The relation of emotional maltreatment to early adolescent competence: developmental processes in a prospective study

Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

The continuation of non-physical abuse from childhood to adulthood in eating disorder patients: An interpretative phenomenological analysis

BACKGROUND

The ED literature has focused on the physical forms of childhood abuse with respect to eating disorders, overlooking non-physical abuse even though eating disorder patients report the latter either as primary experiences or as a revival of their childhood experiences. Additionally, there is no literature exploring whether adult eating disorder patients who have experienced childhood non-physical abuse continue to experience abuse as adults, and if they do, how well-being is impacted or linked with eating pathology.

OBJECTIVE

This study explored the lived experiences of eating disorders patients who have experienced non-physical childhood abuse in childhood and adulthood.

PARTICIPANTS AND SETTINGS

Six adult female eating disorder outpatients each took part in a semi-structured interview.

METHODS

This study used the Interpretative Phenomenological Analysis framework.

RESULTS

Three master themes and eleven superordinate themes were drawn from the analysis, addressing the research question: continuation of non-physical abuse across a lifetime, developmental factors and non-physical abuse, and non-physical abuse and eating pathology.

CONCLUSIONS

The participants' accounts indicate that childhood non-physical abuse is related to eating disorder onset, and abuse continuation in adulthood contributes to the disorder's maintenance. Moreover, the lifelong consequences of non-physical childhood abuse impact psychological factors, such as self-esteem, attachment and emotion regulation, affecting the individuals' adult lives and keeping participants inside a vicious cycle of trauma re-enactment. Low self-esteem is considered by the participants as the key factor for their disturbed relationship with food.

Prevalence of Adverse Childhood Experiences and Their Relationship with Self-esteem Among School-Age Children in Jordan

This study aimed to assess the prevalence of adverse childhood experiences and their relationship with self-esteem among secondary school students in Jordan. A cross-sectional, retrospective design was utilized using a convenience sample of 559 secondary school children (grades 7-11). Results showed that among the participating students, emotional abuse was the most commonly reported type of abuse (59.6%), followed by household violence (52.2%), bullying (44.7%), physical abuse (31.7%), emotional neglect (26.3), physical neglect (12.7%), and parents' separation (5.2%). Male students reported significantly more physical abuse than female students (37.5% vs 26.2%, p < 0.001), and significantly more physical neglect than female students (18.2% vs 7.6%, p < 0.001). However, female students reported significantly more household violence than male student (60.0% vs 43.9%, p < 0.001). Self-esteem scores were lower for students who reported physical abuse (d = 0.38, p < 0.001), household violence (d = 0.25, p < 0.003), emotional neglect (d = 0.45, p < 0.001), physical neglect (d = 0.58, p < 0.001), and bullying (d = 0.29, p = 0.001). Self-esteem was best predicted by physical abuse (β =  - 0.114, p = 0.009), emotional neglect (β =  - 0.169, p < 0.001), and physical neglect (β =  - 0.148, p < 0.001). Efforts should be exerted to prevent violence against children. National programs and community awareness campaigns should focus on the violence's detrimental effects on children.

A Meta-Analytic Review of the Impact of Child Maltreatment on Self-Esteem: 1981 to 2021

An increasing number of studies have examined the relationship between child maltreatment and self-esteem. In this study, we assess the magnitude of this association through a meta-analytic approach. Four English databases (PubMed, PsycINFO, PsycARTICLES, and Web of Science), three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu), and grey literature were systematically searched. A total of 254 independent studies, including 550 effect sizes, met the inclusion criteria for this meta-analysis. Child maltreatment was significantly and negatively associated with self-esteem (P C C ¯  = -0.24, p < .001); emotional abuse and neglect were associated with decreased self-esteem (P C C ¯  = -0.23, p < .01; P C C ¯  = -0.22, p < .01, respectively) at a moderate level; and physical abuse, sexual abuse, and physical neglect were negatively associated with self-esteem (P C C ¯  = -0.14, p < .01; P C C ¯  = -0.14, p < .01; P C C ¯  = -0.17, p < .001, respectively) at a small level. Furthermore, the meta-regression results suggested that the aggregated associations between child maltreatment and self-esteem were not inflated by publication bias, but they were moderated by age and culture. General and subtypes of child maltreatment are associated with decreased self-esteem. Evidence-based and culturally sensitive child maltreatment prevention and intervention programs should be developed and implemented as early as possible.

Clinical characteristics of child and adolescent psychiatric outpatients engaging in fireplay or arson: a case-control study

BACKGROUND

Fireplay and arson incidents among children and adolescents have gained attention because of their potentially severe consequences and societal impacts. Understanding the underlying psychiatric characteristics of individuals engaging in fireplay or arson is crucial for early identification and targeted intervention. However, there is a lack of research conducted in clinical psychiatric populations in this context. This study compared the clinical characteristics of child and adolescent psychiatric outpatients who engaged in fireplay or arson with those without such behaviors.

