Des Runyan | University of Colorado Denver (original) (raw)
Papers by Des Runyan
Child Abuse & Neglect, 2001
Aggression and Violent Behavior
Psychology (Irvine, Calif.), 2012
Few studies have explored the impact of different types of neglect on children's development.... more Few studies have explored the impact of different types of neglect on children's development. Measures of cognition, language, behavior, and parenting stress were used to explore differences between children experiencing various forms of neglect, as well as to compare children with and without a history of early neglect. Children, ages 3 to 10 years with a history of familial neglect (USN), were compared to children with a history of institutional rearing (IA) and children without a history of neglect using the Differential Abilities Scale, Test of Early Language Development, Child Behavior Checklist, and Parenting Stress Index. Factors predicting child functioning were also explored. Compared with youth that were not neglected, children with a history of USN and IA demonstrated lower cognitive and language scores and more behavioral problems. Both internalizing and externalizing behavior problems were most common in the USN group. Externalizing behavior problems predicted paren...
PEDIATRICS, 2005
Context. Child maltreatment remains a significant public health and social problem in the United ... more Context. Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivale...
Journal of Interpersonal Violence, 2000
The methodological, legal, and ethical issues related to questioning children about their maltrea... more The methodological, legal, and ethical issues related to questioning children about their maltreatment experiences in research studies are complex. A review of the literature was conducted examining what studies to date have directly asked children about victimization and how study investigators dealt with the human participants issues related to subsequent disclosure. This article examines how different studies have defined and operationalized abuse in survey questions for children, reports prevalence rates when available, describes the differing methods used to collect child self-report data, and highlights how investigators have dealt with the ethical issues related to informed consent and disclosure up to this point.
Journal of Health Politics, Policy and Law, 1988
Concerned about the possible detrimental impact of the investigative process and court proceeding... more Concerned about the possible detrimental impact of the investigative process and court proceedings on child victims of sexual abuse, many child advocates have proposed extensive evidentiary and procedural revisions of the court process. As part of a long-term study of the effects of child sexual abuse on the victims' mental health, we observed child sexual abuse victims during juvenile and criminal court proceedings. Although it was clear to our observers that going to court was stressful for these children, it was not clear that the only effective way of reducing their stress would be to avoid "live" testimony. We propose that many simple improvements--for example, increasing the involvement of guardians ad litem, providing adequate time to prepare the child for court, reducing the number of continuances granted, and training attorneys and judges to deal effectively with child witnesses--would be less costly and less controversial to implement than closed-circuit or videotaped testimony, new hearsay exceptions, and other more extensive proposals for change.
Child Abuse & Neglect, 1996
American Journal of Preventive Medicine, 2008
Commentary on the methods available for ascertaining the incidence of inflicted traumatic brain i... more Commentary on the methods available for ascertaining the incidence of inflicted traumatic brain injury (inflicted TBI) and the difficulties involved in defining and measuring this condition in young children. Design: Review of published and unpublished international data regarding parental shaking of infants compared to studies assessing incidence. Results: Review of parental report data reveal that the shaking of young children is a surprisingly common act in a wide variety of countries and cultures. While 2.6% of parents of children aged under 2 years in the U.S. report shaking their child as an act of "discipline," survey data from lesser-developed countries on four continents indicate that shaking, as a form of discipline, may be many times more common among infants in their countries and that the consequences, short of hospitalization or death, are inadequately studied. Methodologic challenges to epidemiologic work to develop better estimates are discussed. Conclusions: These data highlight the challenges faced in ascertaining the epidemiology of inflicted TBI in young children. While there is scientific evidence that the shaking of young children can produce profound destruction of children's brains and lives, these data reveal that there are many other children who are shaken by their caregivers but escape the acute clinical presentation of "shaken baby syndrome" or for whom the injuries are not recognized as due to inflicted TBI. The impact of these private acts must be further studied as there may be other long-lasting and serious intracranial impacts that have not been characterized.
