
| Mid high school exam (e.g. Inter or junior cert) | 2 | ||
| Leaving cert | 3 | ||
| Certificate or diploma or apprenticeship exam | 4 | ||
| Primary degree (e.g. BA) | 5 | ||
| Higher degree (e.g. MA) | 6 | ||
| D16 | Are you single or married? | Single and never married of cohabited | 1 |
| (Probe and Circle number) | Single and separated from first cohabiting partner | 2 | |
| Single and separated from first marital partner | 3 | ||
| Single and divorced from first married partner | 4 | ||
| Single and separated or divorced from second or later partner | 5 | ||
| Single and widowed | 6 | ||
| Cohabiting in second or later long term relationship | 7 | ||
| Married in second or later marriage | 8 | ||
| Cohabiting in first long term relationship | 9 | ||
| Married in first long term relationship | 10 | ||
| D17 | How many long term relationships or marriages have you had that have ended/ | Record number in box | |
| D18 | How long have you lived with your current partner? | Record number in box or give 0 if not in relationship | |
| Marital satisfaction (KMS, Schumm et al., 1986) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| The next three questions are about your current marriage or long-term relationship. Give your answers on a 7 point scale from 1= Extremely dissatisfied to 7=extremely satisfied. SHOW 7 POINT SCALE (Circle 0 if the person is not in a relationship at present) | |||||||||
| KMS1 | How satisfied are you with your marriage or main relationship? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| KMS2 | How satisfied are you with your partner as a spouse? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| KMS3 | How satisfied are you with your relationship with your partner? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| Experiences in Close Relationships Inventory (ECR, Brennan, Clark, & Shaver (1998) | ||||||||
|---|---|---|---|---|---|---|---|---|
| The following statements concern how you feel in romantic relationships. We are interested in how you generally experience relationships, not just in what is happening in a current relationship. Respond to each statement by indicating how much you agree or disagree with it on a 7 point scale from 1=Disagree strongly to 7=Agree strongly. SHOW 7 POINT SCALE. Complete this section even if the person is not in a relationship now. | ||||||||
| E1 | I prefer not to show a partner how I feel deep down. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E2 | I worry about being abandoned. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E3 | I am very comfortable being close to romantic partners. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E4 | I worry a lot about my relationships. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E5 | Just when my partner starts to get close to me I find myself pulling away. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E6 | I worry that romantic partners won’t care about me as much as I care about them. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E7 | I get uncomfortable when a romantic partner wants to be very close. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E8 | I worry a fair amount about losing my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E9 | I don’t feel comfortable opening up to romantic partners. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E10 | I often wish that my partner’s feelings for me were as strong as my feelings for him/her. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E11 | I want to get close to my partner, but I keep pulling back. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E12 | I often want to merge completely with romantic partners, and this sometimes scares them away. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E13 | I am nervous when partners get too close to me. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E14 | I worry about being alone. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E15 | I feel comfortable sharing my private thoughts and feelings with my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E16 | My desire to be very close sometimes scares people away. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E17 | I try to avoid getting too close to my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E18 | I need a lot of reassurance that I am loved by my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E19 | I find it relatively easy to get close to my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E20 | Sometimes I feel that I force my partners to show more feeling, more commitment. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E21 | I find it difficult to allow myself to depend on romantic partners. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E22 | I do not often worry about being abandoned. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E23 | I prefer not to be too close to romantic partners. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E24 | If I can’t get my partner to show interest in me, I get upset or angry. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E25 | I tell my partner just about everything. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E26 | I find that my partner(s) don’t want to get as close as I would like. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E27 | I usually discuss my problems and concerns with my partner. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E28 | When I’m not involved in a relationship, I feel somewhat anxious and insecure. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E29 | I feel comfortable depending on romantic partners. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E30 | I get frustrated when my partner is not around as much as I would like. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E31 | I don’t mind asking romantic partners for comfort, advice, or help. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E32 | I get frustrated if romantic partners are not available when I need them. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E33 | It helps to turn to my romantic partner in times of need. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E34 | When romantic partners disapprove of me, I feel really bad about myself. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E35 | I turn to my partner for many things, including comfort and reassurance. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| E36 | I resent it when my partner spends time away from me. | Disagree strongly 1 |
Disagree
2 |
Disagree a little 3 |
Neutral
4 |
Agree a little 5 |
Agree
6 |
Agree strongly 7 |
| D19 | How many children have you? | Record number in box and score 0 if none | |
| D20 | At what age did you have your first child? | Record age in years in box and 0 if none | |
| D21 | Have your children always lived with you ? | I have none | 0 |
| No they have spent some time living with their other parent | 1 | ||
| No they have spent some time living with their relatives | 2 | ||
| No they have spent some time living in care | 3 |
| Parenting satisfaction KPS, (James et al., 1985) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| The next three questions are about your relationship with your children. Give your answers on a 7 point scale from 1= Extremely dissatisfied to 7=extremely satisfied. SHOW 7 POINT SCALE. Circle 0 if person has no children. | |||||||||
| KPS1 | How satisfied are you with your children’s behaviour? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| KPS2 | How satisfied are you with yourself as a parent? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| KPS3 | How satisfied are you with your relationship(s) with your children? | Not applicable 0 |
Extremely dissatisfied 1 |
Very dissatisfied 2 |
Somewhat dissatisfied 3 |
Mixed
4 |
Some what satisfied 5 |
Very satisfied 6 |
Extremely satisfied 7 |
| WHOQOL-100-UK (Skevington, 2005) | |||||||
|---|---|---|---|---|---|---|---|
| This set of questions asks how you feel about your quality of life in the last two weeks. There are no right or wrong answers. Please keep in mind your standards, hopes, pleasures and concerns. The following questions ask about how much you have experienced certain things in the last two weeks, for example, positive feelings such as happiness or contentment. Please use this 5 point scale to give your answer (SHOW A 5 POINT SCALE FROM 1=Not at all to 5=An extreme amount). Questions refer to the last two weeks. | |||||||
| 1 | F1.2 | How much do you worry about pain or discomfort? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 2 | F1.3 | How difficult is it for you to handle pain or discomfort? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 3 | F1.4 | How much do you feel that pain prevents you from doing what you need to do? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 4 | F2.2 | How easily do you get tired? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 5 | F2.4 | How much are you bothered by fatigue? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 6 | F3.2 | To what extent do you have difficulty sleeping? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 7 | F3.4 | How much do sleep problems worry you? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 8 | F4.1 | How much do you enjoy life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 9 | F4.3 | How positive do you feel about the future? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 10 | F4.4 | How much do you feel positive about your life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 11 | F5.3 | How well are you able to concentrate? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 12 | F6.1 | How much do you value yourself? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 13 | F6.2 | How much confidence do you have in yourself? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 14 | F7.2 | How much do you feel inhibited by your looks? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 15 | F 7.3 | Is there any part of your appearance which makes you feel uncomfortable? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 16 | F8.2 | How worried do you feel? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 17 | F8.3 | How much do feelings of sadness or depression interfere with your everyday functioning? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 18 | F 8.4 | How much do feelings of depression bother you? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 19 | F10.2 | To what extent do you have difficulty in performing your routine activities? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 20 | F10.4 | How much are you bothered by limitations in performing everyday living activities? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 21 | F11.2 | How much do you need medication to function in your daily life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 22 | F11.3 | How much do you need medical treatment to function in your daily life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 23 | F 11.4 | How much does your quality of life depend on the use of medical substances or medical aids? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 24 | F13.1 | How alone do you feel? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 25 | F15.2 | How well are your sexual needs fulfilled? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 26 | F15.4 | How bothered are you by difficulties in your sex life? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 27 | F16.1 | How safe do you feel in your daily life? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 28 | F16.2 | To what extent do you feel you are living in a safe and secure environment? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 29 | F16.3 | How much do you worry about safety and security? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 30 | F17.1 | How comfortable is the place where you live? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 31 | F17.4 | How much do you like where you live? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 32 | F18.2 | To what extent do you have financial difficulties? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 33 | F18.4 | How much do you worry about money? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 34 | F19.1 | How easily are you able to get good medical care? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 35 | F21.3 | How much do you enjoy your free time? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 36 | F22.1 | How healthy is your physical environment? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 37 | F22.2 | How concerned are you with the noise in the area where you live? | Not at all 1 |
Not much 2 |
Moderately 3 |
Very well 4 |
Extremely 5 |
| 38 | F23.2 | To what extent do you have problems with transport? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 39 | F23.4 | How much do difficulties with transport restrict your life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 40 | F8N | How fed up do you feel? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| The following questions ask about how completely you experienced, or were able to do certain things in the last two weeks, for example activities of daily living like washing, dressing or eating. Please use this 5 point scale to give your answer (SHOW A 5 POINT SCALE FROM 1=Not at all to 5=Completely). Questions refer to the last two weeks | |||||||
|---|---|---|---|---|---|---|---|
| 41 | F2.1 | Do you have enough energy for everyday life? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 42 | F7.1 | How much are you able to accept your bodily appearance? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 43 | F10.1 | To what extent are you able to carry out your daily activities? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 44 | F11.1 | How dependent are you on medications? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 45 | F14.1 | To what extent do you get the kind of support from others that you need? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 46 | F14.2 | How much can you count on your friends when you need them? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 47 | F17.2 | To what degree does the quality of your home meet your needs? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 48 | F18.1 | To what extent do you have enough money to meet your needs? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 49 | F20.1 | How available to you is the information that you need in your day-to-day life? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 50 | F20.2 | To what extent do you have the opportunities for acquiring the information that you need? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 51 | F21.1 | To what extent do you have the opportunity for leisure activities? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 52 | F21.2 | How much are you able to relax and enjoy yourself? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 53 | F23.1 | To what extent do you have adequate means of transport? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| The following questions ask you to say how satisfied, happy or good you have felt about various aspects of your life over the last two weeks, for example, about your family life or your energy level. Please use this 5 point scale to give your answer (SHOW A 5 POINT SCALE FROM 1=Very dissatisfied to 5=Very satisfied). Questions refer to the last two weeks. | |||||||
|---|---|---|---|---|---|---|---|
| 54 | G2 | How satisfied are you with the quality of your life? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 55 | G3 | In general, how satisfied are you with your life? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 56 | G4 | How satisfied are you with your health? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 57 | F2.3 | How satisfied are you with your energy? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 58 | F3.3 | How satisfied are you with your sleep? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 59 | F5.2 | How satisfied are you with your ability to learn new information? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 60 | F5.4 | How satisfied are you with your ability to make decisions? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 61 | F6.3 | How satisfied are you with yourself? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 62 | F6.4 | How satisfied are you with your abilities? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 63 | F7.4 | How satisfied are you with the way your body looks? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 64 | F10.3 | How satisfied are you with your ability to perform daily living activities? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 65 | F13.3 | How satisfied are you with your personal relationships? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 66 | F15.3 | How satisfied are you with your sex life? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 67 | F14.3 | How satisfied are you with the support you get from your family? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 68 | F14.4 | How satisfied are you with the support you get from your friends? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 69 | F13.4 | How satisfied are you with your ability to provide for, or support others? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 70 | F16.4 | How satisfied are you with your physical safety and security? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 71 | F17.3 | How satisfied are you with the conditions of your living place? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 72 | F18.3 | How satisfied are you with your financial situation? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 73 | F19.3 | How satisfied are you with your access to health services? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 74 | F19.4 | How satisfied are you with the social care services? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 75 | F20.3 | How satisfied are you with your opportunities for acquiring new skills? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 76 | F20.4 | How satisfied are you with your opportunities to learn new information? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 77 | F21.4 | How satisfied are you with the way you spend your spare time? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 78 | F22.3 | How satisfied are you with your physical environment e.g. pollution, climate, noise, attractiveness? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 79 | F22.4 | How satisfied are you with the climate of the place where you live? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 80 | F23.3 | How satisfied are you with your transport? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 81 | F13.2 | How happy do you feel about your relationships with your family? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| For the next set of questions use this 5 point scale to rate how good things have been in the past 2 weeks. (SHOW A 5 POINT SCALE FROM 1=very poor to 5=Very good). | |||||||
|---|---|---|---|---|---|---|---|
| 82 | G1 | How would you rate your quality of life? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 83 | F15.1 | How would you rate your sex life? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 84 | F3.1 | How well do you sleep? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 85 | F5.1 | How would you rate your memory? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 86 | F19.2 | How would you rate the quality of social services available to you? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 87 | F4N | How satisfied are you with your level of happiness? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| The following questions refer to how often you have felt or experienced certain things, for example the support of your family or friends, or negative experiences such as feeling unsafe. Use the 5 point scale to who how often they have occurred in the last 2 weeks (SHOW A 5 POINT SCALE FROM 1=Never to 5-=Always). So for example if you have experienced pain all the time in the last two weeks, use the answer 5=always”. | |||||||
|---|---|---|---|---|---|---|---|
| 88 | F1.1 | How often do you suffer pain? | Never 1 |
Seldom 2 |
Quite often 3 |
Very often 4 |
Always 5 |
| 89 | F4.2 | Do you generally feel content? | Never 1 |
Seldom 2 |
Quite often 3 |
Very often 4 |
Always 5 |
| 90 | F8.1 | How often do you have negative feelings, such as blue mood, despair, anxiety, depression? | Never 1 |
Seldom 2 |
Quite often 3 |
Very often 4 |
Always 5 |
| The following questions refer to any work that you do. Work here means any major activity that you do. This includes voluntary work, studying full-time, taking care of the home, taking care of children, paid work, or unpaid work. So work, as it is used here, means the activities you feel take up a major part of your time and energy. Questions refer to the last two weeks. | |||||||
|---|---|---|---|---|---|---|---|
| 91 | F12.1 | How much are you able to work? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 92 | F12.2 | To what extent do you feel able to carry out your duties? | Not at all 1 |
Not much 2 |
Moderately 3 |
A great deal 4 |
Completely 5 |
| 93 | F12.4 | How satisfied are you with your capacity for work? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| 94 | F12.3 | How would you rate your ability to work? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| The next few questions ask about how well you were able to move around in the last two weeks. This refers to your physical ability to move your body in such a way as to allow you to move about and do the things you would like to do, as well as the things that you need to do. Questions refer to the last two weeks. | |||||||
|---|---|---|---|---|---|---|---|
| 95 | F9.1 | How well are you able to get around? | Very poor
1 |
Poor
2 |
Neither poor nor good 3 |
Good
4 |
Very good
5 |
| 96 | F9.3 | How much do any difficulties in mobility bother you? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 97 | F9.4 | To what extent do difficulties in movement affect your way of life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 98 | F9.2 | How satisfied are you with your ability to move around? | Very dissatisfied
1 |
Dissatisfied
2 |
Neither satisfied nor dissatisfied 3 |
Satisfied
4 |
Very satisfied
5 |
| The following questions are concerned with your personal beliefs and how these affect your quality of life. These questions refer to religion, spirituality and any other personal beliefs you may hold. Once again these questions refer to the last two weeks. | |||||||
|---|---|---|---|---|---|---|---|