METHODS

A retrospective case-control study was conducted using data collected from patients who visited the Department of Child and Adolescent Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine in Japan, between April 2014 and March 2022. Medical records were checked to see if the patient had practically committed behaviors that corresponded to fireplay or arson. The case group was identified using this process. After identifying the case and control groups, sex, diagnosis, antisocial behavior, abuse history, and children-to-parent violence were assessed and compared by careful review of medical records.

RESULTS

The study identified 64 patients who engaged in fireplay or arson, representing approximately 1.1% of the total 5,587 patients (case group). The median age of the patients' first fire-related behavior was 13 years (range, 6-18 years). In the case group, 14.1% of the cases involved arson, resulting in substantial damage. Of the remaining 5523 patients, 2268 patients had datasets for the first consultation (control group). The most prevalent diagnosis in the case group was attention-deficit hyperactivity disorder (ADHD), present in 57.8% of the cases. The study revealed a significant association between fire-related behaviors and ADHD as well as antisocial behavior. Gender differences were observed, with boys being more likely to engage in fireplay or arson than girls.

CONCLUSIONS

This study suggests that clinicians and mental health professionals should closely consider male sex, ADHD, and antisocial behaviors as potential risk factors for fire-related behaviors. Monitoring the case group for the development of psychiatric disorders, including the use of illegal drugs, is recommended to prevent future arson incidents.

A Systematic Review of the Prevalence and Correlates of Emotional Violence by Teachers

There is increasing evidence for the deleterious impact of emotional violence on children`s well-being and development. This systematic review focused on a) the prevalence and (b) correlates of emotional violence by teachers. A literature search of quantitative and peer-reviewed studies published in English between 1980 and April 2021 was conducted. Eighty-four studies met the inclusion criteria. Studies represented all geographical regions of the world, were predominantly cross-sectional and of moderate quality. Studies were heterogeneous in terms of their samples, conceptualization, and measurement of emotional violence. Results indicated that emotional violence by teachers is prevalent across cultural settings, although large variations within and between regions are noted. It is related to mental health, behavioral and academic problems of children above and beyond physical violence by teachers and victimization by peers and parents. Boys are at higher risk of experiencing emotional violence by teachers than girls. Family dysfunction, low socioeconomic status (of the family or the community), and violent school environments appear to increase risk as well. The observed patterns of co-occurrence of emotional violence with physical violence by teachers and victimization by peers as well as perpetration of violence against peers and teachers lend support to notions of poly-victimization and cycles of violence in the school settings. Future research should use representative surveys, examine antecedents, and consequences of emotional violence by teachers using longitudinal and experimental designs and evaluate interventions to prevent emotional violence by teachers.

The mediating role of impulsivity in the associations between child maltreatment types and past month substance use

BACKGROUND

Child maltreatment has emerged as an important risk factor for substance use. However, despite evidence consistently demonstrating that substance use peaks during emerging adulthood, less is known about the specificity of maltreatment effects on substance use during this critical developmental period. Further, the factors that might play a role in these associations are not well understood.

OBJECTIVE

The current study examined the associations between child maltreatment types (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) and past month marijuana, alcohol, and tobacco use among emerging adults, and tested whether impulsivity accounted for these associations.

METHODS

Participants were 500 emerging adults ranging in age between 18 and 25 years old (M = 18.96, SD = 1.22, 49.6% male) recruited from a large, public university in the Midwest United States.

RESULTS

Tests of indirect effects suggested that impulsivity accounted for associations between emotional abuse and past month marijuana, alcohol, and tobacco use.

CONCLUSIONS

Current findings provide support for impulsivity as a mechanism linking childhood emotional abuse to substance use among emerging adults, highlighting the need for targeted screening and intervention.

"I Went into This as One Person, and Then Came Out a Totally Different Person": Native LGBTQ2S+ Young Adults' Conceptions of Trauma

Intersecting sources of stigma influence harmful mental health outcomes for lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) young adults (YA) of color as they must manage multiple oppressions. Experiencing both mental health challenges and victimization, LGBTQ2S+ YA of color struggle with distinctive psychological traumas. There is a critical need to determine how certain groups of LGBTQ2S+ YA of color's marginalized social statuses shape trauma understandings. Native LGBTQ2S+ people in general endure diverse forms of oppression and trauma, such as histories of colonialism, contemporary racism, sexism, homophobia, and classism. Understanding the subjective interpretations of violence and trauma among Native LGBTQ2S+ YA is needed to best meet their mental health needs. Through in-depth interviews with 13 Native LGBTQ2S+ YA between 18 and 24 years old, this study delineates processes of how an underrepresented, underserved group of rurally embedded YA conceptualize violent and traumatic life experiences within the context of their mental health. First, participants described their traumatic experiences as shaping persistent harmful mental health outcomes throughout their lives. Second, YA conceptualized trauma as pivotal moments that were profound and influential in their significance as a turning point in their lives. Finally, YA underscored multiple traumas as cumulative and complex in how they interacted to create distinctively harmful mental health challenges. Expansive conceptualizations of trauma can better inform understandings of trauma etiology and promote inclusive health services.