Journal of Interpersonal Violence, 2000
The conduct of research in the area of child abuse and neglect may be one of the most difficult t... more The conduct of research in the area of child abuse and neglect may be one of the most difficult tasks in social science research. One requirement for valid research is knowledge of the type and amount of exposure. Official reports have been demonstrated to provide a serious undercount of the frequency of maltreatment, and parent report is of limited usefulness. LongSCAN, a consortium of longitudinal studies of abuse and neglect, made the decision to ask children for self-report, but with five independent study sites with unique study-to-sample relationships, ethically implementing this choice demanded customized participant protocols. This article describes the consortium's approach to asking children for direct reports at age 12, the relevant methodological and ethical challenges, and solutions developed with institutional review boards at 4 of the 5 study sites. The wording of consents and the variations in protocol related to reporting to Child Protective Services are discussed.
Journal of Child Sexual Abuse, 1998
International Journal on Child Maltreatment: Research, Policy and Practice
Rates of intimate partner violence (IPV), child physical and sexual abuse, and adolescent births,... more Rates of intimate partner violence (IPV), child physical and sexual abuse, and adolescent births, have declined dramatically since 1993. Research has confirmed increased risk of physical and psychological abuse of children living in homes with IPV or with adolescent parents. We wondered how much of the decline observed in child abuse substantiations could be attributed to reductions in IPV and adolescent childbearing. Accordingly, we examined the rates of substantiated abuse for each U.S. state for the period 2001-2013, as state-level estimates for both IPV and teen pregnancy rates were also available for this period. We modeled the reduction in substantiated child physical, sexual, and psychological abuse by state and combined these data for a national estimate. With a national decline in substantiated child physical abuse of 182.9 cases per 1000,000 children for the period from 2001 to 2013, 7.5% of the decline was attributable to the decline in adolescent births, and 4.9% could be attributed to the decline in IPV. The reduction in births to adolescents was also associated with 9.5% of the reduction in substantiated sexual abuse over the same years. Policy efforts to reduce IPV and adolescent births appear also to have contributed to a decline in child maltreatment.
American journal of epidemiology, 2018
Child abuse is a social phenomenon that has been underresearched and undersupported. The scale of... more Child abuse is a social phenomenon that has been underresearched and undersupported. The scale of the problem is large, with over 3 million US children reported for abuse or neglect each year. An estimated 15% of confirmed victims may be placed in out-of-home care to ensure their safety. Studies have not previously examined the impact of losing a child into foster care on maternal health and mortality. Family and maternal risk factors, such as teen pregnancy, intimate partner violence, or drug and alcohol abuse, have been well documented as risk factors for maltreatment. The findings of Wall-Wieler et al. (Am J Epidemiol. 2018;187(6):1182-1188) are not so much unexpected as they are surprising in that the impact of foster care on maternal health has heretofore been largely unexamined. The innovative use of maternal sisters with children not in foster care as controls provides a powerful control for family genetics, and family environment with likely common early life experiences, in...
JAMA Pediatrics
Intracranial pressure (ICP) monitoring is a mainstay of therapy for children with traumatic brain... more Intracranial pressure (ICP) monitoring is a mainstay of therapy for children with traumatic brain injury (TBI), but its overall association with patient outcome is unclear. To test the hypothesis that ICP monitoring is associated with improved functional survival of children with severe TBI. A propensity-weighted effectiveness analysis was conducted using 2 linked national databases with data from 30 US children's hospitals from January 1, 2007, to December 31, 2012, on 3084 children with severe TBI. Clinical events including neurosurgical procedures were identified using validated computable phenotypes. Data analysis was conducted from September 1, 2016, to March 1, 2017. Placement of an ICP monitor. A composite of hospital mortality, discharge to hospice, or survival with placement of new tracheostomy and gastrostomy tubes. Of the 3084 children in the study (1128 girls and 1956 boys; mean [SD] age, 7.03 [5.44] years), 1002 (32.4%) underwent ICP monitoring, with substantial hospital variation (6% to 50% by hospital). Overall, 484 children (15.7%) experienced the primary composite outcome. A propensity approach using matching weights generated good covariate balance between those who did and those who did not undergo ICP monitoring. Using a propensity-weighted logistic regression model clustered by hospital, no statistically significant difference was found in functional survival between monitored and unmonitored patients (odds ratio of poor outcome among those who underwent ICP monitoring, 1.31; 95% CI, 0.99-1.74). In a prespecified secondary analysis, no difference in mortality was found (odds ratio, 1.16; 95% CI, 0.89-1.50). Prespecified subgroup analyses of children younger and older than 2 years of age and among those with unintentional and inflicted (intentional) injuries also showed no difference in outcome with ICP monitoring. With the use of linked national data and validated computable phenotypes, no evidence was found of a benefit from ICP monitoring on functional survival of children with severe TBI. Intracranial pressure monitoring is a widely but inconsistently used technology with incompletely demonstrated effectiveness. A large prospective cohort study or randomized trial is needed.