| 99 | F24.1 | How much do personal beliefs give meaning to your life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 100 | F24.2 | To what extent do you feel life to be meaningful? | Not at all
1 |
Not much
2 |
Moderately 3 |
Very well
4 |
Extremely 5 |
| 101 | F24.3 | How much do your personal beliefs give you the strength to face difficulties? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| 102 | F24.4 | To what extent do your personal beliefs help you to understand the difficulties in life? | Not at all
1 |
Not much
2 |
A moderate amount 3 |
Very much
4 |
An extreme amount 5 |
| Childhood Trauma Questionnaire (CTQ, Bernstein & Fink, 1998) | ||||||
|---|---|---|---|---|---|---|
| Use a five point scale from1=never true to 5=very often true to show how true these statements were about living in your family . SHOW 5 POINT SCALE |
||||||
| Score the next 36 questions as 0 if the respondent did not live with his or her family | 0 | |||||
| CTQF1 | I didn’t have enough to eat | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF2 | I knew that there was someone to take care of me and protect me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF3 | People in my family called me things like “stupid”, “lazy”, or “ugly”. | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF4 | My parents were too drunk or high to take care of the family | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF5 | There was someone in my family who helped me feel that I was important or special | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF6 | I had to wear dirty clothes | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF7 | I felt loved | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF8 | I thought that my parents wished I had never been born | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF9 | I got hit so hard by someone in my family that I had to see a doctor or go to the hospital | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF10 | There was nothing I wanted to change about my family | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF11 | People in my family hit me so hard that it left me with bruises or marks | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF12 | I was punished with a belt (a strap), a board (a stick), a chord, or some other hard object | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF13 | People in my family looked out for each other | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF14 | People in my family said hurtful or insulting things to me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF15 | I believe that I was physically abused | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF16 | I had the perfect childhood | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF17 | I got hit or beaten so badly that it was noticed by someone like a teacher, neighbour or doctor | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF18 | I felt that someone in my family hated me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF19 | People in my family felt close to each other | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF20 | Someone tried to touch me in a sexual way | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF21 | Someone threatened to hurt me or tell lies about me unless I did something sexual with them | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF22 | I had the best family in the world | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF23 | Someone tried to make me do sexual things or watch sexual things | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF24 | Someone molested me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF25 | I believe that I was emotionally abused | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF26 | There was someone to take me to the doctor if I needed it | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF27 | I believe that I was sexually abused | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQF28 | My family was a source of strength and support. | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| AF1 | What was the most severe form of physical abuse you experienced in your family? | None
0 |
Being hit without being bruised
1 |
Being hit to leave bruises
2 |
Being assaulted to lead to cuts
3 |
Being assaulted to lead to medical attention 4 |
| AF2 | How often did this severe form happen? | Never
0 |
Once
1 |
2-10 times
2 |
11-100 times
3 |
More than 100 times 4 |
| AF3 | How young were you when this first began? | |||||
| AF4 | How many years did it last? | |||||
| AF5 | What was the most severe form of sexual abuse that you experienced in your family? | None
0 |
Non-Contact Flashing Exposure 1 |
Contact Fondling and masturbation 2 |
Attempted penetration (oral, anal or vaginal sex) 3 |
Penetration (oral, anal or vaginal sex) 4 |
| AF6 | How often did this severe form happen? | Never
0 |
Once
1 |
2-10 times
2 |
11-100 times
3 |
More than 100 times 4 |
| AF7 | How young were you when this first began? | |||||
| AF8 | How many years did it last? | |||||
| Childhood Trauma Questionnaire (CTQ, Bernstein & Fink, 1998) | ||||||
|---|---|---|---|---|---|---|
| Use a five point scale from1=never true to 5=very often true to show how true these statements were about living in institutional care. SHOW SCALE. | ||||||
| CTQI1 | I didn’t have enough to eat | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI2 | I knew that there was someone to take care of me and protect me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI3 | My carers called me things like “stupid”, “lazy”, or “ugly”. | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI4 | My carers were too drunk or high to take care of us | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI5 | There was someone in my institution who helped me feel that I was important or special | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI6 | I had to wear dirty clothes | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI7 | I felt loved (by the carers) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI8 | I thought that my carers wished I had never been born | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI9 | I got hit so hard by a carer in my institution that I had to see a doctor or go to the hospital | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI10 | There was nothing I wanted to change about my institution | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI11 | Carers in my institution hit me so hard that it left me with bruises or marks | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI12 | I was punished with a belt (a strap), a board (a stick), a chord, or some other hard object | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI13 | Carers and others in my institution looked out for each other | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI14 | Carers in my institution said hurtful or insulting things to me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI15 | I believe that I was physically abused | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI16 | I had the perfect childhood | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI17 | I got hit or beaten so badly that it was noticed by someone like a teacher, neighbour or doctor | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI18 | I felt that carers in my institution hated me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI19 | People in my institution felt close to each other | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI20 | A carer tried to touch me in a sexual way | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI21 | A carer threatened to hurt me or tell lies about me unless I did something sexual with them | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI22 | I was reared in the best institution in the world | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI23 | A carer tried to make me do sexual things or watch sexual things | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI24 | A carer molested me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI25 | I believe that I was emotionally abused in the institution | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI26 | There was someone to take me to the doctor if I needed it | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI27 | I believe that I was sexually abused in the institution | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| CTQI28 | My institution was a source of strength and support. | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H1 | I was terrified of my carers | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H2 | I was punished unfairly by my carers | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H3 | I could never predict when I would be punished by my carers | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H4 | My carers separated me from my brother(s) or sister(s) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H5 | My carers took away my own clothes | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H6 | My carers destroyed my treasured possessions (pictures, teddy bears, mementoes etc) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H7 | My carers told me I was bad | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H8 | My carers said my mother was bad | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H9 | My carers said my father was bad | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H10 | My carers told me my mother did not love me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H11 | My carers told me my father did not love me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H12 | My carers tried to take away my hope | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H13 | My carers tried to break me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| H14 | What was the worst thing that happened to you in the institution? | |||||
| H15 | How young were you when this first began? | |||||
| H16 | How many years did it last? | |||||
| AI1 | What was the most severe form of physical abuse you experienced in your institution? | None
0 |
Being hit without being bruised
1 |
Being hit to leave bruises
2 |
Being assaulted to lead to cuts
3 |
Being assaulted to lead to medical attention 4 |
| AI2 | How often did this severe form happen? | Never
0 |
Once
1 |
2-10 times
2 |
11-100 times
3 |
More than 100 times 4 |
| AI3 | How young were you when this first began? | |||||
| AI4 | How many years did it last? | |||||
| AI5 | What was the most severe form of sexual abuse that you experienced in your institution? | None
0 |
Non-Contact Flashing Exposure 1 |
Contact Fondling and masturbation 2 |
Attempted penetration (oral, anal or vaginal sex) 3 |
Penetration (oral, anal or vaginal sex) 4 |
| AI6 | How often did this severe form happen? | Never
0 |
Once
1 |
2-10 times
2 |
11-100 times
3 |
More than 100 times 4 |
| AI7 | How young were you when this first began? | |||||
| AI8 | How many years did it last? | |||||
| Institutional Abuse Processes And Coping Inventory | ||||||
|---|---|---|---|---|---|---|
| Lets talk now about your immediate reaction to the abuse and neglect you experienced AS A CHILD OR YOUNGSTER and also YOUR CURRENT REACTIONS TO IT. Use a five point scale from1=never true to 5=very often true to show how true these statements are about your reactions. (SHOW SCALE) |
||||||
| Traumatization | ||||||
| 1TP1 | I felt hurt then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 2TC1 | I feel hurt now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 3TP2 | I felt frightened then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 4TC2 | I feel frightened now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 5TP3 | I felt sad then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 6TC3 | I feel sad now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 7TP4 | I felt humiliated then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 8TC4 | I feel humiliated now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Betrayal and loss of trust | ||||||
| 9BP1 | I trusted everyone then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 10BC1 | I trust everyone now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 11BP2 | I felt betrayed then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 12BC2 | I feel betrayed now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 13BP3 | I cut myself off from other people then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 14BC3 | I cut myself off from other people now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Disrespect of authority | ||||||
| 15DP1 | I was angry at everyone in authority then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 16DC1 | I am angry with everyone in authority now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 17DP2 | I liked people in authority then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 18DC2 | I like people in authority now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 19DP3 | I respected everyone in authority then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 20DC3 | I respect everyone in authority now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Religious Disengagement | ||||||
| 21RP1 | I had faith in God then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 22PC1 | I have faith in God now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 23RP2 | I had faith in the church then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 24RC2 | I have faith in the church now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 25RP3 | I stopped praying then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 26RC3 | I do not pray now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 27RP4 | I only went to mass then because I would be punished if I did not to | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 28RC4 | I do not go to mass now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Stigmatization shame and guilt | ||||||
| 29SP1 | I felt I was worthless then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 30SC1 | I feel I am worthless now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 31SP2 | I felt I was dirty then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 32SC2 | I feel I am dirty now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 33SP3 | I felt ashamed then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 34SC3 | I feel ashamed now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 35SP4 | I felt guilty and believed the abuse was my fault then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 36SC4 | I feel guilty and believe the abuse is my fault now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Powerlessness | ||||||
| 37PP1 | I believed I had full control over my life then (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 38PC1 | I believe I have full control over my life now (-) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 39PP2 | I believed that my life was controlled by others then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 40PC2 | I believe that my life is controlled by others now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 41PP3 | I thought I could do nothing to change my situation then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 42PC3 | I think I can do nothing to change my situation now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Avoidance of reminders of abuse | ||||||
| 43AP1 | I avoid thinking about the abuse then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 44AC1 | I avoid thinking about the abuse now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 45AP2 | I avoided situations that reminded me of abuse then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 46AC2 | I avoid situations that remind me of abuse now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 47AP3 | I avoided people who reminded me of the abuse then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 48AC3 | I avoid people who remind me of the abuse now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Re-enactment | ||||||
| 49XP1 | I felt the urge to attack or abuse other people then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 50XC1 | I feel the urge to attack or abuse other people now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 51XP2 | I hurt other people then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 52XC2 | I hurt other people now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 53XP3 | I felt the urge to harm or injure myself then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 54XC3 | I feel the urge to harm or injure myself now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 55XP4 | I harmed or injured myself then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 56XC4 | I harm or injure myself now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping through spiritual support | ||||||
| 57CSP1 | I prayed to God then, and that made the abuse bearable | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 58CSPC1 | I pray to God now, and that makes the abuse bearable | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 59CSP2 | I talked to a priest then and that made the abuse bearable | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 60CSC2 | I talk to a priest now and that makes the abuse bearable | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping by complying | ||||||
| 61CCP1 | I tried to behave well for the teachers /nuns /brothers /priests so I would not be punished then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 62CCC1 | I try to behave well and fit in with people at work and in my family now to avoid conflict and arguments | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 63CCP2 | I was careful never to break a rule then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 64CCC2 | I am careful never to break a rule now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 65CCP3 | I was careful always to show respect to the brothers, priests, nuns and teachers then (even if I didn’t feel respect) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 66CCC3 | I am careful always to show respect to people in authority now (even if I do not feel respect) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping by opposing | ||||||
| 67COP1 | I stood up to my abusers then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 68COC1 | I am standing up to my abusers and anyone in authority who tries to hurt me now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 69COP2 | I ran away from the institution then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 70COC2 | I leave situations where people in authority hurt me or take advantage of me | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 71COP3 | I planned revenge on my abusers then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 72COC3 | I am planning revenge on my abusers now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping through social support | ||||||
| 73CTP1 | I had a good friendship with a close friend I could trust and this made the abuse bearable then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 74CTC1 | I have a good friendship with a close friend I can trust and this makes the abuse bearable now (This friend is not my partner, husband or wife) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 75CTP2 | I had a good friendship with an adult I could trust and this made the abuse bearable then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 76CTC2 | I have a good friendship with a person I trust and look up to and this makes the abuse bearable now (this could be doctor or counsellor but not a partner) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 77CTP3 | I reminded myself that my mother or father was still alive, cared about me, and this made the abuse bearable then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 78CTC3 | I have a good relationship with my partner who I know cares about me and who I can tell my troubles to now and this makes the abuse bearable ( A partner is a wife /husband /cohabitee/lover) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping though skill mastery | ||||||
| 79CMP1 | I put my energy into my school work and that made me feel better then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 80CMC1 | I put my energy into my work and that makes me feel better now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 81CMP2 | I put my energy into sports or music and that made me feel better then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 82CMC2 | I put my energy into sport or music and that makes me feel better now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 83CMP3 | I put my energy into a skill that I could do well that made me feel better then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 84CMC3 | I put my energy into a skill that I can do well that makes me feel better now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping through planning | ||||||
| 85CLP1 | Then I planned each day very carefully to avoid abuse and make good things happen (like having a laugh, getting well fed, and keeping warm) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 86CLC1 | Now I plan each day very carefully to avoid bad feelings and make good things happen (like having a laugh, getting well fed, and keeping warm) | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 87CLP2 | When I was leaving school I followed a plan to get a job that would suit me and make my situation better | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 88CLC2 | Now I still follow a plan to make sure my job suits me and makes my situation better | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 89CLP3 | When I was settling down with my partner, I waited for at least 6 months to make sure we were well suited to live together | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 90CLC3 | When my partner and I are planning something important we take time to plan it very carefully | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Coping by alcohol, drugs and food | ||||||
| 91CDP1 | I drank alcohol to cope then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 92CDC1 | I drink alcohol to cope now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 93CDP2 | I took other drugs to cope then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 94CDC2 | I take other drugs to cope now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 95CDP3 | I comforted myself by eating a lot then | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| 96CDC3 | I comfort myself by overeating now | Never true 1 |
Rarely True 2 |
Sometimes true 3 |
Often true 4 |
Very often true 5 |