Differences in developmental problems between victims of different types of child maltreatment

This study examined differences in developmental problems between children who were victims of two child maltreatment dimensions: abuse versus neglect, and physical versus emotional maltreatment. Family demographics and developmental problems were examined in a clinical sample of 146 Dutch children from families involved in a Multisystemic Therapy - Child Abuse and Neglect treatment trajectory. No differences were found in child behavior problems within the dimension abuse versus neglect. However, more externalizing behavior problems (e.g., aggressive problems) were found in children who experienced physical maltreatment compared to children who experienced emotional maltreatment. Further, more behavior problems (e.g., social problems, attention problems, and trauma symptoms) were found in victims of multitype maltreatment compared to victims of any single-type maltreatment. The results of this study increase the understanding of the impact of child maltreatment poly-victimization, and highlight the value of classifying child maltreatment into physical and emotional maltreatment.

Trajectories of Resilience in University Inductees following Outdoor Adventure (OA) Residential Programmes

Even before COVID-19, university inductees were vulnerable to transitional stressors, which impact upon their psychological well-being and ability to complete their studies. Resilience, as a psychological construct, may be analogous to holding the functioning that supports higher-level academic performance in twenty-first century higher education (HE). Given the significant investment HE requires, coupled with students’ capacity to develop their resilience, universities may be expected to promote psychological resilience in new students. Linking HE to resilience, outdoor adventure (OA) residential programmes have enabled inductees to build components of resilience (i.e., increased self-perception, feelings of control, and intrapersonal relationships) that may heighten their immediate and longer-term academic performance. Yet, few studies have examined the sustainability of these effects. Across five annual cohorts, the self-perceived resilience of 2500 inductees was profiled across three time-point trajectories: (i) pre-OA programme, (ii) post-OA programme, and (iii) three months post-OA programme. Further, the functionality of inductees’ enduring resilience was evaluated for predicting their prospective academic performance at the end of their first year of study. Students’ self-perceived resilience, well-being, and positive recollection of OA experiences reflected their bounce-back ability and a healthy trajectory of productive functioning. Students reporting higher levels of resilience after three months of following the programme were more likely to achieve better prospective academic outcomes. The large sample size ensured that a powerful detection of change was established across time. However, given the absence of a comparison condition across all time points, any lasting improvements in students’ resilience was unable to be attributed to the OA programme. Nonetheless, the results give significant grounds for further research in this direction, including the study of more distinct narrative enquiries at follow-up. In this way, pedagogical practices, supporting effective interventions, may be deployed with incoming students, with the aim of building and maintaining students’ on-going resilience across different learning contexts.

Physiological Stress Response Reactivity Mediates the Link Between Emotional Abuse and Youth Internalizing Problems

Youth who are raised in emotionally abusive families are more likely to have poor mental health outcomes such as depression and anxiety. However, the mechanisms of this association are unclear. The present study utilized a longitudinal sample of low-SES youth (N = 101, M_ageT1 = 10.24) to examine stress response reactivity (i.e. vagal withdrawal, sympathetic activation, and hypothalamic-pituitary-adrenal [HPA] axis activation) as mediators between emotional abuse and prospective youth internalizing symptoms. Results indicated that blunted HPA reactivity to a laboratory social stress task mediated the association between emotional abuse and youth internalizing symptoms. Emotional abuse was also associated with blunted parasympathetic nervous system activity (i.e. less vagal withdrawal than average). In sum, emotional abuse is a potent risk factor for youth internalizing symptoms, and this link may be mediated via dysregulation in physiological stress response systems. Primary prevention of childhood emotional abuse and secondary prevention programs that target self-regulation skills may reduce rates of youth internalizing symptoms and disorders.

Self-Blame Mediates the Link between Childhood Neglect Experiences and Internalizing Symptoms in Low-Risk Adolescents

Childhood neglect is the most common type of maltreatment, ranging from minor isolated incidents to consistent failures in emotional/physical caregiving. It has been associated with developmental impairments and considered a risk factor for the emergence of psychopathology, particularly internalizing disorders. This study aimed to explore individual differences in response to the continuum of severity of neglect in community adolescents, as well as the role of specific cognitive emotion regulation strategies (CERSs) as mediators between childhood neglect and current internalizing symptoms. Low-risk adolescents (12-19 years old; M age 15.88 years; N = 123; 64 Females) completed questionnaires assessing these experiences. We employed a regression model and a simple mediation analyses. Findings indicate a positive association between childhood neglect, internalizing behaviors, and the adoption of self-blame as CERS. Moreover, the use of self-blame in response to everyday stress partially mediated the relationship between neglect and internalizing behaviors (effect size: .28). Findings support the hypothesis that even in a low risk sample, neglect is associated with internalizing symptoms, and highlight the importance of assessing individual differences in the experience of neglect. Moreover, the mediation effect of the CERSs of self-blame might serve as a potential target for psychotherapeutic interventions aimed at reducing internalizing symptoms.