The Annals of Family Medicine, 2010
Behavioral Sciences & the Law, 2016
Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for youn... more Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding discipline? Judgments of community norms across a wide range of children's ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as "harsh." The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. Copyright © 2016 John Wiley & Sons, Ltd.
Child Abuse & Neglect, 2016
Child sexual abuse (CSA) continues to be a significant problem with significant short and long te... more Child sexual abuse (CSA) continues to be a significant problem with significant short and long term consequences. However, extant literature is limited by the reliance on retrospective recall of adult samples, single-time assessments, and lack of longitudinal data during the childhood and adolescent years. The purpose of this study was to compare internalizing and externalizing behavior problems of those with a history of sexual abuse to those with a history of maltreatment, but not sexual abuse. We examined whether gender moderated problems over time. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 6, 8, 10, 12, 14, and 16 (N=977). The Child Behavior Checklist was used to assess internalizing and externalizing problems. Maltreatment history and types were obtained from official Child Protective Services (CPS) records. Generalized Estimating Equations (GEE) were used to assess behavior problems over time by maltreatment group. Findings indicated significantly more problems in the CSA group than the maltreated group without CSA over time. Internalizing problems were higher for sexually abused boys compared to girls. For sexually abused girls internalizing problems, but not externalizing problems increased with age relative to boys. This pattern was similar among maltreated but not sexually abused youth. Further efforts are needed to examine the psychological effects of maltreatment, particularly CSA longitudinally as well as better understand possible gender differences in order to best guide treatment efforts.
Child Abuse & Neglect, 2001
Aggression and Violent Behavior
Psychology (Irvine, Calif.), 2012
Few studies have explored the impact of different types of neglect on children's development.... more Few studies have explored the impact of different types of neglect on children's development. Measures of cognition, language, behavior, and parenting stress were used to explore differences between children experiencing various forms of neglect, as well as to compare children with and without a history of early neglect. Children, ages 3 to 10 years with a history of familial neglect (USN), were compared to children with a history of institutional rearing (IA) and children without a history of neglect using the Differential Abilities Scale, Test of Early Language Development, Child Behavior Checklist, and Parenting Stress Index. Factors predicting child functioning were also explored. Compared with youth that were not neglected, children with a history of USN and IA demonstrated lower cognitive and language scores and more behavioral problems. Both internalizing and externalizing behavior problems were most common in the USN group. Externalizing behavior problems predicted paren...
PEDIATRICS, 2005
Context. Child maltreatment remains a significant public health and social problem in the United ... more Context. Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivale...
Journal of Interpersonal Violence, 2000
The methodological, legal, and ethical issues related to questioning children about their maltrea... more The methodological, legal, and ethical issues related to questioning children about their maltreatment experiences in research studies are complex. A review of the literature was conducted examining what studies to date have directly asked children about victimization and how study investigators dealt with the human participants issues related to subsequent disclosure. This article examines how different studies have defined and operationalized abuse in survey questions for children, reports prevalence rates when available, describes the differing methods used to collect child self-report data, and highlights how investigators have dealt with the ethical issues related to informed consent and disclosure up to this point.