| Life Problem List | |||
|---|---|---|---|
| I am going to ask you if any of a series of major life problems have happened to you. Please answer yes or no | |||
| P1 | Unemployment: Have there been periods as long as a year since you left school where you have not worked? | Yes 1 |
No 0 |
| P2 | Homelessness: Have you ever had periods as long as a year where you were homeless? | Yes 1 |
No 0 |
| P3 | Frequent illness: Have you had frequent physical illness throughout your life? (seriously ill more than 5 times) | Yes 1 |
No 0 |
| P4 | Frequent hospitalization for physical health: Have you been frequently hospitalized for physical illness throughout your life? (more than 5 times) | Yes 1 |
No 0 |
| P5 | Mental health: Have you had periods of very bad anxiety or depression during your life? | Yes 1 |
No 0 |
| P6 | Substance use: Have you had had problems with drinking or taking drugs during your life? | Yes 1 |
No 0 |
| P7 | Self-harm: Have you been hospitalized because you tried to harm yourself? | Yes 1 |
No 0 |
| P8 | Hospitalization for mental health: Have you been hospitalized more than twice for mental health problems (including anxiety depression, substance use, self harm etc)? | Yes 1 |
No 0 |
| P9 | Anger control in intimate relationships: Have you ever hit your partner and bruised him or her? | Yes 1 |
No 0 |
| P10 | Anger control with children: Have you ever hit your children and bruised them? | Yes 1 |
No 0 |
| P11 | Violent crime: Have you been charged with violent offences? | Yes 1 |
No 0 |
| P12 | Incarceration for violent crime: Have you been imprisoned for violent offences? | Yes 1 |
No 0 |
| P13 | Non-violent crime: Have you been charged with non-violent offences? | Yes 1 |
No 0 |
| P14 | Incarceration for non-violent crime: Have you been imprisoned for non-violent offences? | Yes 1 |
No 0 |
| Trauma Symptom Inventory (TSI) | |||||
|---|---|---|---|---|---|
| This next set of items describes experiences that may or may not have happened to you. Please indicate how often each of the following experience has happened to you in the last 6 months on a 4 point scale where 0=Never and 3= Often. (SHOW SCALE) | |||||
| TSI1 | Nightmares or bad dreams | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!2 | Trying to forget about a bad time in your life | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!3 | Irritability | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI4 | Stopping yourself from thinking about the past | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI5 | Getting angry about something that wasn’t very important | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI6 | Feeling empty inside | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI7 | Sadness | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI8 | Flashbacks (sudden memories or images of upsetting things) | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI9 | Not being satisfied with your sex life | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI10 | Feeling like you were outside of your body | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI11 | Lower back pain | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!12 | Sudden disturbing memories when you were not expecting them | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!13 | Wanting to cry | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI14 | Not feeling happy | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI15 | Becoming angry for little or no reason | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI16 | Feeling like you don’t know who you really are | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI17 | Feeling depressed | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI18 | Having sex with someone you hardly knew | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI19 | Thoughts or fantasies about hurting someone | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI20 | Your mind going blank | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI21 | Fainting | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!22 | Periods of trembling or shaking | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!23 | Pushing painful memories out of your mind | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI24 | Not understanding why you did something | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI25 | Threatening or attempting suicide | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI26 | Feeling like you were watching yourself from far away | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI27 | Feeling tense or ‘on edge’ | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI28 | Getting into trouble because of sex | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI29 | Not feeling like your real self | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI30 | Wishing you were dead | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI31 | Worrying about things | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!32 | Not being sure of what you want in life | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!33 | Bad thoughts or feelings during sex | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI34 | Being easily annoyed by other people | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI35 | Starting arguments or picking fights to get your anger out | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI36 | Having sex or being sexual to keep from being lonely or sad | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI37 | Getting angry when you didn’t want to | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI38 | Not being able to feel your emotions | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI39 | Confusion about your sexual feelings | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI40 | Using drugs other than marijuana | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI41 | Feeling jumpy | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!42 | Absent-mindedness | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!43 | Feeling paralysed for minutes at a time | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI44 | Needing other people to tell you what to do | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI45 | Yelling or telling people off when you felt you shouldn’t have | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI46 | Flirting or ‘coming on’ to someone to get attention | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI47 | Sexual thoughts or feelings when you thought you shouldn’t have them | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI48 | Intentionally hurting yourself ( for example by scratching, cutting, or burning) even though you weren’t trying to commit suicide | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI49 | Aches and pains | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI50 | Sexual fantasies about being dominated or overpowered | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI51 | High anxiety | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!52 | Problems in your sexual relations with another person | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!53 | Wishing you had more money | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI54 | Nervousness | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI55 | Getting confused about what you thought or believed | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI56 | Feeling tired | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI57 | Feeling mad or angry inside | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI58 | Getting into trouble because of your drinking | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI59 | Staying away form certain people or places because they remind you of something | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI60 | One side of your body going numb | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI61 | Wishing you could stop thinking about sex | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!62 | Suddenly remembering something upsetting from your past | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!63 | Wanting to hit someone or something | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI64 | Feeling hopeless | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI65 | Hearing someone talk to you who wasn’t really there | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI66 | Suddenly being reminded of something bad | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI67 | Trying to block out certain memories | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI68 | Sexual problems | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI69 | Using sex to feel powerful or important | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI70 | Violent dreams | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI71 | Acting ‘sexy’ even though you didn’t really want sex | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!72 | Just for a moment seeing or hearing something upsetting that happened earlier in your life | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!73 | Using sex to get love or attention | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI74 | Frightening or upsetting thoughts popping into your mind | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI75 | Getting your own feelings mixed up with someone else’s | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI76 | Wanting to have sex with someone who you knew was bad for you | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI77 | Feeling ashamed about your sexual feelings or behaviour | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI78 | Trying to keep from being alone | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI79 | Losing your sense of taste | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI80 | Your feelings or thoughts changing when you were with other people | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI81 | Having sex that had to be kept secret from other people | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!82 | Worrying that someone is trying to steal your ideas | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!83 | Not letting yourself feel bad about the past | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI84 | Feeling like things weren’t real | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI85 | Feeling like you were in a dream | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI86 | Not eating or sleeping for 2 or more days | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI87 | Trying not to have any feelings about something that once hurt you | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI88 | Daydreaming | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI89 | Trying not to think or talk about things in your life that were painful | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI90 | Feeling like life wasn’t worth living | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI91 | Being startled or frightened by sudden noises | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!92 | Seeing people form the spirit world | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TS!93 | Trouble controlling your temper | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI94 | Being easily influenced by others | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI95 | Wishing you didn’t have any sexual feelings | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI96 | Wanting to set fire to a public building | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI97 | Feeling afraid you might die or be injured | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI98 | Feeling so depressed that you avoided people | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI99 | Thinking that someone was reading your mind | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| TSI100 | Feeling worthless | Never 0 |
Rarely 1 |
Sometimes 2 |
Often 3 |
| SCID I for DSM IV-TR |
|---|
|
Follow these rules for all disorders
If the first criterion is not met in the past month then there is no current disorder, check for lifetime disorder by asking the first criterion questions again beginning with Has there ever … If the first criterion is not met for a current or lifetime disorder, code the current and lifetime disorders as absent and go to next disorder. If the first criterion is met for a current or lifetime disorder, for each criterion, always ask the first question and then ask probes as required until you have enough information to rate the criterion as 3= true; 1=absent or false; or 2=subthreshold. After completing ratings for all criteria for a disorder, if the criteria for a current disorder in the past month are met, code the current disorder as present and go to next disorder. After completing ratings for all criteria for a disorder, if the criteria for a lifetime disorder (but not a current disorder) are met, code ‘disorder ever’ as present and go to next disorder. Do not code both a current and lifetime disorder as present. Summarize the final list of diagnoses on the summary SCID grid. |
| Major Depression Questions | Major Depression Criteria | ||||
|---|---|---|---|---|---|
| A | Now I am going to ask you some more questions about your mood. | 5 or more of the following symptoms have been present during the same 2 week period and represent a change from previous functioning: At least one of the symptoms is either 1. depressed mood or 2. loss of interest or pleasure |
|||
| A1 | In the last month has there been a period of time when you were feeling depressed or down most of the day nearly every day? What was it like? (If yes) how long did it last? As long as 2 weeks? |
1. Depressed mood most of the day, nearly every day as indicated either by subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). | 1 | 2 | 3 |
| A2 | What about losing interest or pleasure in things you usually enjoyed? (If yes) Was it nearly every day? How long did it last? As long as two weeks? |
2. Markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly everyday (as indicated by either subjective account or observation made by others) | 1 | 2 | 3 |
| If Neither A1 nor A2 is present, check for lifetime episodes by asking questions A1 and A2 again beginning with Has there ever … If Neither A1 nor A2 was ever present, skip this section and go to next disorder. |
|||||
| When rating the following items code 1 if clearly due to a general medical condition or to mood-incongruent delusions or hallucinations. For the following questions focus on the worst 2 weeks in the past month (or else the past 2 weeks if equally depressed for entire month) For a lifetime disorder, focus on the worst two weeks ever. |
|||||
| A3 | During this two week period how was your appetite? What about compared to your usual appetite? Did you have to force yourself to eat? Did you eat less/more than usual Was that nearly every day? Did you loose or gain any weight? How much? Were you trying to loose or gain weight? |
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month) or decrease or increase in appetite nearly every day. | 1 | 2 | 3 |
| A4 | During this two week period how were you sleeping? Trouble falling asleep, waking frequently, troubles staying asleep, waking too early or sleeping too much? How many hours per night compared to usual? Was that nearly every night? |
4. Insomnia or hypersomnia nearly every day | 1 | 2 | 3 |
| A5 | During this two week period were you so fidgety and restless that you were unable to sit still? Was it so bad that other people noticed it? What did they notice? Was that nearly every day? (If no) what about the opposite…talking or moving more slowly than is normal for you? Was it so bad that other people noticed it? What did they notice? Was that nearly every day? |
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). | 1 | 2 | 3 |
| A6 | During this two week period what was your energy like? Tired all the time?Nearly every day? |
6. Fatigue or loss of energy nearly every day | 1 | 2 | 3 |
| A7 | During this two week period how did you feel about yourself? Worthless? Nearly every day? What about feeling guilty about things you had done or not done? Nearly every day? |
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) | 1 | 2 | 3 |
| A8 | During this two week period did you have trouble thinking or concentrating? What kinds of things did it interfere with? Nearly every day? (If no) Was it hard to make decisions about everyday things? Nearly every day? |
8.Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) | 1 | 2 | 3 |
| A9 | During this two week period were things so bad you were thinking a lot about death or that you would be better off dead? What about thinking of hurting yourself? (If yes) Did you do anything to hurt yourself? |
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide | 1 | 2 | 3 |
| B | Criterion B – Does not meet criteria for a mixed episode) is omitted from SCID | ||||
| C | Has (your depression/use own words) made it hard for you to do your work, take care of things at home or get along with people? | C. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. | 1 | 2 | 3 |
| If the current symptoms are not clinically significant ask: Have there been any other times when you have been depressed and it had more of an effect on your life? If – Yes – go back to A1 and ask about this lifetime episode. |
|||||
| D | Just before (your depression/use own words) began were you physically ill? (if yes) What did the doctor say? Just before this began were you taking any medications? Just before this began, were you drinking or using any street drugs? |
D. The symptoms are not due to the direct physiological effect of a substance. | 1 | 3 | |
| E | Did (your depression/use own words) begin soon after someone close to you died? | E. The symptoms are not better accounted for by simple bereavement. After loss of a loved one, depression is diagnosed if the symptoms persist longer than two months or are characterised by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms or psychomotor retardation. | 1 | 3 | |
| For a major depressive episode (MDE) criteria A,C,D and E must be met. | 1 | 3 | |||
| Screening for Manic or hypomanic episode Have you ever had a period of time when you were feeling so good, high, excited, or hyper that other people thought you were not your normal self or you were so hyper that you got in trouble? Did anyone else say you were manic? Was that more than you feeling good? (If no) What about a period of time where you were so irritable that you found yourself shouting at people or starting fights or arguments ? Did you find yourself shouting at people you really didn’t know? When was that? What was it like? How long did that last? At least a week? |
There has never been a manic episode, a mixed episode, a hypomanic episode
For a manic episode there must be a distinct period of a least a week of abnormally and persistently elevated, expansive or irritable mood. |
1 | 3 | ||
| For a current diagnosis of Major Depressive Disorder The participant must meet the criteria for MDE in the past month, have no history of a manic episode, a mixed episode, or a hypomanic episode and the MDE is not better accounted for by a psychotic disorder. |
1 | 3 | |||
| For a lifetime diagnosis of Major Depressive Disorder The participant must meet the criteria for Lifetime MDE, have no history of a manic episode, a mixed episode, or a hypomanic episode and the MDE is not better accounted for by a psychotic disorder. |
1 | 3 |
| Dysthymia Questions | Dysthymia Criteria | ||||
|---|---|---|---|---|---|
| A | (If participant has no major depressive episode now, check for dysthymia) For the past couple of years have you been bothered by depressed mood most of the day, more days than not? More than half the time? (If yes) What was it like? |
Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation made by others, for a least two years. | 1 | 2 | 3 |
| If criterion A is not met, skip this section and go to the next disorder. Do not check for lifetime episodes of dysthymia because this diagnosis cannot reliably be made. |
|||||
| B | Presence while depressed of 2 or more of the following symptoms B1-B6 | ||||
| B1 | During these periods of (use own words for chronic depression) do you also Loose your appetite? What about overeating? |
B1. Poor appetite or overeating | 1 | 2 | 3 |
| B2 | During these periods of (use own words for chronic depression) do you also Have trouble sleeping or sleep too much? |
B2. Insomnia or hypersomnia | 1 | 2 | 3 |
| B3 | During these periods of (use own words for chronic depression) do you also have little energy to do things or feel tired a lot? | B3. Low energy or fatigue | 1 | 2 | 3 |
| B4 | During these periods of (use own words for chronic depression) do you also Feel down on yourself? Feel worthless or a failure? |
B4. Low self-esteem | 1 | 2 | 3 |
| B5 | During these periods of (use own words for chronic depression) do you also have trouble concentrating or making decisions? | B5. Poor concentration or difficulty making decisions | 1 | 2 | 3 |
| B6 | During these periods of (use own words for chronic depression) do you also Feel hopeless? |
B6. Feelings of hopelessness | 1 | 2 | 3 |
| C | What is the longest period of time during this period of long lasting depression that you felt OK (No dysthymic symptoms)? | C. During the 2 year period of the disturbance the person has never been without the symptoms in criteria A and B for more than 2 months at a time. | |||
| D | How long have you been feeling this way? Did it begin gradually or did it start with a bad period of depression? (If a major depressive episode occurred in the past) Now I want to know whether you got completely back to your usual self after that (major depressive episode/ use own words) before this long period of being mildly depressed? Were you back to yourself for at least two months? |
D. No major depressive episode has been present during the first 2 years of the dysthymia. | 1 | 2 | 3 |
| E | Have you ever had a period of time when you were feeling so good, high, excited, or hyper that other people thought you were not your normal self or you were so hyper that you got in trouble? Did anyone else say you were manic? Was that more than you feeling good? (If no) What about a period of time where you were so irritable that you found yourself shouting at people or starting fights or arguments ? Did you find yourself shouting at people you really didn’t know? When was that? What was it like? How long did that last? At least a week? |
E. There has never been a manic episode, a mixed episode, a hypomanic episode and the criteria have never been met for cyclothymic disorder.