Traumatic Brain Injury, Abuse, and Poor Sustained Attention in Youth and Young Adults Who Previously Experienced Foster Care

Youth and young adults who previously experienced foster care are prone to negative life events, such as physical injuries, and adverse childhood experiences (ACE), such as abuse, neglect, and household dysfunction. The purpose of the present study was to identify the prevalence of traumatic brain injury (TBI), ACE, and poor sustained attention and the associations of these events in this group of vulnerable persons. Participants completed standardized questionnaires on the prevalence of self-reported TBI (TBI) and ACE and performed the Sustained Attention to Response Task (SART) test to measure sustained attention. Chi-squared and Kruskal-Wallis rank-sum tests were used to assess demographic differences and associations between TBI and ACE. Sustained attention was assessed using analysis of variance and linear modeling. Seventy-one participants-46 youth and young adults who previously experienced foster care (vulnerable group) and 25 age-matched healthy controls-completed the standardized questionnaires. Analyses indicated that vulnerable participants reported markedly higher rates of TBI and ACE than healthy controls. Vulnerable persons with TBI reported significantly higher Total ACE scores (p = 0.02), were more likely to have a history of family dysfunction (p = 0.02), and were more likely to have lived with a mentally ill guardian (p = 0.01) than vulnerable persons with no TBI. TBI was significantly associated with Total Errors (p = 0.001 and p = 0.02) and Omission Errors (p < 0.001 and p = 0.01) in all participants and in vulnerable participants, respectively, after adjusting for education level.

RAISE study protocol: a cross-sectional, multilevel, neurobiological study of resilience after individual stress exposure

INTRODUCTION

This paper describes the protocol for an ongoing project funded by the Royal Society, the Resilience After Individual Stress Exposure (RAISE) study; which aims to examine the factors and mechanisms that facilitate resilient functioning after childhood adversity (CA).

METHODS AND ANALYSIS

We aim to recruit up to 200 participants. We will use dimension reduction techniques (principal component analysis) on standard-normally transformed individual parameters of mental health, social functioning and CA to calculate a composite measure of adaptive (ie, 'resilient') psychosocial functioning. To examine the neuroimmune responses to stress and their relationship with the brain and social environment, we will use a well validated functional MRI task; the Montreal imaging stress task and venepuncture. We will run group or dimensional comparisons in multiple levels of biological and psychological outcomes, as well as mediation and moderation analyses to study how key biological systems (ie, the hypothalamic-pituitary-adrenal axis and the immune system) interrelate and interact with brain function and social influences in order to facilitate resilient functioning after CA. We hypothesise that resilient functioning will be facilitated by reduced morning cortisol and cytokine levels before and after the stressor and improved neural responses to such stress, as well as increased gray matter volume in the hippocampus and prefrontal cortex, enhanced inhibitory control and emotion regulation, and more friendship and family support.

ETHICS AND DISSEMINATION

This study has been reviewed and given favourable opinion by the National Research Ethics Service, NRES Committee East of England-Cambridge Central and external reviewers from the Royal Society (RGF\R1\180064 and RGF\EA\180029). The results of the RAISE study will be disseminated through (1) publications in scientific peer reviewed journals, (2) presentations on relevant scientific conferences and meetings, (3) publications and presentations for the general public and (4) through social media.

Psychological maltreatment: An international challenge to children's safety and well being

BACKGROUND

Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment.

OBJECTIVES

This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment.

PARTICIPANTS AND SETTINGS

NA.

METHOD

Literature review, intervention description of fabricated or induced illness, and expert opinion.

RESULTS

PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence.

CONCLUSIONS

PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.

The complex neurobiology of resilient functioning after childhood maltreatment

BACKGROUND

Childhood maltreatment has been associated with significant impairment in social, emotional and behavioural functioning later in life. Nevertheless, some individuals who have experienced childhood maltreatment function better than expected given their circumstances.

MAIN BODY

Here, we provide an integrated understanding of the complex, interrelated mechanisms that facilitate such individual resilient functioning after childhood maltreatment. We aim to show that resilient functioning is not facilitated by any single 'resilience biomarker'. Rather, resilient functioning after childhood maltreatment is a product of complex processes and influences across multiple levels, ranging from 'bottom-up' polygenetic influences, to 'top-down' supportive social influences. We highlight the complex nature of resilient functioning and suggest how future studies could embrace a complexity theory approach and investigate multiple levels of biological organisation and their temporal dynamics in a longitudinal or prospective manner. This would involve using methods and tools that allow the characterisation of resilient functioning trajectories, attractor states and multidimensional/multilevel assessments of functioning. Such an approach necessitates large, longitudinal studies on the neurobiological mechanisms of resilient functioning after childhood maltreatment that cut across and integrate multiple levels of explanation (i.e. genetics, endocrine and immune systems, brain structure and function, cognition and environmental factors) and their temporal interconnections.

CONCLUSION

We conclude that a turn towards complexity is likely to foster collaboration and integration across fields. It is a promising avenue which may guide future studies aimed to promote resilience in those who have experienced childhood maltreatment.