Journal of Health Politics, Policy and Law, 1988
Concerned about the possible detrimental impact of the investigative process and court proceeding... more Concerned about the possible detrimental impact of the investigative process and court proceedings on child victims of sexual abuse, many child advocates have proposed extensive evidentiary and procedural revisions of the court process. As part of a long-term study of the effects of child sexual abuse on the victims' mental health, we observed child sexual abuse victims during juvenile and criminal court proceedings. Although it was clear to our observers that going to court was stressful for these children, it was not clear that the only effective way of reducing their stress would be to avoid "live" testimony. We propose that many simple improvements--for example, increasing the involvement of guardians ad litem, providing adequate time to prepare the child for court, reducing the number of continuances granted, and training attorneys and judges to deal effectively with child witnesses--would be less costly and less controversial to implement than closed-circuit or videotaped testimony, new hearsay exceptions, and other more extensive proposals for change.
Child Abuse & Neglect, 1996
American Journal of Preventive Medicine, 2008
Commentary on the methods available for ascertaining the incidence of inflicted traumatic brain i... more Commentary on the methods available for ascertaining the incidence of inflicted traumatic brain injury (inflicted TBI) and the difficulties involved in defining and measuring this condition in young children. Design: Review of published and unpublished international data regarding parental shaking of infants compared to studies assessing incidence. Results: Review of parental report data reveal that the shaking of young children is a surprisingly common act in a wide variety of countries and cultures. While 2.6% of parents of children aged under 2 years in the U.S. report shaking their child as an act of "discipline," survey data from lesser-developed countries on four continents indicate that shaking, as a form of discipline, may be many times more common among infants in their countries and that the consequences, short of hospitalization or death, are inadequately studied. Methodologic challenges to epidemiologic work to develop better estimates are discussed. Conclusions: These data highlight the challenges faced in ascertaining the epidemiology of inflicted TBI in young children. While there is scientific evidence that the shaking of young children can produce profound destruction of children's brains and lives, these data reveal that there are many other children who are shaken by their caregivers but escape the acute clinical presentation of "shaken baby syndrome" or for whom the injuries are not recognized as due to inflicted TBI. The impact of these private acts must be further studied as there may be other long-lasting and serious intracranial impacts that have not been characterized.
Journal of Interpersonal Violence, 2000
The conduct of research in the area of child abuse and neglect may be one of the most difficult t... more The conduct of research in the area of child abuse and neglect may be one of the most difficult tasks in social science research. One requirement for valid research is knowledge of the type and amount of exposure. Official reports have been demonstrated to provide a serious undercount of the frequency of maltreatment, and parent report is of limited usefulness. LongSCAN, a consortium of longitudinal studies of abuse and neglect, made the decision to ask children for self-report, but with five independent study sites with unique study-to-sample relationships, ethically implementing this choice demanded customized participant protocols. This article describes the consortium's approach to asking children for direct reports at age 12, the relevant methodological and ethical challenges, and solutions developed with institutional review boards at 4 of the 5 study sites. The wording of consents and the variations in protocol related to reporting to Child Protective Services are discussed.
Journal of Child Sexual Abuse, 1998
International Journal on Child Maltreatment: Research, Policy and Practice
Rates of intimate partner violence (IPV), child physical and sexual abuse, and adolescent births,... more Rates of intimate partner violence (IPV), child physical and sexual abuse, and adolescent births, have declined dramatically since 1993. Research has confirmed increased risk of physical and psychological abuse of children living in homes with IPV or with adolescent parents. We wondered how much of the decline observed in child abuse substantiations could be attributed to reductions in IPV and adolescent childbearing. Accordingly, we examined the rates of substantiated abuse for each U.S. state for the period 2001-2013, as state-level estimates for both IPV and teen pregnancy rates were also available for this period. We modeled the reduction in substantiated child physical, sexual, and psychological abuse by state and combined these data for a national estimate. With a national decline in substantiated child physical abuse of 182.9 cases per 1000,000 children for the period from 2001 to 2013, 7.5% of the decline was attributable to the decline in adolescent births, and 4.9% could be attributed to the decline in IPV. The reduction in births to adolescents was also associated with 9.5% of the reduction in substantiated sexual abuse over the same years. Policy efforts to reduce IPV and adolescent births appear also to have contributed to a decline in child maltreatment.