For a manic episode there must be a distinct period of a least a week of abnormally and persistently elevated, expansive or irritable mood. |
1 | 2 | 3 |
| F | Did this begin soon after someone close to you died? | F. The disorder does not occur exclusively during the course of chronic psychotic disorders such as schizophrenia or delusional disorder. | 1 | 3 | |
| G | Just before (your depression/use own words) began were you physically ill? (If yes) What did the doctor say? Just before this began were you taking any medications? (If yes) any change in the amounts you were using? Just before this began, were you drinking or using any street drugs? |
G. The symptoms are not due to the direct physiological effect of a substance. | 1 | 2 | 3 |
| H | How much do your depressed feelings interfere with your life? | H. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. | 1 | 2 | 3 |
| For a current diagnosis of Dysthymia criteria A, B,C,D, E, F, G, & H must be coded 3 and cover the past 2 year period. | 1 | 3 | |||
| A lifetime diagnosis of Dysthymia cannot reliably be made so do not try to make one. |
| Panic disorder without agoraphobia Question | Panic Disorder without agoraphobia Criteria | ||||
|---|---|---|---|---|---|
| A1 | Have you ever had a panic attack when you suddenly felt frightened, or anxious or suddenly developed a lot of physical symptoms? (If yes) Have these attacks ever come on completely out of the blue in situations where you didn’t expect to feel nervous or uncomfortable? How many of these kinds of attacks have you had? At least two? |
A. 1. Recurrent unexpected panic attacks | 1 | 2 | 3 |
| If criterion A1 is not met, skip this section and go to next disorder. | |||||
| A2 | After any of these attacks did you worry that there might be something terrible wrong with you, like you were having a heart attack or were going crazy? How long did you worry? At least a month? (If no) Did you worry lot about having another one? How long did you worry? At least a month? (If no) Did you do anything differently because of the attacks like avoiding certain places or not going out alone ? What about avoiding certain types of activities like exercise? What about things like always making sure you were near a bathroom or exit? |
A 2. At least one of the attacks has been followed by a month or more of one of the following: a. Persistent concern about having additional attacks b. Worry about the implications of the attack or its consequences (losing control, having a heart attack, going crazy) c. A significant change in behaviour is related to the attacks |
1 | 2 | 3 |
| When was the last bad one? What was the first thing you noticed? Then what? Did the symptoms come on all of a sudden? (If yes) How long did it take from when it began to when it got really bad? Less than 10 minutes? |
Four or more of the 13 panic attack symptoms listed below developed abruptly and reached a peak within ten minutes | 1 | 2 | 3 | |
| 1 | During the attack did your heart race, pound or skip? | 1.Palpitations, pounding heart, accelerated heart rate | 1 | 2 | 3 |
| 2 | During the attack did you sweat? | 2. Sweating | 1 | 2 | 3 |
| 3 | During the attack did you tremble or shake? | 3. Trembling or shaking | 1 | 2 | 3 |
| 4 | During the attack were you short of breath? Did you have trouble catching your breath? |
4.Sensations of shortness of breath or smothering | 1 | 2 | 3 |
| 5 | During the attack did you feel as if you were choking? | 5. Feeling of choking | 1 | 2 | 3 |
| 6 | During the attack did you have chest pain or pressure? | 6.Chest pain or discomfort | |||
| 7 | During the attack did you have nausea or upset stomach or the feeling that you were going to have diarrhoea? | 7. Nausea or abdominal distress | 1 | 2 | 3 |
| 8 | During the attack did you feel dizzy or unsteady or like you might faint? | 8. Feeling dizzy, unsteady, light-headed or faint | 1 | 2 | 3 |
| 9 | During the attack did things around you seem unreal or did you feel detached from things around you or detached from part of your body? | 9.Derealization (feelings of unreality) or depersonalisation (being detached from oneself) | 1 | 3 | |
| 10 | During the attack were you afraid you were going crazy or might lose control? | 10. Fear of losing control, going crazy | 1 | 2 | 3 |
| 11 | During the attack were you afraid that you might die? | 11.Fear of dying | 1 | 2 | 3 |
| 12 | During the attack did you have tingling or numbness in parts of your body? | 12. Paresthesias (numbness or tingling sensations) | |||
| 13 | During the attack did you have hot flushes (flashes) or chills? | 13. Chills or hot flushes. | 1 | 2 | 3 |
| B | Agoraphobia questions are asked in next section | B. Absence of agoraphobia | 1 | 2 | 3 |
| C | Just before you began having panic attacks, were you taking any drugs, caffeine, diet pills or other medicines? How much coffee, tea or caffeinated soda do you drink per day? Just before the panic attacks were you physically ill? (If yes) what did the doctor say? |
C. Not due to the direct physiological effect of a substance (e.g., a drug of abuse or medication) or to a general medical condition. | 1 | 3 | |
| D | Social phobia, specific phobia, OCD, PTSD questions are asked in later sections. | D. Panic attacks not better accounted for by another disorder such as social phobia, specific phobia, OCD, PTSD or separation anxiety. | 1 | 3 | |
| Have you had panic attacks in the past month? | For a current diagnosis of panic disorder 4 or the 13 panic attack symptoms must be coded 3 and criteria A, B, C & D must be met in the past month | 1 | 3 | ||
| For a lifetime diagnosis of panic disorder 4 or the 13 panic attack symptoms must be coded 3 and criteria A, B , C & D must be met prior to the last month | 1 | 3 |
| Agoraphobia Questions | Agoraphobia Criteria | ||||
|---|---|---|---|---|---|
| A | Are there situations that make you nervous because you are afraid that you might have a panic attack? If yes -Tell me about that? What about being uncomfortable if you are more than a certain distance from home? What about being in a crowded place like a busy store, movie theatre or restaurant? What about standing in a queue? What about being on a bridge? What about using public transportation like a bus, train or driving a car? |
A. Anxiety about being in places or situations from which escape might be difficult(or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone: being in a crowd or standing in line; being on a bridge; and travelling in a bus, train or automobile. | 1 | 2 | 3 |
| If criterion A is not met – go back and code panic disorder without agoraphobia if appropriate and skip this section. | |||||
| B | Do you avoid these situations? (If no) When you are in one of these situations, do you feel very uncomfortable or like you might have a panic attack? Can you go into one of these situations only if you are with someone you know? |
B. Agoraphobic situations are avoided (e.g. travel is restricted) or else endured with marked distress or with anxiety about having a panic attack or panic like symptoms or require the presence of a companion | 1 | 2 | 3 |
| C | Social phobia, specific phobia, OCD, PTSD questions are asked in later sections. | C. The anxiety disorder is not better accounted for by another disorder such as social phobia, specific phobia, OCD, PTSD or separation anxiety. | 1 | 3 | |
| Have you had these problems (AGORAPHOBIA) in the past month? | For a current diagnosis of panic disorder with agoraphobia, a diagnosis of panic disorder must first be made and them criteria A, B & C above must be met in the past month | 1 | 3 | ||
| For a lifetime diagnosis of panic disorder with agoraphobia, a diagnosis of panic disorder must first be made and them criteria A, B & C above must be before the past month | 1 | 3 | |||
| For a current diagnosis of agoraphobia (without panic disorder), there must be no history of panic disorder and criteria A, B & C above must be met in the past month | 1 | 3 | |||
| For a lifetime diagnosis of agoraphobia (without panic disorder) there must be no history of panic disorder and criteria A, B & C above must be before the past month | 1 | 3 |
| Social Phobia Questions | Social Phobia Criteria | ||||
|---|---|---|---|---|---|
| A | Was there anything that you have been afraid to do or felt uncomfortable doing in front of other people, like speaking, eating or writing? Tell me about it? What were you afraid would happen when …(feared action)? (If public speaking only) Do you think that your are more uncomfortable than most other people in that situation? |
A. Marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. | 1 | 2 | 3 |
| If criterion A is not met – skip this section and go to next disorder. | |||||
| B | Have you always felt anxious when you ..(confronted phobic stimulus)? | B. Exposure to the feared social situation almost invariably provokes anxiety which may take the form of situationally bound or situationally predisposed panic attack | 1 | 2 | 3 |
| C | Did you think that you were more afraid of ….(phobic activity) than you should have been or than made sense? | C. The person recognises that the fear is excessive or unreasonable | 1 | 3 | |
| D | Did you go out of your way to avoid ..(phobic activity)? (If no) How hard was is it for you to (do feared activity)? |
D. The feared social or performance situations are avoided or else endured with intense anxiety or distress | 1 | 2 | 3 |
| E | How much did (feared activity) interfere with your life? How much has the fact that you have this fear bothered you? |
E. The avoidance, anxious anticipation or distress in the feared social or performance situations interferes significantly with the persons normal routine occupational (academic) functioning or social activities or relationships, or there is marked distress about having the phobia. | 1 | 2 | 3 |
| F | (If under 18 years) For how long have you had these fears? | F. In individuals under 18 years the duration is at least 6 months | 1 | 2 | 3 |
| G | Just before you began having these fears, were you taking any drugs, caffeine, diet pills or other medicines? How much coffee, tea or caffeinated soda do you drink per day? Just before the panic attacks were you physically ill? (If yes) what did the doctor say? |
G. The fear or avoidance is not due to the direct physiological effect of a substance (e.g., a drug of abuse or medication) or to a general medical condition, and is not better accounted for by another disorder (e.g., panic disorder without agoraphobia, separation anxiety disorder, body dysmorphic disorder, PDD, or schizoid personality disorder) | 1 | 3 | |
| H | If a general medical condition or other mental disorder is present, the fear in A. is unrelated to it. | 1 | 3 | ||
| Have you had these problems in the past month? | For a current diagnosis of Social Phobia criteria A, B,C,D, E, F, G, & H must be coded 3 in the past month | 1 | 3 | ||
| For a lifetime diagnosis of Social Phobia criteria A, B,C,D, E, F, G, & H must be coded 3 prior to the past month | 1 | 3 |
| Specific Phobia Questions | Specific Phobia Criteria | ||||
|---|---|---|---|---|---|
| A | Are there any other things that you have been especially afraid of like flying, seeing blood, getting an injection, heights, closed places or certain kinks of animals or insects Tell me about it? What were you afraid would happen when …(confronted with phobic stimulus)? |
A. Marked and persistent fear that is excessive and unreasonable cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). | 1 | 2 | 3 |
| If criterion A is not met – skip this section and go to next disorder. | |||||
| B | Did you always feel frightened when you ..(confronted with phobic stimulus)? | B. Exposure to the feared stimulus almost invariably provokes an immediate anxiety response which may take the form of situationally bound or situationally predisposed panic attack | 1 | 2 | 3 |
| C | Did you think that you were more afraid of ….(phobic stimulus) than you should have been or than made sense? | C. The person recognises that the fear is excessive or unreasonable | 1 | 3 | |
| D | Did you go out of your way to avoid ..(phobic stimulus)? (If no) How hard was is it for you to (\confront phobic stimulus)? |
D. The phobic situation(s) is avoided or else endured with intense anxiety or distress | 1 | 2 | 3 |
| E | How much did (phobia) interfere with your life? Is there anything you’ve avoided because of being afraid of the (phobic stimulus)? How much has the fact that you have this fear bothered you? |
E. The avoidance, anxious anticipation or distress in the feared situation(s) interferes significantly with the person’s normal routine occupational (academic) functioning or social activities or relationships, or there is marked distress about having the phobia. | 1 | 2 | 3 |
| F | (If under 18 years) For how long have you had these fears? | F. In individuals under 18 years the duration is at least 6 months | 1 | 2 | 3 |
| G | Questions for OCD, PTSD, Social Phobia, Panic disorder with or without agoraphobia, or agoraphobia with or without panic disorder are else where in this part of the interviews | G. The anxiety, panic attacks or phobic avoidance associated with the specific object or situation are not better accounted for by another disorder (e.g., OCD, PTSD, Social Phobia, Panic disorder with or without agoraphobia, or agoraphobia with or without panic disorder) | 1 | 3 | |
| Have you had these problem in the past month? | For a current diagnosis of Specific Phobia criteria A, B,C,D, E, F, G, & H must be coded 3 in the past month | 1 | 3 | ||
| For a lifetime diagnosis of Specific Phobia criteria A, B,C,D, E, F, G, & H must be coded 3 prior to the last month | 1 | 3 |
| Obsessive Compulsive Disorder (OCD) Questions | OCD Criteria | ||||
|---|---|---|---|---|---|
| A | Now I would like to ask you if you have ever been bothered by thoughts that didn’t make any sense and kept coming back to you even when you tried not to have them? What were they? (If participant is not sure what is meant) Thoughts like hurting someone even though you really didn’t want to or being contaminated by germs or dirt? When you had these thoughts did you try hard to get them out of your head? Where did you think these thoughts were coming from? Was there ever anything that you had to do over and over again and couldn’t resist doing like washing your hands again and again, counting up to a certain number, or checking something several times to make sure that you’d done it right? Why did you have to do (COMPULSIVE ACT)? |
A. Either obsessions or compulsions.
Obsessions are defined by 1, 2, 3, & 4. 1. Recurrent or persistent thoughts impulses or images that are experienced as intrusive or inappropriate and cause marked anxiety or distress. 2. The thoughts, images or impulse are not excessive worries about real life problems. 3. The person attempts to ignore or suppress these thoughts, impulses or images or to neutralize them with some other thought or action. 4. The person recognises that the thoughts images or impulses are the product of his or her own mind (and not imposed from without as in thought insertion). Compulsions are defined by 1 & 2. 1. Repetitive behaviours (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the person feels driven to performing in response to an obsession or according to rules that must be applied rigidly. 2. The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralise or prevent or are clearly excessive. |
1
1 1 1 1 1 1 |
2
2 2 2 2 2 2 |
3
3 3 3 3 3 3 |
| If criterion A is not met, skip this section and go to next disorder. | |||||
| B | Have you thought about (OBSESSIVE THOUGHTS) or done (COMPULSIVE ACTS) more than you should have or more than made sense? (If no) How about when you first started having this problem? |
B. The person has at one time recognised that the obsessions or compulsions are unreasonable but this condition does not apply to children | 1 | 3 | |
| C | What effect did this (OBSESSIVE THOUGHTS AND/OR COMPULSIVE ACTS) have on your life? Did it bother you a lot? How much time do you spend on (Obsessive Thoughts And/Or Compulsive Acts) ? |
C. The obsessions or compulsions cause considerable distress, are time consuming (more than 1 hour a day), and impair social and academic functioning | 1 | 2 | 3 |
| D | D. If another Axis 1 disorder is present the content of the obsessions or compulsions is not restricted to it (e.g. food and eating disorder or drugs and substance abuse disorder? | 1 | 2 | 3 | |
| E | Just before you began having (OBSESSIONS OR COMPULSIONS) were you taking any drugs or medicines? Just before the (OBSESSIONS OR COMPULSIONS) started, were you physically ill? |
E. The disorder is not due to the direct physiological effect of a substance or to a general medical condition. | 1 | 2 | 3 |
| Have you had these (OBSESSIONS OR COMPULSIONS) in the past month? | For a current diagnosis of OCD criteria A, B,C,D, & E must be coded 3 for the past month | 1 | 3 | ||
| For a lifetime diagnosis of OCD criteria A, B,C,D, & E must be coded 3 before the past month | 1 | 3 |
| Post Traumatic Stress Disorder (PTSD) Questions | PTSD Criteria | ||||
|---|---|---|---|---|---|
| A | Sometimes things happen to people that are extremely upsetting, things like being in a life threatening situation like a major disaster, every serious accident or fire; being physically assaulted or raped, seeing another person killed or dead, or badly hurt, or hearing about some thing horrible that has happened to someone you are close to. At any time during your life, have any of these kinds of things happened to you? (If any events are mentioned, list them and ask) Sometimes these things keep coming back in nightmares, flashbacks, or thoughts that you cant get rid of. Has that ever happened to you? (If no) What about being very upset when you were in a situation that reminded you of one of these terrible things? Which (traumatic event if there was more than one) of these do you think affected you most? How did you react when (the trauma) happened? Were you afraid or did you feel terrified or helpless? |
A. The person has been exposed to a traumatic event in which both of the following were present:
1. The person experienced, witnessed, or was confronted with an event that involved actual or threatened death or serious injury of self or others 2. The person’s response involved intense fear, helplessness or horror or in the case of children disorganised behaviour |
1 | 2 | 3 |
| If criterion A is not met, skip this section and go to next disorder | |||||
| B | Now I’d like to ask about specific ways it may have affected you, for example…
Did you think about (TRAUMA) when you didn’t want to or did thoughts about (TRAUMA) come to you suddenly when you didn’t want them to? What about having dreams about (TRAUMA)? What about finding yourself acting or feeling as if you were back in the situation? What about having physical symptoms like breaking out in a sweat, breathing heavily, or irregularly, or your heart pounding or racing? |
B. The traumatic event is persistently re-experienced in one or more of the following ways 1.Recurrent and intrusive distressing recollections of the event including thoughts, images, or in children repetitive play in which the themes of the trauma are re-enacted 2. Recurrent distressing dreams of the event or in children the dreams may have unrecognizable fearful content 3. Acting or feeling as if the traumatic event were recurring (including, hallucinations, illusions and dissociative flashbacks, or in children re-enactments) 4. Intense psychological distress to exposure to internal or external cues that symbolize the traumatic event |
1 | 2 | 3 |
| C | Since the TRAUMA have you made a special effort to avoid thinking or talking about what happened?
Have you stayed away from things or people that reminded you of (TRAUMA)? Have you been unable to remember some important part of what happened? Have you been much less interested in doing things that used to be important to you, like seeing friends, reading books or watching TV? Have you felt “numb” or like you no longer had strong feelings about anything or loving feelings for anyone? |
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness as indicated by 3 of the following:
1. Avoidance of thought feelings or conversations associated with the trauma 2. Avoidance of activities, places or people that arouse recollection of the trauma 3. Inability to recall an important aspect of the trauma 4. Markedly diminished interest or participation in significant activities 5. Restricted range of affect 6. Sense of foreshortened future |
1 | 2 | 3 |
| D |
Since the trauma have you had trouble sleeping? What kind of trouble? Have you been unusually irritable? What about outbursts of anger? Have you had trouble concentrating? Have you been watchful or on guard even though there was no reason to be? |
D. Persistent symptoms of increased arousal as indicated by 2 of the following: 1. Sleep difficulties 2. Irritability or outbursts of anger 3. Difficulty concentrating 4. Hypervigilance 5. Exaggerated startle response |
1 | 2 | 3 |
| E | About how long did these problems (SUCH AS PTSD SYMPTOMS) last? | E. Duration of disturbance longer than 1 month | 1 | 2 | 3 |
| F | F. The disturbance causes clinically significant distress and impairment of social or academic functioning. | 1 | 2 | 3 | |
| Have you had these (PTSD SYMPTOMS) in the past month? | For a current diagnosis of PTSD criteria A, B,C,D, E, & F must be coded 3 for the past month | 1 | 3 | ||
| For a lifetime diagnosis of PTSD criteria A, B,C,D, E, & F must be coded 3 before the past month | 1 | 3 |
| Generalised Anxiety Disorder (GAD) Questions | GAD Criteria | ||||
|---|---|---|---|---|---|
| A | In the last 6 months have you been particularly nervous or anxious? Do you worry a lot about bad things that might happen? What do you worry about? How much do you worry about (Events or activities)? During the past 6 months would you say that you have been worrying more days than not? |
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for 6 months about a number of events or activities (such as school or work performance). | 1 | 2 | 3 |
| If criterion A is not met, check for lifetime disorder by asking Was there ever a period of about 6 months when ….. If criterion A is not met for a lifetime disorder, skip the section and go to next disorder |
|||||
| B | When you are worrying this way do you find it hard to stop yourself? | B. The person finds it difficult to control the worry. | 1 | 2 | 3 |
| C | Now I’m going to ask you some questions that often go along with being nervous. Thinking about those periods in the past six months when you’re feeling nervous or anxious Do you often feel physically restless –can’t sit still? Do you often tire easily? Do you have trouble concentrating or does your mind go blank? Are you often irritable? Are your muscles often tense? Do you often have trouble falling or staying asleep? |
C. The anxiety or worry is associated with 3 of the following in adults or 1 of the following in children for more days than not in the past 6 months.