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies demonstrating that childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. The authors discuss several candidate genes and environmental factors (for example, substance use) that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.

The Relation of Childhood Abuse Experiences to Problematic Sexual Behaviors in Male Youths Who Have Sexually Offended

Psychological abuse and sexual abuse, either alone or in combination, have been implicated as developmental antecedents of problematic sexual thoughts and behaviors in studies of sexually aggressive males (Jesperson, Lalumière, & Seto, 2009; Knight & Sims-Knight, 2011; Levenson & Grady, 2016; Seto & Lalumière, 2010). Recently, psychological abuse perpetrated by a male caregiver has emerged as strongly associated with subsequent hypersexuality in adult males who had sexually offended. In a study of 529 adult male sexual offenders, Kingston, Graham, and Knight (2017) found that male caregiver psychological abuse was the most prominent correlate of hypersexual thoughts and behaviors in adulthood, above and beyond the effects of other abuse types, such as physical abuse and sexual abuse. Consequently, we hypothesized that, among juveniles who had sexually offended, higher self-reported levels of childhood psychological and sexual abuse, in contrast to other types of childhood maltreatment experiences, would covary with higher subsequent levels of normophilic sexualized thoughts and behaviors. Consistent with Kingston et al., Male Caregiver Psychological Abuse accounted for a significant amount of the variance in subsequent reported hypersexuality in this juvenile sample. Furthermore, this factor also emerged as a significant correlate of deviant sexual behaviors and fantasies, such as paraphilic interests and pedophilic preference. Sexual Abuse was also found to be significantly associated with hypersexuality. These findings provide additional support for the demonstrated relation between psychological abuse by a male caregiver and subsequent problematic sexual thoughts and behaviors. These data are also consistent with other research that suggests a gender symmetry effect in the impact of parental discipline and the differential effect of male caregiver abuse on male children.

Psychological maltreatment and its relationship with self-esteem and psychological stress among adolescents in Tanzania: a community based, cross-sectional study

BACKGROUND

Despite the growing recognition of childhood psychological maltreatment as a public health and human rights concern, it remains rampant in developing countries including Tanzania and has a negative impact on the victim's self-esteem during adolescence. There is a lack of published studies in Tanzania that examine the relationship between childhood psychological maltreatment and self-esteem during adolescence. This study describes the relationship between childhood psychological maltreatment and self-esteem and psychological distress among adolescents in Tanzania.

METHODS

This was a cross-sectional, community-based study of secondary school students that was conducted in randomly selected secondary schools in five regions in Tanzania between April 2016 and February 2017. A multistage cluster sampling technique was employed to obtain the required number of study participants. The Rosenberg self-esteem scale, Kessler psychological distress scale (K10) and Childhood Trauma Questionnaire (CTQ) questionnaires were used to measure the variables in the study. Pearson correlation analysis was used to analyse the correlation between variables (Psychological maltreatment and self-esteem and psychological distress).

RESULTS

A sample of 1000 secondary school students was recruited for this study, of which 553 (55.3%) were males and 447 (44.7%) were females. The mean age at presentation was 16.45 ± 6.42 years. Out of the 1000 participants, 766 (76.6%) experienced psychological maltreatment. Emotional abuse was reported in 24.7% of the participants, while emotional neglect was reported in 51.9% of cases. There was a strong positive correlation between psychological maltreatment and self-esteem (r = 0.55, p < 0.001), whereas the correlation between psychological maltreatment and psychological distress was significantly but weak (r = - 0.086, p = 0.007). The results also show a strong positive correlation between psychological distress and self-esteem (r = 0.16, p < 0.001).

CONCLUSION

Finding from this study demonstrated that childhood psychological maltreatment is prevalent in our setting and is associated with psychological distress and low self-esteem during adolescence. Urgent intervention targeting at reducing occurrence of childhood psychological maltreatment is necessary to reduce the incidence of low self-esteem and psychological distress among Tanzanian adolescents.

Harsh parenting and child aggression: Child moral disengagement as the mediator and negative parental attribution as the moderator

As the negative outcomes of harsh parenting for child development have been gradually revealed, researchers become increasingly interested in the mechanisms through which harsh parenting affects child development. This study aimed to explore the mediating role of child moral disengagement and the moderating role of negative parental attribution in the relation of harsh parenting to child aggression. A sample of 397 Chinese adolescents aged from 12 to 16 years (227 boys and 170 girls, Mage = 13.98) with their parents were recruited as participants from two public schools situated in rural areas of Shandong province in China. Data were gathered from parents reporting on their harsh parenting and negative parental attribution, adolescents reporting on their moral disengagement, and peers nominating out aggressive children. Results indicated that harsh parenting was both directly and indirectly associated with adolescent aggression via adolescent moral disengagement. Negative parental attribution was found to moderate the indirect relation of harsh parenting to adolescent aggression via moral disengagement. Specifically, harsh parenting was only significantly associated with moral disengagement for adolescents with high levels of moral disengagement was more likely to induce aggression among adolescents with high levels of negative parental attribution (bsimple = of harsh parenting to adolescent aggression, adolescent moral disengagement could mediate the association between harsh parenting and aggressive behaviors for adolescents with high levels of negative parental attribution.