American journal of epidemiology, 2018
Child abuse is a social phenomenon that has been underresearched and undersupported. The scale of... more Child abuse is a social phenomenon that has been underresearched and undersupported. The scale of the problem is large, with over 3 million US children reported for abuse or neglect each year. An estimated 15% of confirmed victims may be placed in out-of-home care to ensure their safety. Studies have not previously examined the impact of losing a child into foster care on maternal health and mortality. Family and maternal risk factors, such as teen pregnancy, intimate partner violence, or drug and alcohol abuse, have been well documented as risk factors for maltreatment. The findings of Wall-Wieler et al. (Am J Epidemiol. 2018;187(6):1182-1188) are not so much unexpected as they are surprising in that the impact of foster care on maternal health has heretofore been largely unexamined. The innovative use of maternal sisters with children not in foster care as controls provides a powerful control for family genetics, and family environment with likely common early life experiences, in...
JAMA Pediatrics
Intracranial pressure (ICP) monitoring is a mainstay of therapy for children with traumatic brain... more Intracranial pressure (ICP) monitoring is a mainstay of therapy for children with traumatic brain injury (TBI), but its overall association with patient outcome is unclear. To test the hypothesis that ICP monitoring is associated with improved functional survival of children with severe TBI. A propensity-weighted effectiveness analysis was conducted using 2 linked national databases with data from 30 US children's hospitals from January 1, 2007, to December 31, 2012, on 3084 children with severe TBI. Clinical events including neurosurgical procedures were identified using validated computable phenotypes. Data analysis was conducted from September 1, 2016, to March 1, 2017. Placement of an ICP monitor. A composite of hospital mortality, discharge to hospice, or survival with placement of new tracheostomy and gastrostomy tubes. Of the 3084 children in the study (1128 girls and 1956 boys; mean [SD] age, 7.03 [5.44] years), 1002 (32.4%) underwent ICP monitoring, with substantial hospital variation (6% to 50% by hospital). Overall, 484 children (15.7%) experienced the primary composite outcome. A propensity approach using matching weights generated good covariate balance between those who did and those who did not undergo ICP monitoring. Using a propensity-weighted logistic regression model clustered by hospital, no statistically significant difference was found in functional survival between monitored and unmonitored patients (odds ratio of poor outcome among those who underwent ICP monitoring, 1.31; 95% CI, 0.99-1.74). In a prespecified secondary analysis, no difference in mortality was found (odds ratio, 1.16; 95% CI, 0.89-1.50). Prespecified subgroup analyses of children younger and older than 2 years of age and among those with unintentional and inflicted (intentional) injuries also showed no difference in outcome with ICP monitoring. With the use of linked national data and validated computable phenotypes, no evidence was found of a benefit from ICP monitoring on functional survival of children with severe TBI. Intracranial pressure monitoring is a widely but inconsistently used technology with incompletely demonstrated effectiveness. A large prospective cohort study or randomized trial is needed.
The Annals of Family Medicine, 2010
Behavioral Sciences & the Law, 2016
Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for youn... more Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding discipline? Judgments of community norms across a wide range of children's ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as "harsh." The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. Copyright © 2016 John Wiley & Sons, Ltd.
Child Abuse & Neglect, 2016
Child sexual abuse (CSA) continues to be a significant problem with significant short and long te... more Child sexual abuse (CSA) continues to be a significant problem with significant short and long term consequences. However, extant literature is limited by the reliance on retrospective recall of adult samples, single-time assessments, and lack of longitudinal data during the childhood and adolescent years. The purpose of this study was to compare internalizing and externalizing behavior problems of those with a history of sexual abuse to those with a history of maltreatment, but not sexual abuse. We examined whether gender moderated problems over time. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 6, 8, 10, 12, 14, and 16 (N=977). The Child Behavior Checklist was used to assess internalizing and externalizing problems. Maltreatment history and types were obtained from official Child Protective Services (CPS) records. Generalized Estimating Equations (GEE) were used to assess behavior problems over time by maltreatment group. Findings indicated significantly more problems in the CSA group than the maltreated group without CSA over time. Internalizing problems were higher for sexually abused boys compared to girls. For sexually abused girls internalizing problems, but not externalizing problems increased with age relative to boys. This pattern was similar among maltreated but not sexually abused youth. Further efforts are needed to examine the psychological effects of maltreatment, particularly CSA longitudinally as well as better understand possible gender differences in order to best guide treatment efforts.