1. Restlessness or feeling keyed up or on edge 2. Being easily fatigued 3. Difficulty concentrating or mind going blank. 4. Irritability 5. Muscle tension 6. Sleep disturbance |
1 | 3 | |
| D | D. The focus of the anxiety or worry is not confined to features of an Axis 1 disorder (panic disorder, OCD, PTSD, social phobia, eating disorders) | 1 | 2 | 3 | |
| E | What effect has the anxiety, worry or (physical symptoms) had on your life? Has it made it hard to do your work or be with your friends? |
E. The anxiety or physical symptoms cause clinically significant distress or impairment in social, occupational, school and other important area of functioning | 1 | 2 | 3 |
| F | When did this worrying start? | F. The disturbance is not due to the direct physiological effect of a substance or to a general medical condition. Does not occur exclusively during the course of a mood disorder, psychotic disorder or pervasive developmental disorder |
1 | 2 | 3 |
| For a current diagnosis of GAS criteria A, B,C,D, E, & F must be coded 3 for the past 6 months | 1 | 3 | |||
| For a lifetime diagnosis of GAS criteria A, B,C,D, E, & F must be coded 3 for a period before the past 6 months | 1 | 3 |
| Alcohol Abuse Question | Alcohol Abuse Criteria | ||||
|---|---|---|---|---|---|
| A | What are your drinking habits like How much do you drink? How often? What do you drink? |
A. A maladaptive pattern of alcohol use leading to clinically significant impairment or distress as manifested by one or more of A1-A4 occurring within a 12 month period: | 1 | 2 | 3 |
| If not currently drinking heavily to check for lifetime disorder ask… Was there ever a time in your life when you were drinking a lot more? How often were your drinking? What were you drinking? How much? How long did that period last? |
|||||
| If there is no evidence of past or current heavy drinking skip this section and the alcohol dependence section and got the substance abuse section. | |||||
| Currently (or during the time when you were drinking heavily did…) does your drinking cause problems for you? Does/did anyone object to your drinking? Let me ask you a few more questions about the time when you were drinking most or had most drink-related problems. |
|||||
| A1 | Did you miss work or school because you were intoxicated, high or very hung over? How Often? What about doing a bad job at work or failing courses at school because of your drinking? (If appropriate) What about not keeping your house clean or not taking proper care of your children because of your drinking? How often? |
A1. Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to alcohol use; alcohol related absences, suspensions, or expulsions from school; neglect of children or household) | 1 | 2 | 3 |
| A2 | Did you ever drink in a situation in which it was dangerous to drink at all? Did you ever drive while you were really too drunk to drive? How many times? |
A2. Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by alcohol use). | 1 | 2 | 3 |
| A3 | Did your drinking get you into trouble with the law? Tell me more about that? How many times? |
A.3. Recurrent alcohol related legal problems (e.g., arrests for alcohol-related disorderly conduct) | 1 | 2 | 3 |
| A4 | Did your drinking cause problems with other people, such as with family members, friends, or people at work? Did you ever get into physical fights when you were drinking? What about having bad arguments about your drinking? Did you keep on drinking anyway? |
A4. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol (e.g., arguments with spouse about consequences of intoxication, physical fights) | 1 | 2 | 3 |
| B | B. Symptoms have never met the criteria for alcohol dependence. | ||||
| For a current diagnosis of Alcohol Abuse, criteria A and B are met for the past month | 1 | 3 | |||
| For a lifetime diagnosis of Alcohol Abuse, criteria A and B are met before the past month | 1 | 3 |
| Alcohol Dependence Question | Alcohol Dependence Criteria | ||||
|---|---|---|---|---|---|
| A | Now I would like to ask you some more questions about the time when you were drinking most or had most drink-related problems. | A. A maladaptive pattern of alcohol use leading to clinically significant impairment or distress as manifested by three or more of the following occurring at any time in the same 12 month period | 1 | 2 | 3 |
| A3 | During that time did you often find that when you started drinking you ended up drinking much more than you were planning to? If No – What about drinking over a much longer period of time than you were planning to? |
3. Alcohol is often taken in larger amounts or over a longer period than was intended | 1 | 2 | 3 |
| A4 | Did you try to cut down or try to stop drinking alcohol? If yes – Did you ever actually stop drinking altogether? How many times did your try to cut down or stop altogether? If no – Did you want to stop or cut down? Is this something you kept worrying about? |
4. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use | 1 | 2 | 3 |
| A5 | Did you spend a lot of time drinking being high, or hung over? | 5. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects | 1 | 2 | 3 |
| A6 | Did you often have times when you would drink so often that you started to drink instead of working, spending time with your family, or friends or engaging in other important activities such as sports, gardening or playing music? | 6. Important social, occupational, or recreational activities are given up or reduced because of alcohol use | 1 | 2 | 3 |
| A7 | Did your drinking cause any psychological problems such as making you depressed or anxious, making it hard to sleep, or causing blackouts? Did your drinking cause significant physical problems or make a physical problem worse? Did you keep on drinking anyway? |
7. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol (e.g., continued drinking despite recognition than an ulcer was made worse by alcohol consumption). | 1 | 2 | 3 |
| A1 | Did you find that you needed to drink a lot more in order to get the feeling you wanted than you did when you first started drinking? If yes – How much more? If no – What about finding that when you drank the same amount, it had much less effect than before? |
1. Tolerance, as defined by either or the following: A. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect B. Markedly diminished effect with continued use of the same amount of alcohol |
1 | 2 | 3 |
| A2 | Did you ever have any withdrawal symptoms when you cut down or stopped drinking such as Sweating or racing heart hand shakes trouble sleeping feeling nauseated or vomiting Feeling agitated Feeling anxious How about having a seizure or seeing, feeling, or hearing things that weren’t really there? If no- Did you ever start the day with a drink, or did you often drink or take some other drug or medication to keep yourself from getting the shakes or becoming sick? |
2. Withdrawal as manifested by either A or B. A. At least two of the following developing within several hours to a few days after cessation of (or reduction in) heavy and prolonged alcohol use Sweating or pulse rate over 100bpm Increased hand tremor Insomnia Nausea or vomiting Psychomotor agitation Anxiety Grand mal seizures Transient visual, tactile or auditory hallucinations or illusions B. alcohol or tranquillizers taken to relieve or avoid withdrawal symptom |
1 | 2 | 3 |
| For a current diagnosis of alcohol dependence 3 of the 7 criteria were present in past month | 1 | 3 | |||
| For a lifetime diagnosis of alcohol dependence 3 of the 7 criteria were present prior to the past month | 1 | 3 |
| Substance Abuse Question | Substance Abuse Criteria | ||||
|---|---|---|---|---|---|
| Have you ever taken any of these drugs to get high, to sleep better, or lose weight, or the change you mood. Which one caused you the most problems? (Circle) Which one did you use the most? (Circle) If no significant drug use occurred – skip substance use and substance dependence sections and go the personality disorder section |
Downers – Sedative-Hypnotics-Anxiolytics Quaalude (ludes) Seconol (reds) Valium (roche 5) Xanex, librium, barbiturates, Miltown, Ativan, Dalmane, Halcion, Restoril Cannabis Marijuana, hashish (Hash), THC, pot, grass, weed, reefer Uppers – Stimulants Amphetamine, speed, crystal meth, dexadrine, Ritalin, diet pills, ice Opiods Heroin, morphine, opium, Methadone, Darvon, codine, Percodan, Demerol, Dilaudid Cocaine Snorting, IV, freebase, crack, speedball Hallucinogens- Psychedelics LSD (Acid), mescaline, peyote, psilocybin, STP, mushrooms, Extacy, MDMA PCP – Phencyclidine Angel dust, Special K, ketamine Other Steroids, glue, ethyl chloride, paint, inhalants, nitrous oxide (laughing gas), amyl or butyl nitrate (poppers), sleep or diet pills |
||||
| A | Now I’d like to ask you some questions about your use of (DRUG USED THE MOST OR CASUSED MOST PROBLEMS). During that time.. | A. A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one or more of A1-A4 occurring within a 12 month period: | 1 | 2 | 3 |
| A1 | Did you miss work or school because you were intoxicated, high or very hung over? How Often? What about doing a bad job at work or failing courses at school because you used DRUG? (If appropriate) What about not keeping your house clean or not taking proper care of your children because of DRUG? How often? |
A1. Recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance related absences, suspensions, or expulsions from school; neglect of children or household) | 1 | 2 | 3 |
| A2 | Did you ever use DRUG in a situation in which it might have been dangerous? How often? |
A2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use). | 1 | 2 | 3 |
| A3 | Did your use of DRUG get you into trouble with the law? How often and when? |
A.3. Recurrent substance related legal problems (e.g., arrests for substance-related disorderly conduct) | 1 | 2 | 3 |
| A4 | Did your use of DRUG cause problems with other people, such as with family members, friends, or people at work? Did you ever get into physical fights when you were using DRUG? What about having bad arguments about your drug use? Did you keep on using DRUG anyway? |
A4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substance (e.g., arguments with spouse about consequences of intoxication, physical fights) | 1 | 2 | 3 |
| B | B. Symptoms have never met the criteria for substance dependence. | ||||
| For a current diagnosis of Substance Abuse, criteria A and B are met for the past month | 1 | 3 | |||
| For a lifetime diagnosis of Substance Abuse, criteria A and B are met prior to the past month | 1 | 3 |
| Substance Dependence Question | Substance Dependence Criteria | ||||
|---|---|---|---|---|---|
| A | I would like to ask you some more questions about (TIME WHEN USING THE MOST DRUGS/TIME WHEN DRUGS CAUSED THE MOST PROBLEMS). | A. A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by three or more of the following occurring at any time in the same 12 month period | 1 | 2 | 3 |
| A3 | During that time did you often find that when you started using DRUG you ended up using much more than you were planning to? If No – What about using it over a much longer period of time than you were planning to? |
3. Substance is often taken in larger amounts or over a longer period than was intended | 1 | 2 | 3 |
| A4 | Did you try to cut down or stop using DRUG? If yes – Did you ever actually stop using DRUG altogether? How many times did your try to cut down or stop altogether? If no – Did you want to stop or cut down? Is this something you kept worrying about? |
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use | 1 | 2 | 3 |
| A5 | Did you spend a lot of time using DRUG or doing what ever you had to get to it? Did it take you a long time to get back to normal? |
5. A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances) use the substance or recover from its effects | 1 | 2 | 3 |
| A6 | Did you often have times when you would use DRUG so often that you started to use DRUG instead of working, spending time with your family, or friends or engaging in other important activities such as sports, gardening or playing music? | 6. Important social, occupational, or recreational activities are given up or reduced because of substance use | 1 | 2 | 3 |
| A7 | Did your drug use cause any psychological problems such as making you depressed or anxious, making it hard to sleep, or causing blackouts? Did your drug use cause significant physical problems or make a physical problem worse? If yes – Did you keep on using anyway? |
7. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by substance(e.g., current cocaine use despite recognition of cocaine induced depression). | 1 | 2 | 3 |
| A1 | Did you find that you needed to use a lot more DRUG in order to get the feeling you wanted than you did when you first started using it? If yes – How much more? If no – What about finding that when you used the same amount, it had much less effect than before? |
1. Tolerance, as defined by either or the following: A. A need for markedly increased amounts of the substance to achieve intoxication or desired effect B. Markedly diminished effect with continued use of the same amount of the substance |
1 | 2 | 3 |
| A2 | Did you ever have any withdrawal symptoms when you cut down or stopped suing DRUG? If yes- what symptoms did you have? If withdrawal symptoms occurred – After not using DRUG for a few hours or more, did you often use it to keep yourself from getting sick with WITHDRAWAL SYMPTOMS? What about using NAME ANOTHER DRUG IN THE SAME CLASS when you were feeling sick with WITHDRAWAL SYMPTOMS so that you would feel better? |
2. Withdrawal as manifested by either A or B A. A characteristic withdrawal syndrome for the substance B. the same or a closely related substance is taken to relieve or avoid withdrawal symptoms Sedatives |
1 | 2 | 3 |
| For a current diagnosis of substance dependence 3 of the 7 criteria were present in past month | 1 | 3 | |||
| For a lifetime diagnosis of substance dependence 3 of the 7 criteria were present within a 1 year period excluding the past month | 1 | 3 |
| SCID II for DSM IV-TR |
|
Follow these rules for all rating all 4 personality disorders
For each criterion, always ask the first question and then ask probes as required until you have enough information to rate the criterion as 3= true; 1=absent or false; or 2=subthreshold. After completing ratings for all criteria for a personality disorder, if the criteria for a current personality disorder are met, code the personality disorder as present and go to next disorder. Do not rate lifetime personality disorders which are no longer current (as you did for mood, anxiety and substance use disorders). Summarize the final list of diagnoses on the summary SCID grid. |
| Avoidant PD Questions | Avoidant PD Criteria | ||||
|---|---|---|---|---|---|
| A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following | |||||
| 1 | Have you avoided jobs or tasks that involved having to deal with a lot of people? Give me some examples? What was the reason that you avoided these? Have you ever refused a promotion because it would involve dealing with more people than you would be comfortable with? |
(1) avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. To score 3- must give 2 examples. |
1 | 2 | 3 |
| 2 | Do you avoid getting involved with people unless you are certain they will like you? If you don’t know someone likes you would you ever make the first move? |
(2) is unwilling to get involved with people unless certain of being liked To score 3 – almost never takes initiative in a social relationship |
1 | 2 | 3 |
| 3 | Do you find it hard to be open even with people your are close to? Why is this? Are you afraid of being made fun of or embarrassed? |
(3) shows restraint within intimate relationships because of the fear of being shamed or ridiculed To score 3 – true for almost all relationships |
1 | 2 | 3 |
| 4 | Do you often worry about being criticized or rejected in social situations? Give me some examples. Do you spend a lot of time worrying about this? |
(4) is preoccupied with being criticized or rejected in social situations To score 3 – a lot of time is spent worrying about social situations |
1 | 2 | 3 |
| 5 | Are you usually quiet when you meet new people? Why is that? Is it because you feel in some way inadequate or not good enough? |
(5) is inhibited in new interpersonal situations because of feelings of inadequacy To score 3 – Acknowledges trait and gives many (3) examples |
1 | 2 | 3 |
| 6 | Do you believe that you are not as good, as smart, or as attractive as most other people? Tell me about that? |
(6) views self as socially inept, personally unappealing, or inferior to others To score 3 – acknowledges belief. |
1 | 2 | 3 |
| 7 | Are you afraid to try new things? Is that because you are afraid of being embarrassed? Give me some examples |
(7) is usually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing To score 3 – several examples (3) of avoiding activities because of fear of embarrassment |
1 | 2 | 3 |
| Avoidant PD – 4 items or more are coded 3. | 1 | 3 |
| Dependent PD Questions | Dependent PD Criteria | ||||
|---|---|---|---|---|---|
| A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: | |||||
| 1 | Do you need a lot of advice or reassurance from others before you can make everyday decisions – like what to wear or what to order in a restaurant? Can you give me some example of the kinds of decision you would ask for advice or reassurance about? Does this happen most of the time? |
(1) has difficulty making everyday decisions without an excessive amount of advice and reassurance from others To score 3 – several (3) examples |
1 | 2 | 3 |
| 2 | Do you depend on other people to handle important areas in your life such as finances, child care, or living arrangements? Give me some examples. Is this more than just getting advice from people? Has this happened with most important areas of your life? |
(2) needs others to assume responsibility for most major areas of his or her life Do not include just getting advice from others or sub culturally expected behaviour To score 3 – several (3) examples |
1 | 2 | 3 |
| 3 | Do you find it hard to disagree with people even when you think they are wrong? Give me some examples of when you found it hard to disagree. What are you afraid will happen if you disagree`? |
(3) has difficulty expressing disagreement with others because of fear of loss of support or approval. Do not include realistic fears of retribution. To score 3 – acknowledges trait or several (3) examples |
1 | 2 | 3 |
| 4 | Do you find it hard to start work on tasks when there is no one to help you? Give me some examples. Why is that? Is this because you are not sure you can do it right? |
(4) has difficulty initiating projects or doing things on his or her own (because of lack of self-confidence in judgement or abilities rather than a lack of motivation or energy) To score 3 – acknowledges trait |
1 | 2 | 3 |
| 5 | Have you often volunteered to do things that are unpleasant? Give me some examples of these types of things. Why is that? |
(5) goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant Do not include behaviour intended to achieve goals other than being liked, such as job advancement. To score 3 – acknowledges trait or gives one example |