Childhood Emotional Maltreatment and Problematic Social Media Use Among Adolescents: The Mediating Role of Body Image Dissatisfaction

Preliminary evidence suggests that childhood maltreatment is associated with higher problematic social media use (PSMU). It has also been established that childhood emotional maltreatment (CEM) is associated with body image dissatisfaction (BID). However, the direct and indirect impacts of CEM on PSMU via BID remain untested. The present study examined these direct and indirect relationships among a sample of 385 adolescents (mean age 15.62 years, range 14–18 years). Results indicated that female adolescents had higher levels of CEM, BID, and PSMU compared to males. Structural equation modeling indicated that CEM was indirectly associated with PSMU via BID among males. However, only BID was positively associated with PSMU among females. The findings are in accordance with theoretical models suggesting that individuals’ core characteristics including early childhood experiences and psychopathological factors are associated with different types of specific internet-use disorders.

Young Adult Retrospective Reports of Adverse Childhood Experiences: Prevalence of Physical, Emotional, and Sexual Abuse in Italy

This study sought to understand the prevalence of childhood abuse in Italy using an instrument developed by the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) and adapted to the Italian context. The study participants were 312 young adults, 106 males (34%), and 206 females (64%), aged 18-24 years, from various northwest Italian universities and workplaces, using an ISPCAN Child Abuse Screening Tool retrospective questionnaire (ICAST-R). With reference to comparative data from other countries, the Italian context reveals a high incidence of emotional abuse (62%) followed by physical abuse (44%) and sexual abuse (18%). While males reported more physical abuse, females reported more exposure to sexual and emotional abuse. Moreover, the validity of the ICAST instrument was evaluated. The internal consistency for the three subscales was similar to the findings of previous studies, with Cronbach's alphas ranging from 0.51 for emotional abuse to 0.59 for sexual abuse. We observe that children undergo forms of emotional and physical maltreatment for disciplinary purposes, and for this reason, such abuse is excused. Greater prevention measures should be adopted in this direction. Finally, our study has contributed to the validation of the ICAST-R instrument for use in the Italian context.

Psychological abuse, substance abuse distress, dissatisfaction with friendships, and incident psychiatric problems

OBJECTIVE

The aim of this study was to assess the mediating role of dissatisfaction with friendships in adulthood in the associations between psychological abuse in childhood, substance abuse distress in childhood, and incident psychiatric problems (IPPs) in adulthood over 13 years of follow-up.

METHODS

We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 9502), a representative, longitudinal, prospective cohort study. Poisson regression analysis was used to assess the associations between psychological abuse, substance abuse distress, dissatisfaction with friendships in adulthood, and IPPs in adulthood. Indirect effects and proportion mediated (%) were assessed with the difference-in-coefficients method.

RESULTS

Psychological abuse (relative risk [RR] = 1.66, 95% confidence interval [CI]: 1.45-1.89) and substance abuse distress in childhood (RR = 1.38, 95% CI: 1.18-1.62) were associated with an increased risk of dissatisfaction with friendships in adulthood. Dissatisfaction with friendships in adulthood was associated with an increased risk of IPPs in adulthood (RR = 1.71, 95% CI: 1.33-2.20). Moreover, dissatisfaction with friendships in adulthood mediated 9.31% (95% CI: 4.25-14.57) of the association between psychological abuse in childhood and IPPs in adulthood, and 9.17% (95% CI: 4.35-16.33) of the association between substance abuse distress in childhood and IPPs in adulthood.

CONCLUSIONS

Dissatisfaction with friendships in adulthood mediates a minor proportion of the associations between psychological abuse, substance abuse distress, and IPPs in adulthood. Interventions aimed at decreasing dissatisfaction with friendships may dampen some of the effect of psychological abuse and substance abuse distress in childhood on IPPs in adulthood.

Mental Health Pathways Linking Childhood Maltreatment to Interpersonal Revictimization During Adolescence for Girls in the Child Welfare System

This study compares the association of histories of childhood emotional, physical, and sexual abuse, and physical neglect with revictimization among adolescent girls, and investigates the role of posttraumatic stress and symptoms of depression as mediators. Participants were 234 girls aged 12 to 19 years, who have been involved with the child welfare system in a Midwestern urban area. Data were collected from baseline surveys of a trauma-focused group program to which the participants were referred. The majority of participants were youths of color (75%) who were primarily African American (70%), and the remaining participants were White, non-Hispanic (25%). Data were collected through surveys that assessed histories of child abuse and neglect, symptoms of posttraumatic stress and depression, and experiences of physical, verbal, and relational revictimization in the last 3 months. All types of abuse and neglect were significantly associated with higher frequencies of revictimization and higher levels of posttraumatic stress and depressive symptoms. Parallel mediation analyses demonstrated that both posttraumatic stress and depression fully mediated the relationships between emotional abuse and revictimization, and sexual abuse and revictimization. Physical abuse was fully mediated by posttraumatic stress, but not by depression. Results also indicated that neither posttraumatic stress nor depression were mediators for the relationship between neglect and revictimization. There were similar pathways to revictimization in adolescents from emotional and sexual abuse through posttraumatic stress and depression. Evidence is mounting for the deleterious effects of emotional abuse. There is evidence that treatment of both posttraumatic stress and depression in emotionally and sexually abused adolescents involved in child welfare is warranted to prevent future revictimization.

Emotionally Abusive Behavior in Italian Middle School Teachers as Identified by Students

The aim of this article was to estimate the prevalence of psychological maltreatment in Italian middle school students by their teachers, and to test the applicability of surveying instruments for this phenomenon in Italian educational settings. The sample consisted of 105 teachers and 128 middle school students, who were asked about their experiences with emotionally abusive behaviors (i.e., demeaning, discriminating, dominating, destabilizing, distancing, and diverse) in the Italian school system. Teachers did not tend to perceive their behavior as abusive, while the students showed a very high perception of abuse (98%). Males were more likely to be victims of abuse, and they also reported lower scores in the Achievement scale. Emotional child abuse is highly present in Italian educational settings, and there is a strong need for interventions aimed at supporting teacher education, in the hopes of increasing the general well-being in schools.

School readiness of maltreated children: Associations of timing, type, and chronicity of maltreatment

Children who have been maltreated during early childhood may experience a difficult transition into fulltime schooling, due to maladaptive development of the skills and abilities that are important for positive school adaptation. An understanding of how different dimensions of maltreatment relate to children's school readiness is important for informing appropriate supports for maltreated children. In this study, the Australian Early Development Census scores of 19,203 children were linked to information on child maltreatment allegations (substantiated and unsubstantiated), including the type of alleged maltreatment, the timing of the allegation (infancy-toddlerhood or preschool), and the total number of allegations (chronicity). Children with a maltreatment allegation had increased odds of poor school readiness in cognitive and non-cognitive domains. Substantiated maltreatment was associated with poor social and emotional development in children, regardless of maltreatment type, timing, or chronicity. For children with unsubstantiated maltreatment allegations, developmental outcomes according to the type of alleged maltreatment were more heterogeneous; however, these children were also at risk of poor school readiness irrespective of the timing and/or chronicity of the alleged maltreatment. The findings suggest that all children with maltreatment allegations are at risk for poor school readiness; hence, these children may need additional support to increase the chance of a successful school transition. Interventions should commence prior to the start of school to mitigate early developmental difficulties that children with a history of maltreatment allegations may be experiencing, with the aim of reducing the incidence of continuing difficulties in the first year of school and beyond.

Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study

AIMS

Childhood maltreatment and a family history of a schizophrenia spectrum disorder (SSD) are each associated with social-emotional dysfunction in childhood. Both are also strong risk factors for adult SSDs, and social-emotional dysfunction in childhood may be an antecedent of these disorders. We used data from a large Australian population cohort to determine the independent and moderating effects of maltreatment and parental SSDs on early childhood social-emotional functioning.

METHODS

The New South Wales Child Development Study combines intergenerational multi-agency data using record linkage methods. Multiple measures of social-emotional functioning (social competency, prosocial/helping behaviour, anxious/fearful behaviour; aggressive behaviour, and hyperactivity/inattention) on 69 116 kindergarten children (age ~5 years) were linked with government records of child maltreatment and parental presentations to health services for SSD. Multivariable analyses investigated the association between maltreatment and social-emotional functioning, adjusting for demographic variables and parental SSD history, in the population sample and in sub-cohorts exposed and not exposed to parental SSD history. We also examined the association of parental SSD history and social-emotional functioning, adjusting for demographic variables and maltreatment.

RESULTS

Medium-sized associations were identified between maltreatment and poor social competency, aggressive behaviour and hyperactivity/inattention; small associations were revealed between maltreatment and poor prosocial/helping and anxious/fearful behaviours. These associations did not differ greatly when adjusted for parental SSD, and were greater in magnitude among children with no history of parental SSD. Small associations between parental SSD and poor social-emotional functioning remained after adjusting for demographic variables and maltreatment.

CONCLUSIONS

Childhood maltreatment and history of parental SSD are associated independently with poor early childhood social-emotional functioning, with the impact of exposure to maltreatment on social-emotional functioning in early childhood of greater magnitude than that observed for parental SSDs. The impact of maltreatment was reduced in the context of parental SSDs. The influence of parental SSDs on later outcomes of maltreated children may become more apparent during adolescence and young adulthood when overt symptoms of SSD are likely to emerge. Early intervention to strengthen childhood social-emotional functioning might mitigate the impact of maltreatment, and potentially also avert future psychopathology.

Exploration of trauma, dissociation, maladaptive schemas and auditory hallucinations in a French sample

OBJECTIVES

The main goal of the present study was to explore the associations between several key variables that have been shown to partially mediate the link between specific trauma exposure and auditory hallucinations (AH), that is, maladaptive schemas and dissociation in the general population.