1 | 2 | 3 |
| 6 | Do you usually feel uncomfortable when you are by yourself. Why is that? Is it because you need someone to take care of you? |
(6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself To score 3 – acknowledges trait |
1 | 2 | 3 |
| 7 | When a close relationship ends do you feel you immediately have to find someone else to take care of you? Tell me about that. Have you reacted this way almost always when close relationships have ended? |
(7) urgently seeks another relationship as a source of care and support when a close relationship ends To score 3 – happens when most close relationships end. |
1 | 2 | 3 |
| 8 | Do you worry a lot about being left alone to take care of yourself? Are there often times when you keep worrying about this? Do you have period when you worry about this all the time? |
(8) is unrealistically preoccupied with fears of being left to take care of himself or herself. To score 3 –persistent unrealistic worry. |
1 | 2 | 3 |
| Dependent PD – 5 or more items are coded as 3 | 1 | 3 |
| Borderline PD Questions | Borderline PD Criteria | ||||
|---|---|---|---|---|---|
| A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: | |||||
| 1 | Have you often become frantic when you thought that someone you really cared about was going to leave you. What have you done? Have you threatened or pleaded with him or her? |
(1) frantic efforts to avoid real or imagined abandonment. Do not include suicidal or self-mutilating behaviour covered in Criterion 5 To score 3 – several (3) examples |
1 | 2 | 3 |
| 2 | Do your relationships with people you really care about have lots of extreme ups and downs? Tell me about them. Were there times you thought they were everything you wanted and other times you thought they were terrible? How many relationships were like this? |
(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation To score 3 – either one prolonged relationship or several briefer relationships in which the alternating pattern occurs at least twice. |
1 | 2 | 3 |
| 3 | Have you all of a sudden changed your sense of who you are and where you are headed? Give me some examples of this. Does your sense of who you are often change dramatically? Tell me more about that? Are you different with different people or in different situations so that you sometimes don’t know who you really are? Give me some examples of this? Do you feel this way a lot? Have there been lots of sudden changes in your goals, career plans. Religious beliefs, and so on? |
(3) identity disturbance: markedly and persistently unstable self-image or sense of self Do not include normal adolescent uncertainty To score 3 – acknowledges trait |
1 | 2 | 3 |
| 4 | Have you often done things impulsively? What kind of things? What about buying things you really couldn’t afford? What about having sex with people you hardly know or unsafe sex? What about drinking too much or taking drugs? What about driving recklessly? What about uncontrollable eating? If yes to any of these – Tell me about that. How often does it happen What kinds of problems has it caused? |
(4) impulsivity in at least two areas that are potentially self-damaging (for example, spending, sex, substance abuse, reckless driving, binge eating.) Do not include suicidal or self-mutilating behaviour covered in Criterion 5. To score 3 – several (3) examples |
1 | 2 | 3 |
| 5 | Have you tried to hurt or kill yourself or threatened to do so? Have you ever cut, burned or scratched yourself on purpose? Tell me about that |
(5) recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour To score 3 – 2 or more events when not in a major depressive episode |
1 | 2 | 3 |
| 6 | Do you have a lot of sudden mood changes? Tell me about that. How long do your bad moods last? How often do these mood changes happen? How suddenly do your moods change? |
(6) affective instability due to a marked reactivity of mood (for example, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) To score 3 – acknowledges trait |
1 | 2 | 3 |
| 7 | Do you often feel empty inside? Tell me more about this. |
(7) chronic feelings of emptiness To score 3 – acknowledges trait |
1 | 2 | 3 |
| 8 | Do you often have temper outbursts or get so angry that you lose control? Tell me about this. Do you hit people or throw things when you get angry? Tell me about this. Do even little things get you very angry? When does this happen? Does this happen often? |
(8) inappropriate intense anger or difficulty controlling anger (for example, frequent displays of temper, constant anger, recurrent physical fights) To score 3 – acknowledges trait and gives one example |
1 | 2 | 3 |
| 9 | When you are under a lot of stress do you get suspicious of other people or feel especially spaced out? Tell me about that. |
(9) transient, stress-related paranoid ideation or severe dissociative symptoms To score 3 – several (3) examples that do not occur during a psychotic disorder or a mood disorder with psychotic features. |
|||
| Borderline PD – 5 or more items are coded as 3 | 1 | 3 |
| Antisocial PD Questions | Antisocial PD Criteria | 1 | 3 | ||
|---|---|---|---|---|---|
| B | Are you currently over 18? | B. The individual is at least age 18 years. | 1 | 2 | 3 |
| D | D. The occurrence of antisocial behaviour is not exclusively during the course of schizophrenia or a manic episode. | 1 | 2 | 3 | |
| If the person meets criterion B (over 18 years) and criterion D (antisocial behaviour not due to mania or schizophrenia) proceed to ask about conduct problems before age 15 (criterion C – items C1-C15 below) until at least 2 of the 15 criteria are met. | |||||
| C | C. There is evidence of Conduct Disorder with onset before age 15 years. | 1 | 2 | 3 | |
| C1 | Before you were 15 would you bully or threaten other kids? Tell me about that. |
(1) Before the age of 15 often bullied threatened or intimidated others | |||
| C2 | Before you were 15 would you start fights? How often? |
(2) Before the age of 15 often initiated physical fights | |||
| C3 | Before you were 15 did you hurt or threaten someone with a weapon like a bat, brick, broken bottle, knife or gun? Tell me about that? |
(3) Before the age of 15 used a weapon that can cause serious physical harm to others (e.g., bat, brick, broken bottle, knife, gun) | |||
| C4 | Before you were15 did you deliberately torture someone or cause someone physical pain and suffering? What did you do? |
(4) Before the age of 15 was physically cruel to people | |||
| C5 | Before you were 15 did you torture or hurt animals on purpose? What did you do? |
(5) Before the age of 15 was physically cruel to animals | |||
| C6 | Before you were 15 did you rob, mug or forcibly take something from someone by threatening him or her? Tell me about that. |
(6) Before the age of 15 stole while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) | |||
| C7 | Before you were 15 did you force someone to have sex with you, to get undressed in front of your, or to touch you sexually? Tell me about that. |
(7) Before the age of 15 forced someone into sexual activity | |||
| C8 | Before you were 15 did you set fires? Tell me about that. |
(8) Before the age of 15 deliberately engaged in fire setting with the intention of causing serious damage | |||
| C9 | Before you were 15 did you deliberately destroy things that weren’t yours? What did you do? |
(9) Before the age of 15 deliberately destroyed others’ property (other than by fire setting) | |||
| C10 | Before you were 15 did you break into houses, other buildings, or cars? Tell me about that. |
(10) Before the age of 15 broke into someone else’s house, building or car | |||
| C11 | Before you were 15 did you lie a lot or con other people? Want would you lie about? |
(11) Before the age of 15 often lied to obtain goods or favours or to avoid obligations (i.e., cons others) | |||
| C12 | Before you were 15 did you sometimes steal or shoplift things or forge someone’s signature? Tell me about it. |
(12) Before the age of 15 stole items of nontrivial value without confronting the victim (e.g., shoplifting, stealing but without breaking and entering, forgery) | |||
| C13 | Before you were 15 did you run away and stay away overnight? Was that more than once? With whom were you living at the time? |
(13) Before the age of 15 ran away from home overnight at least twice while living in parental or parental surrogate home ( or once without returning for a lengthy period) | |||
| C13 | Before you were 13 did you often stay out very late, long after the time you were supposed to be home? How often? |
(14) Before the age of 13 often stayed out at night despite parental prohibitions | |||
| C15 | Before you were 13 did you often skip school or mitch? How often? |
(15) Before the age of 13 often truanted from school | |||
| If two items from C1-C15 are present criterion C is met, so proceed to questions about criterion A | |||||
| A | A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following: | ||||
| A1 | Now, since you were 15 have you done things that are against the law – even if you weren’t caught – like stealing, using or selling drugs, writing bad checks, or having sex for money ? If no – Have you ever been arrested for anything? |
(1) Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest To score 3 – several (3) examples |
1 | 2 | 3 |
| A2 | Since you were 15, do you often find you have to lie to get what you want? Have you ever used an alias or pretended you were someone else? Have you ever conned others to get what you want? |
(2) Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure To score 3 – several (3) examples |
1 | 2 | 3 |
| A3 | Since you were 15, do you often do things on the spur of the moment without thinking how it will affect you or other people? What kind of things? Was there ever a time when you had no regular place to live? For how long? |
(3) Impulsivity or failure to plan ahead To score 3 – several (3) examples |
1 | 2 | 3 |
| A4 | Since you were 15, have you been in many fights? How often? Have you ever hit or thrown things at your spouse or partner? How often? Have you ever hit a child, yours or someone else’s – so hard that he or she had bruises or had to stay in bed or see a doctor? Tell me about that. Have you physically threatened or hurt someone? Tell me about that. |
(4) Irritability and aggressiveness, as indicated by repeated physical fights or assaults To score 3 – several (3) examples |
1 | 2 | 3 |
| A5 | Since you were 15, did you ever drive a car when you were drunk or high? How many speeding tickets or penalty points for speeding have you gotten or car accidents have you been in? Do you always use protection if you have sex with someone you don’t know well? Has anyone ever said that you allowed a child that you were taking care of to be in a dangerous situation? |
(5) Reckless disregard for safety of self or others To score 3 – several (3) examples |
1 | 2 | 3 |
| A6 | How much of the time in the last 5 years were you not working? If for a prolonged period – Why? Was there work available? When you were working did you miss a lot of work? If yes- Why? Did you ever walk off a job without having another one to go to? If yes –How many times did this happen? Have you ever owed people money and not paid them back? How often? What about not paying child support, or not giving money to children or someone else who depended on you? |
(6) Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations To score 3 – several (3) examples |
1 | 2 | 3 |
| A7 | How do you feel about (LIST SOME ANTSOCIAL ACTS THAT THE PERSON DID)? Do you think what you did was wrong in any way? |
(7) Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another To score 3 –lacks remorse about several (3) antisocial acts |
1 | 2 | 3 |
| Antisocial PD – 3 or more items from A1-A7 are coded as 3 and criterion B (over 18) criterion C (conduct disorder before 15) and criterion D (absence of current mania or schizophrenia) are met. | 1 | 3 |
| Global Assessment of Functioning (GAF) Base your GAF rating on all available information and put GAF rating below and on the SCID grid |
|
|---|---|
| Consider psychological, social and occupational functioning on a hypothetical continuum of mental health-illness. Do not include impairment in functioning due to physical or environmental limitations. | |
| 100 | 91 |
Superior functioning in a wide rage of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many qualities. No symptoms. |
|
90 | 81 |
Absent or minimal symptoms, good functioning in all areas, interested and involved in a wide range or activities, socially effective, generally satisfied with life, no more than everyday problems or concerns. |
|
80 | 71 |
If symptoms are present they are transient and expectable reactions to psychosocial stresses; no more than slight impairment in social, occupational, or school functioning |
|
70 | 61 |
Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships. |
|
60 | 51 |
Moderate symptoms OR any moderate difficulty in social, occupational, or school functioning. |
|
50 | 41 |
Serious symptoms OR any serious impairment in social, occupational, or school functioning. |
|
40 | 31 |
Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood. |
|
30 | 21 |
Behaviour is considered influenced by delusions or hallucinations OR serious impairment in communications or judgment OR inability to function in all areas. |
|
20 | 11 |
Some danger or hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication. |
|
10 | 0 |
Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death |
| SCID GRID | |||
|---|---|---|---|
| Summarize the results of the SCID I and SCID II and the Global Assessment of Functioning on this Grid | |||
| Any DSM IV Axis 1 psychological Disorder | |||
| ANYC | Any axis 1 disorder current | Yes 1 |
No 0 |
| ANYE | Any axis 1 disorder ever | Yes 1 |
No 0 |
| Mood Disorders | |||
| MC | Any mood disorder current | Yes 1 |
No 0 |
| ME | Any mood disorder ever | Yes 1 |
No 0 |
| MDC | Major depression current | Yes 1 |
No 0 |
| MDE | Major depression ever | Yes 1 |
No 0 |
| DC | Dysthymia current | Yes 1 |
No 0 |
| Anxiety disorders | |||
| AC | Any anxiety disorder current | Yes 1 |
No 0 |
| AE | Any Anxiety disorder ever | Yes 1 |
No 0 |
| PDC | Panic disorder without agoraphobia current | Yes 1 |
No 0 |
| PDE | Panic disorder without agoraphobia ever | Yes 1 |
No 0 |
| PDAC | Panic disorder with agoraphobia current | Yes 1 |
No 0 |
| PDAE | Panic disorder with agoraphobia ever | Yes 1 |
No 0 |
| AGC | Agoraphobia without panic disorder current | Yes 1 |
No 0 |
| AGE | Agoraphobia without panic disorder ever | Yes 1 |
No 0 |
| SPC | Social phobia current | Yes 1 |
No 0 |
| SP | Social phobia ever | Yes 1 |
No 0 |
| PC | Specific phobia current | Yes 1 |
No 0 |
| PE | Specific phobia ever | Yes 1 |
No 0 |
| OCDC | Obsessive compulsive disorder current | Yes 1 |
No 0 |
| OCDE | Obsessive compulsive disorder ever | Yes 1 |
No 0 |
| PTSDC | Posttraumatic stress disorder current | Yes 1 |
No 0 |
| PTSDE | Posttraumatic stress disorder ever | Yes 1 |
No 0 |
| GADC | Generalized anxiety disorder current | Yes 1 |
No 0 |
| GADE | Generalized anxiety disorder ever. | Yes 1 |
No 0 |
| Substance induced disorders | |||
| ASDC | Any alcohol or substance use disorder current | Yes 1 |
No 0 |
| ASDE | Any alcohol and substance use disorder ever | Yes 1 |
No 0 |
| ALCC | Alcohol abuse current | Yes 1 |
No 0 |
| ALCE | Alcohol abuse ever | Yes 1 |
No 0 |
| ALCDC | Alcohol dependence current | Yes 1 |
No 0 |
| ALCDE | Alcohol dependence ever | Yes 1 |
No 0 |
| SAC | Other substance abuse current | Yes 1 |
No 0 |
| SAE | Other substance abuse ever | Yes 1 |
No 0 |
| SDC | Other substance dependence current | Yes 1 |
No 0 |
| SDE | Other substance dependence ever | Yes 1 |
No 0 |
| Personality disorders | |||
| ANYPDC | Any personality disorder | Yes 1 |
No 0 |
| AVPD | Avoidant current | Yes 1 |
No 0 |
| DPPD | Dependent current | Yes 1 |
No 0 |
| BPD | Borderline current | Yes 1 |
No 0 |
| ANPD | Antisocial current | Yes 1 |
No 0 |
| Overall functioning | Yes 1 |
No 0 |
|
| GAF | Global assessment of functioning | Yes 1 |
No 0 |
| Personal Strengths | |||||||
|---|---|---|---|---|---|---|---|
| We are coming to the end of the interview now. There are three final questions. These are about your own strengths and people or things that have given you strength in your life. | |||||||
| S1 | You have shown great strength in your life facing very difficult situations. Have you any ideas about where this strength comes from? |
Relationship with current partner
1 |
Relationship with a friend including other survivors
2 |
Relationship with therapist or counsellor
3 |
Relationship with god or spiritual force
4 |
Self-reliance My work My skills My character strengths like Optimism Etc 5 |
Other Specify 6 |
| S2 | You have faced very difficult challenges in your life. What has helped you most in facing these? |
Relationship with current partner
1 |
Relationship with a friend including other survivors
2 |
Relationship with therapist or counsellor
3 |
Relationship with god or spiritual force
4 |
Self-reliance My work My skills My character strengths like Optimism Etc 5 |
Other Specify 6 |
| S3 | What is the thing that means most to you in your life? | Relationship with current partner
1 |
Relationship with a friend including other survivors
2 |
Relationship with therapist or counsellor
3 |
Relationship with god or spiritual force
4 |
Self-reliance My work My skills My character strengths like Optimism Etc 5 |
Other Specify 6 |
| Thank you for your help with this interview. By Christmas we will be giving our independent report of the results of this study of 400 survivors of institutional living to the Commission to Inquire into Child Abuse and this will be referred to in the final Report of the Commission. As a routine procedure we give all participants in the study this leaflet on how to contact a counsellor, just in case this is something you want to do it the future. Is there anything you would like to add or ask before I show you out? Would you like me to call you in a few days to check that you are OK and that there is nothing further you wish to add or ask at that point? Thank you again for your help. |
Appendix 2. Scripts and Information Sheets
Telephone recruitment script
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TELEPHONE RECRUITMENT SCRIPT
Hello, this is X from UCD. I am contacting you in connection with the Child Abuse Commission. Pause for answer. If the participant declines the invitation, say: If the participant says that they would like more information or would like to take part in the study, say: If the participant says they would like to participate, then set up a time. If the participant requires more information, say the following: Pause for answer. If the participant declines the invitation, say: If the participant says they would like to participate, then set up a time. |
Follow-up phone call script
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FOLLOW-UP PHONE CALL SCRIPT
Hello this is NAME from the research study. We met the other day in LOCATION. |
Information leaflet on contacting the National Counselling Service
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HOW DO I TO CONTACT A COUNLELLOR?
Thank you for participating in this research project. If you require counselling for abuse-related issues including any issues arising from the research interview you may contact the National Counselling Service (NCS) in Ireland or the Immigrant Counselling and Psychotherapy service (ICAP) in England and request an appointment. The National Counselling Service, which is free and confidential, has been set up as part of the Government Strategy for victims of institutional abuse. If you are in England you can contact the Immigrant Counselling and Psychotherapy service (ICAP). Here is a list of NCS centres in Ireland and ICAP centres in the UK. Ms. Isolde Blau, Director of Counselling, Laragh Counselling Service, NHE, Prospect House, Prospect Road, Glasnevin, Dublin 9. Phone 1800 234 110 or 01-8824100. Covers Dublin – North of the Liffey Ms. Rachel Mooney, Director of Counselling, AVOCA Counselling Service, NHE, Baggot Street Hospital, Lower Baggot Street, Dublin 4. Phone: 1800 234 111 or 01 6681740. Covers Dublin – South of the Liffey (Ringsend-Crumlin), Dun Laoghaire etc., Wicklow Ms. Marion Rackard, Director of Counselling, Alba Counselling Service, NHE, 2 McElwain Terrace, Newbridge, Co. Kildare. Phone 1800 234 112 or 045 448176. Covers Kildare, South West Dublin (Tallaght, Walkinstown, Drimnagh, Crumlin, Clondalkin, Lucan), Parts of Wicklow (e.g. Blessington, Baltinglass) Ms. Theresa Flacke, Director of Counselling, NHE, Woodquay Centre Counselling Service, 7 Daly’s Lane, Woodquay, Galway. Phone 1800 234 114 or 091 561336. Covers Galway, Roscommon, Mayo. Ms. Noreen Harrington, Director of Counselling, NHE, 106 O’Connell Street, Limerick. Phone 1800 234 115 or 061 411900. Covers Clare, Limerick, North Tipperary. Mr. Philip Moore, Director of Counselling, Harbour Counselling Service, NHE, Penrose Wharf, Penrose Quay, Cork. Phone 1800 234 116 or 021 4861360. Covers Cork, Kerry Ms. Fiona Ward, Director of Counselling, Rian Counselling Service, NHE, 34 Brew’s Hill, Navan, Co. Meath. Phone 1800 234 117 or 046 9067010. Covers Cavan, Monaghan, Meath. Louth |
| Mr. Gerard O’Neill, Director of Counselling, COMHAR, Adult Counselling Service, South Eastern Health Board, 49 O’Connell Street, Waterford. Phone 1800 234 118 or 051 852122. Covers Waterford, Kilkenny, Wexford, South TipperaryMr. Tom McGrath, Director of Counselling, NHE, 68 John Street, Sligo. Phone 1800 234 119 or 071 9142161. Covers Donegal, Sligo, Leitrim.
London. ICAP Immigrant Counselling and Psychotherapy, 79 1/2 Tollington Park, London N4 3AG , UK Phone 0207-272-7906 Birmingham. ICAP: Immigrant Counselling and Psychotherapy, 72 Digbeth, Birmingham, B5 6DH, UK, Phone 0121-666-7707 |
Briefing for directors of NCS centres
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BRIEFING FOR DIRECTORS OF NCS CENTRES
Dear Colleagues Jonathan Egan, M Psych Sc Director of Counselling, |
Summary of the institutional abuse survey
What follows is a summary of key findings from the survey contained in chapter 1, which was commissioned by CICA and conducted by Professor Alan Carr, from the UCD School of Psychology.
Past research
Past international research on child abuse, institutional living, institutional abuse and clerical abuse suggests that children brought up in institutions and abused as children may show a range of problems as adults. However, no large-scale studies have been conducted to investigate whether or not these tentative findings from the international literature reflect the experiences of survivors of institutional living in Ireland.
Aims of the current study
The aim of the present study was to profile survivors of institutional child abuse in industrial and reformatory schools on demographic, historical and psychological variables.
Methodology
Between May 2005 and February 2006 just under 250 adult survivors of institutional living recruited through CICA were interviewed in Ireland and the UK by a team which included 29 trained interviewers, all of whom had degrees in psychology. The overall exclusion rate was 26% (326 of 1267). The participation rate was 20% (246 of 1267). The response rate for the study was 26% (246 of 941). (This low response rate is not unusual. A response rate of 9% was obtained in the Time to Listen Report on Confronting Child Sexual Abuse by Catholic Clergy (Goode, McGee & O’Boyle, 2003)).
The sample of participants interviewed was not representative of all CICA attenders, or indeed of adult survivors of institutional living. It is probable that participants were better adjusted than CICA attenders who did not take part, because the old and the ill were excluded from the study. The interview protocol covered demographic characteristics, history of family and institutional living, recollections of child abuse within the family and institutions, psychological processes associated with institutional life, coping strategies used to deal with institutional life, current trauma symptoms, current and past diagnoses of psychological and personality disorders, relationships with partners and children, adult attachment style, main life problems, current quality of life, and global level of functioning. Interviews were conducted in an ethical way that safeguarded participants’ wellbeing. Data were managed in a way to safeguard participants’ anonymity.
Profile of overall sample
Demographic characteristics
The 247 participants in this study included roughly equal numbers of men and women of about 60 years of age, who had entered institutions run by nuns, religious brothers or priests due to family adversity or petty criminality. Participants had spent an average of 5.4 years living with their families before entering an institution and on average spent 10 years living in an institution. The majority were of lower socioeconomic status and low educational attainment. The majority had been, or were currently married or in a long-term relationships, with a high rate of relationship stability. Most married participants had children, with three children being the average, and most had brought up their own children.
Institutional abuse
From Figure 1 it may be seen that on the institutional version of the Childhood Trauma Questionnaire, more than 90% of participants were classified as having experienced physical and emotional child abuse and neglect within institutions, and about half as having experienced institutional child sexual abuse. For about 40% of participants, severe physical abuse was the worst thing that happened to them in an institution. For a further third it was humiliation and degradation. For 16% it was sexual abuse and for about a tenth it was combined physical and sexual abuse. Worst institutional abusive experiences began at about 9 years and lasted for 5 about years.
Figure 1. Rates of institutional child maltreatment on the institutional version of the childhood trauma scale among all 247 participants
Family-based child abuse
From Figure 2 it may be seen that on the family version of the Childhood Trauma Questionnaire almost half of the 121 participants who had memories of having lived with their families were classified as having experienced physical neglect; about a quarter as having suffered emotional neglect or physical abuse; about a fifth as having suffered emotional abuse; and under a tenth as having suffered sexual abuse.
Figure 2. Rates of family-based child maltreatment on the family version of the childhood trauma scale among the 121 participants who had memories of having lived with their families.
Life problems
All participants had experienced one or more significant life problems. From Figure 3 it may be seen that mental health problems, unemployment and substance use were the three most common difficulties and were reported by a third to three quarters of participants.
Figure 3. Rates of life problems among all 247 participants.
Strengths
From figure 4 it may be seen that self-reliance, optimism, work and skills were the most frequently reported resources that helped participants most in facing life challenges.
Figure 4. Factors that helped participants most in facing life challenges
Psychological disorders
81.78% of participants at some point in their life had had a psychological disorder and only under a fifth had never had any psychological disorder. Anxiety disorders were the most common, followed by mood disorders. From Figure 5 it may be seen that rates of current anxiety, mood and substance use disorders were more than double those found in community surveys in Europe and the USA.
Figure 5. Rates of current psychological disorders among survivors of institutional living compared with rates in normal community samples in Europe and the USA.
Trauma symptoms
From Figure 6 it may be seen that the majority of participants showed clinically significant posttraumatic symptomatology on the Trauma Symptom Inventory, indicative of continuing posttraumatic adjustment difficulties.
Figure 6. Rates of trauma symptoms on the Trauma Symptom Inventory
Adult attachment styles
On the Experiences in Close Relationships Inventory more than four fifths (93.41%) of participants were classified as having an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships. A fearful attachment style characterized by high interpersonal anxiety and avoidance was by far the most common. Less than a fifth of cases (16.59%) were classified as having a secure adult attachment style.
Male and female survivors
Male (N=135) and female (N=112) participants had different profiles. Male participants spent longer living with their families before entering institutions and fewer years in institutions. More entered institutions run by religious brothers or priests for petty crime and left because their sentence was over, while more females lived in institutions run by nuns. Male participants achieved a higher socio-economic status than females, and more had children who spent time living separately from them with the child’s other parent. While worst abusive experiences began at an older age, for male participants, they reported more institutional sexual abuse. While female participants had significantly more current panic disorder with agoraphobia, significantly more male participants had lifetime diagnoses of alcohol and substance use disorders, especially alcohol dependence. Male participants had significantly higher numbers of life problems, but also higher levels of global functioning and marital satisfaction than females.
Older and younger survivors
Older participants (N=134) in their 60s and younger participants in their 50s (N=113) had distinct profiles. More older participants left their institutions because they were too old to stay on and more were now retired. They had longer relationships with their current partners and were older when their first children were born. Younger participants reported greater institutional, physical, sexual and emotional abuse. More had current anxiety, mood and personality disorders, especially PTSD, generalized anxiety disorder and avoidant personality disorder. Younger participants had more trauma symptoms, adult life problems, a lower quality of life and lower level of global functioning compared with older participants.
Participants from the CICA confidential and investigation committees
Participants from the confidential (N=175) and investigation (N=71) committees had distinct profiles. Participants from the confidential committee had spent fewer years with their families before entering an institution and more years in institutions run by nuns. More entered because they were illegitimate and left because they were too old to stay on. They were younger when their worst experiences began. More had maintained stable long-term relationships with their partners and provided their own children with a stable family in which to grow up. More participants from the investigation committee entered intuitions run by religious brothers or priests through the courts for petty crime and left because their sentences were over. They reported greater institutional sexual abuse than participants from the confidential committee. More participants from the investigation committee had a current diagnosis of major depression.
Subgroups defined by duration of time in an institution and circumstances of entry
The following four subgroups, defined by duration of time in an institution and circumstances of entry, were compared:
- Group 1 included those who had spent more than 12 years in an institution and entered before 5 years of age (N=110).
- Group 2 included participants who had spent 5-11 years in institutions because of family problems (N=67).
- Group 3 included participants who had spent 5-11 years in institution and entered through the courts (N=22).
- Group 4 included participants who had spent 4 or fewer years in institution (N=48).
In the analysis of these four groups the most poorly adjusted as adults were not those who had spent longest living in institutions (more than 12 years), but rather those who had spent less time in institutions (under 11 years), entered institutions through the courts, and reported institutional sexual abuse, in addition to physical abuse within their families. These had more antisocial personality disorders, substance use disorders and life problems such as unemployment and criminality. What follows is a summary of the profiles of the four groups from this analysis.
Group 1 included those who had spent more than 12 years in an institution and entered before 5 years of age They had spent the least time with their families (under one and a half years) and the longest time living in institutions (about fifteen years) of any of the four groups. Compared to groups 3 and 4, more were girls placed in orphanages run by nuns because they were illegitimate, or because their parents had died or could not look after them. More left because they were too old to stay on, and more had mixed feelings about leaving. More had experienced physical abuse which began at a younger age and persisted longer than in group 4. Severe emotional abuse was most commonly cited as the worst thing that happened to this group and it began at an earlier age and lasted longer than worst experiences of other groups. Compared with groups 3 and 4, this group reported fewer psychological disorders and life problems. They identified relationships with friends, self-reliance, optimism, and their work and skills as the sources of their strength.
Group 2 included participants who had spent 5-11 years in institutions because of family problems Participants in this group entered institutions run predominantly by nuns because their parents could not cope or died, and left when they were too old to stay. Compared with groups 3 and 4, more members of group 2 were female, younger when their most severe form of sexual abuse began, and more identified severe emotional abuse as the worst thing that had happened to them. Compared with group 4 more identified self-reliance, optimism, and their work and skills as the source of their strength.
Group 3 included participants who had spent 5-11 years in institution and entered through the courts Compared with groups 1 and 2, more members of this group were male, lived in institutions run by religious brothers or priests, and were survivors of institutional sexual abuse. Compared to the other three groups they identified sexual abuse as the worst thing that had happened to them, and more had experienced physical abuse within their families. Compared with groups 1 and 2, this group had more alcohol and substance use disorders, antisocial personality disorders, violent and non-violent crime, imprisonment for violent and non-violent crime, and unemployment. For this group, their self-reliance, optimism, and their work and skills were identified as the main sources of their strength in adulthood, compared with group 4.
Group 4 included participants who had spent 4 or fewer years in institution Participants in this group spent the most time with their families (more than ten and a half years) and the shortest time living in an institution (just under three years) compared with the other three groups. Most were boys placed in institutions run by religious brothers or priests because of petty crime and left because their short sentences were over, or because their families wanted them back, and few had mixed feelings about leaving. Institutional sexual abuse was the form of maltreatment that distinguished this group, and compared with groups 1 and 2, they showed more alcohol and substance use disorders, antisocial personality disorders, non-violent crime, imprisonment for non-violent crime and unemployment. Their relationships with their partners was identified as the main source of their strength in adulthood.
Subgroups defined by worst form of institutional abuse
The following subgroups, defined by worst form of institutional abuse, were compared:
- Group 1 included participants for whom severe sexual and physical abuse was the worst thing they had experienced (N=23).
- Group 2 included participants for whom severe physical abuse was the worst thing they had experienced (N=99).
- Group 3 included participants for whom severe sexual abuse was the worst thing they had experienced (N=40).
- Group 4 included participants for whom severe emotional abuse was the worst thing they had experienced (N=85).
In this analysis the most poorly adjusted as adults were not those who reported severe combined physical and sexual abuse, but rather, those who pinpointed severe sexual abuse as the worst thing that had happened to them while living in an institution. In this analysis, the best adjusted were those who had suffered severe emotional abuse. What follows is a summary of the profiles of the four groups from this analysis.
Group 1 included participants for whom severe sexual and physical abuse was the worst thing they had experienced
Participants in this group had experienced more physical and sexual institutional abuse than at least two of the other 3 groups (in this analysis). They had spent less time with their families before entering an institution than group 3. Like members of group 3, more had children who spent some time living separately with the child’s other parent. Compared with groups 2 and 4, more had a current diagnosis of posttraumatic stress disorder (PTSD) and multiple trauma symptoms.
Group 2 included participants for whom severe physical abuse was the worst thing they had experienced
Participants in this group had the lowest educational achievement, were older than groups 1 and 3 (in this analysis), and more had put their own children up for adoption. Compared with group 3, their worst abusive experience had lasted longer. Like group 4, fewer had PTSD than groups 1 and 3, and they had fewer life problems than group 3.
Group 3 included participants for whom severe sexual abuse was the worst thing they had experienced
Compared with group 4 (in this analysis), more participants in group 3 were male and were admitted through the courts to institutions run by religious brothers for petty crime. Like group 1, more had children who spent time with their other parent who lived separately compared to group 4. Also, compared to group 4, more had PTSD, multiple trauma symptoms, lifetime alcohol and substance use disorders, antisocial personality disorders and multiple life problems.
Group 4 included participants for whom severe emotional abuse was the worst thing they had experienced
Compared to group 3 (in this analysis), more participants in this group were female and on average had spent the longer living in institutions run by nuns. Their worst experiences began at an earlier age than any other group and more had mixed feelings about leaving.
Profiles associated with patterns of adult psychological disorders
There was an association between having psychological disorders and reporting both institutional and family-based child abuse and neglect. Certain patterns of psychological disorders were associated with institutional abuse alone, and other patterns were associated with institutional family-based child abuse and neglect. For participants with 4 or more co-existing diagnoses, and for those with mood disorders, greater institutional, but not family-based physical, sexual and emotional abuse was reported. Participants with PTSD, alcohol and substance use disorders, avoidant and antisocial personality disorder reported both institutional and family-based abuse or neglect. Participants with multiple diagnoses had the poorest adult psychological adjustment and those with no diagnoses were the best adjusted. Subgroups selected by diagnosis showed an intermediate level of adult psychological adjustment between these extremes. What follows are brief profiles of groups with different patterns or types of psychological disorders.
Multiple diagnoses
Participants with 4 or more diagnoses (N=83), were compared with those who had 1-3 diagnoses (N=119), and with those who had no diagnoses (N=45). Those with 4 or more diagnoses reported greater institutional sexual and emotional abuse (but not more family-based abuse) than participants with fewer diagnoses. Participants with 4 or more diagnoses had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with 1-3 diagnoses, who in turn were less well adjusted than participants with no diagnoses. More participants with 4 or more diagnoses had a fearful adult attachment style, and fewer had secure or dismissive adult attachment styles. On average more participants with 4 or more diagnoses were in their 50s compared with those with no diagnoses who where were in their 60s. Also, more participants with 4 or more diagnoses were unemployed and of lower socio-economic status than participants with fewer diagnoses.
Mood disorders
Participants with mood disorders (N=142), more than half of whom had co-existing anxiety disorders, reported greater institutional sexual and emotional abuse and greater institutional severe physical and sexual abuse (but not family-based child abuse) than participants with no diagnoses (N=45). Participants with mood disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. More participants with mood disorders had a fearful adult attachment style, and fewer had a secure adult attachment style. On average participants with mood disorders were in their late 50s while those with no diagnoses were in their 60s. Also, on average, participants with mood disorders had had their first child in their mid-20s, while those with no diagnoses had their first children a couple of years later.
Posttraumatic stress disorder
Participants with PTSD (N=63), more than half of whom had other co-existing anxiety disorders and alcohol or substance use disorders, reported greater institutional physical, sexual and emotional abuse, and greater institutional severe physical and sexual abuse than participants with no diagnoses (N=45). They also reported having experienced greater family-based emotional abuse. Participants with PTSD had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Fewer participants with PTSD had a dismissive adult attachment style. On average participants with PTSD were in their 50s while those with no disorders were in their 60s.
Alcohol and substance use disorders
Participants with alcohol and substance use disorders (N=99), more than half of whom had a co-existing anxiety disorder, reported greater institutional sexual and emotional abuse, and greater institutional severe sexual abuse than participants with no diagnoses (N=45). They also reported having experienced greater family-based physical and emotional abuse. Participants with alcohol and substance use disorders had more trauma symptoms and life problems, and a lower quality of life and global level of functioning than participants with no diagnoses. Compared with those with no diagnoses, participants with alcohol and substance use disorders were younger (in their 50s not their 60s); had had their first children at a younger age (in early, not their late 20s); were of lower socio-economic status; and fewer had entered an institution because their parents had died.
Avoidant personality disorder
Participants with avoidant personality disorders (N=52) reported greater institutional and family-based emotional abuse than those with no diagnoses (N=45). Almost all participants with an avoidant personality disorder had a co-existing anxiety, mood or substance use disorder. Participants with avoidant personality disorder had more trauma symptoms and life problems, and a lower quality of life and global level of functioning, than participants with no diagnoses. Compared to those with no diagnoses, more participants with an avoidant personality disorder had a fearful adult attachment style and fewer had a secure adult attachment style. Compared to participants with no diagnoses, participants with avoidant personality disorder were younger (in their 50s, not their 60s) and more had been placed in institutions run by nuns because their parents could not care for them.
Antisocial personality disorder
Participants with antisocial personality disorder (N=17) reported greater institutional sexual abuse than participants with no diagnoses (N=45). All participants with antisocial personality disorder had co-existing anxiety, mood or substance use disorders. Participants with antisocial personality disorder had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and lower parental satisfaction than participants with no diagnoses. Compared to those with no diagnoses, participants with antisocial personality disorder were younger (in their 50s, not their 60s); had spent fewer years in institutions (5 ½ not nearly 10 years); more were unemployed; and more were of low socio-economic status.
Borderline personality disorder
Participants with borderline personality disorder (N=14) and those with no diagnoses (N=45), did not differ in their reported levels of institutional or family-based child abuse, although both reported a high level of child abuse. All participants with borderline personality disorder had co-existing anxiety, mood or substance use disorders. Participants with borderline personality disorders had more trauma symptoms, more life problems, a lower quality of life, a lower global level of functioning, and more had a fearful adult attachment style than participants with no diagnoses. Compared to those with no diagnoses, participants with borderline personality disorder were younger (in their 50s, not 60s), more were unemployed, and on average reported being abused from an earlier age.
Institutional abuse processes and coping strategies
Scales were developed to assess the psychological processes of traumatization, re-enactment of abuse and spiritual disengagement; as well as positive and negative coping strategies. Participants completed versions of these scales to reflect their current experience and their recollection of their experiences when living in institutions as children. Participants reported a reduction in the psychological processes of traumatization, re-enactment of abuse and an increase in spiritual disengagement from childhood to adult life. Participants also reported an increase in the use of positive coping strategies and a reduction in the use of coping by complying and avoidant coping strategies from childhood to adulthood.
A model of institutional abuse, psychological processes and adult adjustment
Figure 7 represents a model which shows that a history of childhood institutional abuse is associated with current psychological processes of traumatization, re-enactment and spiritual disengagement, which in turn are associated with current adult mental health and quality of life. The model also shows that a history of having spent more childhood years within the family and current use of positive coping strategies are positively associated with quality of life and low levels of present traumatization. This model was developed by first correlating all factors within the model, and then testing the fit of the proposed model to the pattern of correlations between its constituent factors using structural equation modelling.
Figure 7. A path diagram of the model of institutional abuse
Strengths and limitations
This study had three main limitations: (1) there was a high exclusion rate and a low response rate; (2) there was no control group; and (3) the study used a crossectional not a longitudinal design. There were also four main strengths: (1) it was the largest study of its kind conducted to date; (2) an extensive reliable and valid interview protocol was used; (3) data were collected by psychologists trained in using the interview protocol; (4) in the statistical analyses, steps were taken to reduce type 1 error (interpreting non-significant results as significant)
Recommendations
Recommendations arising from this research fall into four broad categories: prevention, treatment, training and research.
Prevention
The first recommendation is that legislation, policies, practices and procedures be regularly reviewed and revised to maximize protection of children and adolescents in institutional care in Ireland from all forms of abuse and neglect. Specifically the Children First: National Guidelines for the Protection and Welfare of Children (Department of Health and Children, 1999) require regular review and revision to insure that they are being properly implemented and that children and adolescents in institutional care, and other forms of substitutive care in Ireland are being adequately protected.
Treatment
The second recommendation is that evidence-based psychological treatment continue to be made available to adult survivors of Irish institutional abuse. Specifically the National Counselling Service for adult survivors of child abuse in Ireland and similar appropriate services in the UK should continue to be accessible to Irish survivors of institutional abuse. Staff in such services should be appropriately qualified and trained to offer services to clients with complex difficulties, such as multiple co-existing disorders including anxiety disorders, mood disorders, substance use disorders and personality disorders. It is important the these services be evidence-based (Carr, 2006).
Staff training
The third recommendation is that staff at centres which provide psychological treatment for adult survivors of Irish institutional abuse have regular continuing professional education and training to keep them abreast of developments in the field of evidence-based treatment of survivors of childhood trauma.
Research
The fourth recommendation is that research be conducted to evaluate the effectiveness of psychological treatment for adult survivors of institutional abuse. The report of Survivors’ Experiences of the National Counselling Service for Adults who Experienced Childhood Abuse (Leigh et al., 2003) was an important first step in evaluating client satisfaction with the National Counselling Service. However, it did not address the critical issue of the effectiveness of the service provided. Such research is urgently required. Research is also required on levels of child abuse among looked after children (including all categories of children in care and children living in a variety of health, educational, correctional and social services institutions).
Other documents arising from the project
Three theses and a series of academic papers have been written based on this study.
- Flanagan, E. (2006). Psychological disorders in adult survivors of institutional living. Thesis for the degree of Doctor of Psychological Science in Clinical Psychology, UCD, Dublin. In this thesis the profiles of subgroups of survivors with different psychological disorders are presented.
- Fitzpatrick, M. (2007) Psychological profiles of adult survivors of childhood institutional living in Ireland. Thesis for the degree of Doctor of Psychological Science in Clinical Psychology, UCD, Dublin. In this thesis the profiles of subgroups of survivors who had spent different amounts of time in institutions and experienced different types of abuse are presented.
- Flanagan-Howard, R. (2007). Psychometric Properties of the Institutional Abuse Processes and Coping Inventory. Thesis for the degree of Doctor of Psychological Science in Clinical Psychology, UCD, Dublin. In this thesis the development of scales to measure psychological processes associated with institutional abuse and coping strategies is presented.
Carr, A., Dooley, B., Fitzpatrick, M, Flanagan, E.,. Flanagan-Howard, R., Tierney, K., White, M., Daly, M. & Egan, J. (2007). Adult adjustment of survivors of institutional child abuse in Ireland. This paper documents the adult adjustment of survivors of childhood institutional abuse.
Fitzpatrick, M., Carr, A., Dooley, B., Flanagan-Howard, R., Flanagan, E., Shevlin, K., Tierney, K., White, M., Daly, M. & Egan J. (2007). Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland. This paper establishes the unique profiles Irish adult survivors of severe sexual, physical and emotional institutional abuse.
- Flanagan-Howard, R., Carr, A., Shevlin, M., Dooley, B., Fitzpatrick, M. Flanagan, E., Tierney, K., White, M., Daly, M. & Egan, J. (2007). Development and Initial validation of the Institutional Child Abuse Processes and Coping Inventory among a sample of Irish adult survivors of institutional abuse. This paper documents the development a psychometric instrument to evaluate psychological processes associated with institutional abuse and coping strategies used to deal with such abuse.
- Flanagan, E., Carr, A., Dooley, B., Fitzpatrick, M. Flanagan-Howard, R., Shevlin, M., Tierney, K., White, M., Daly, M. & Egan, J. (2007). Profiles of resilient survivors of institutional abuse in Ireland. This paper documents the profiles of resilient survivors of institutional abuse, who had no psychological disorders.
- Carr, A., Flanagan, E., Dooley, B., Fitzpatrick, M. Flanagan-Howard, R., Shevlin, M., Tierney, K., White, M., Daly, M. & Egan, J. (2007). Profiles of Irish survivors of institutional abuse with different adult attachment styles. This paper documents the profiles of Irish survivors of institutional abuse with different adult attachment styles
Staines Submissions:
An Assessment of the Health Status of Children Detained at Irish Industrial Schools 1940-1983
98 pg Microsoft Word Document
Click to access 01-REPSTAINES2-001.PDF
Christian Brothers Congregation (St Helen’s Provence) Response to Dr. Staines Report
6 pg Microsoft Word Document
Click to access 02-CBSUBSTA-002.PDF
Christian Brothers Congregation (St Mary’s Provence) Response to Dr. Staines Report
18 pg Microsoft Word Document
Click to access 03-CBSUBSTA-003.PDF
Comments of Religious Sisters of Charity on Report to Dr. Staines Report
32 pg Microsoft Word Document
Click to access 05-SCSUBSTX1-002.PDF
Commission to Inquire into Child Abuse: Report by Dr. Diarmaid Ferriter, St. Patrick’s College, DCU June 2006
38 pg Microsoft Word Document
Click to access CICA-VOL5-07A.pdf
Residential Child Care in England 1948-1975 Richard Rollison, Bath Consultancy, Bath, England
52 pg Microsoft Word Document
Click to access CICA-VOL5-08A.pdf
Commission Personnel 2004-2009
Chairperson
The Honourable Mr. Justice Sean Ryan
Commissioners
Ms. Mary Fennessy
Ms. Norah Gibbons
Mr. Fred Lowe
Ms. Anne McLoughlin
Dr. Imelda Ryan
Ms. Marian Shanley
Professor Edward Tempany
Legal Team
Ms. Feena Robinson Solicitor
Ms. Elisa McHugh Solicitor
Mr. Frank Clarke S.C.
Mr. Noel MacMahon S.C.
Ms. Mary Ellen Ring S.C.
Mr. Brian McGovern S.C.
Ms. Karen Fergus S.C.
Ms. Roisin Lacey Barrister
Ms. Anne Reilly Barrister
Mr. Darren Lehane Barrister
Ms. Ciara McGoldrick Barrister
Ms. Laura Rattigan Barrister
Mr. Paul Ward Barrister
Paralegals
Mr. Morgan Beirne
Ms. Saoirse Brady
Ms. Louise Bright
Mr. Wayne Butler
Ms. Breda Connolly
Ms. Brenda Caulfield
Ms. Kate Ferguson
Ms. Mary Foley
Ms. Elizabeth Fitzgerald
Ms. Aine Grogan
Ms. Philomena Lyons
Mr. Robert McDermott
Ms. Janice McGann
Ms. Fina Murphy
Ms. Diana Stafford
Ms. Elizabeth Roth
Ms. Maureen Synott
Administration
Ms. Brenda McVeigh (Commission Secretary)
Mr. Michael Stapleton
Ms. Deirdre Kenny
Ms. Deirdre Finnegan
Ms. Deirdre Kellet
Mr. Paul Boland
Ms. Clare O’Driscoll
Mr. Conor Ryan
Mr. Carthage Minnock
Mr. Patrick Malone
Ms. Ciara Peters
Ms. Laura Cavanagh
Ms. Finola Colley
Ms. Susan Cummins
Mr. John Diver
Ms. Siobhan Farrelly
Ms. Cliona Foley
Ms. Maeve Kelleher
Ms. Aoife Keegan
Ms. Grace Kiely
Ms. Kathy Langley
Mr. Gerard Matthews
Ms. Rita McGuigan
Ms. Sarah O’Connor
Ms. Amy Paris
Ms. Katie Steel
Ms. Jennifer Wylie
Investigation Committee
Ms. Caitriona Kennan
Ms. Louise O’Connor
Ms. Darra Power Mooney
Mr. Noel Barry (Usher)
Mr. Barry O’Brien
Mr. Brendan Reedy
Mr. James Behan
Ms. Catherine Buckley
Ms. Mary Caulfield
Ms. Kate Earlie
Ms. Silvia Gallagher
Ms. Stefania Giangregorio
Ms. Nicola Hannigan
Ms. Nicole Harrington
Ms. Cliona Hickey
Ms. Sinead Holly
Ms. Natalie Holster
Ms. Kasia Koper
Ms. Helene Lewis
Ms. Helen Lynch
Ms. Sile Mannion
Ms. Erina Mako
Ms. Emma Murphy
Ms. Tara Murphy
Ms. Anna Nelson
Ms. Niamh O’Hehir
Ms. Aisling Roche
Ms. Karen Ryan
Ms. Breda Ryan
Ms. Caitriona Tumulty
Confidential Committee
Ms. Norella Broderick
Ms. Mary Durack
Ms. Danielle Griffin
Ms. Melanie Hall
Ms. Sandra Hoswell
Ms. Catherine Mulligan
Notes
1.Personnel before 2004 are listed in the Third Interim Report.
2.This list includes persons who worked for some significant period of time during these years.
ACTS
rapevictimsofthecatholicchurch 
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