METHODS

In total, 425 voluntary participants were recruited from the general population and completed online the Childhood Trauma Questionnaire, the Young schema questionnaire, the Dissociative Experiences Scale, and the Launay-Slade Hallucination Scale. Data were analysed using Partial Least Squares Structural Equation Modelling.

RESULTS

Our model showed that: (1) sexual and emotional abuse impact on AH both through the effect of maladaptive schemas and dissociation; (2) physical abuse impact on AH only through the effect of dissociation. More specifically, we found that four maladaptive schemas impact on AH: Abandonment, Vulnerability, Self-sacrifice and Subjugation.

CONCLUSIONS

Overall, our findings indicate that specific early maladaptive schemas may play a fundamental role in the association between exposure to trauma and auditory hallucination together with dissociation symptoms in the general population. Consequently, our study suggest considering maladaptive schemas as an important therapeutic target when working with individuals experiencing AH with or without a psychiatry disorder.

Direct and Indirect Effects of Maltreatment and Social Support on Children's Social Competence Across Reporters

Children's social competence is a key characteristic of resilience, yet little research has assessed contributing factors to this construct. The objectives of this study were to examine direct and indirect effects of maltreatment on children's social competence, the promotive role of child and caregiver social support, and factors contributing to reports of child social competence across informants. Structural equation modeling evaluated the influence of CPS report history, child adjustment, and child and caregiver social support on child social competence in n = 783 caregiver-child dyads. CPS report history (age 0-8) was indirectly related to low social competence through child adjustment problems. Social support was a significant promotive factor of child social competence, with caregiver social supports predicting higher levels of parent-reported child social competence. Child social support predicted self-reported child social competence. Findings reinforce the assertion that both caregiver and child social support networks are critical to promoting child well-being after adversity.

The joint impact of parental psychological neglect and peer isolation on adolescents' depression

Adolescents receive psychological or emotional care from both parents and peers, which is crucial for mental health at this stage. Little research has been undertaken to evaluate the experience and consequences of caregiver psychological neglect during adolescence. Less is known about the unique and combined impacts of neglectful experiences with parents and peers. The purpose of this study was to evaluate the relationship between exposure to caregiver psychological neglect and isolation from peers with depression for a population of at-risk adolescents. A sample of 2776 adolescents who represent a cohort population of adolescents in contact with Child Protective Services in the U.S. was studied. Data come from the National Survey of Child and Adolescent Well-being (NSCAW) and are pooled across four waves representing seven years duration. Structural equation modeling with latent variables was used to estimate within-time associations. A two-stage-least squares path model was used to determine within-time reciprocal effects between depression and neglectful experiences. Adolescents who are emotionally neglected by their primary caregivers and are isolated from peers have substantially increased depression, a combined standardized effect of 0.78-0.91. Isolation from peers is more impactful for depression compared to psychological neglect by caregivers. The effects of deficits in these two primary sources of emotional support explain 40 percent of the variation in depression. The relationships between depression and peer isolation and depression and psychological neglect are reciprocal, but the primary direction of effect is from neglectful experiences to depression.

Gender differences in the association between emotional maltreatment with mental, emotional, and behavioral problems in Swedish adolescents

Emotional maltreatment is a common form of child abuse with a powerful negative impact on mental health. The aim of this study was to examine the effect of emotional maltreatment on mental health and mental well-being in a general population of Swedish 12- to 13-year old girls and boys. Data was collected via self-report questionnaires in classroom settings from 1134 students. Emotional maltreatment had significant effects on mental health and mental well-being for both girls and boys. Moreover, there were significant interaction effects between gender and levels of emotional maltreatment. Girls reported decreased mental health and mental well-being at lower degrees of emotional maltreatment compared to boys. Furthermore, girls reported larger decreases in mental health in response to exposure of emotional maltreatment. For internalizing symptoms, mental well-being and psychosomatic symptoms, exposure level of emotional maltreatment seemed to magnify the gender differences. For externalizing symptoms, there were no differences between girls and boys in the group reporting no emotional maltreatment and the increase in externalizing symptoms were of equal magnitude for both genders. Given the impact of emotional maltreatment on mental health in the general population, results from this study implies that a trauma-informed perspective is necessary in understanding gender differences in mental health in early adolescence. Further research is needed in order to understand the underlying processes generating the differences in girls and boys responses to emotional maltreatment.

Emotional Clarity as a Mechanism Linking Emotional Neglect and Depressive Symptoms during Early Adolescence

The present study examined whether emotional abuse and neglect differentially predicted decreases in emotional clarity, and whether emotional clarity, in turn, predicted increases in depressive symptoms. Participants included 204 early adolescents (52% African-American; 54% female; Mean age= 12.85 years) who completed four assessments with measures of depressive symptoms, emotional clarity, and emotional abuse and neglect. Hierarchical linear regressions indicated that emotional neglect significantly predicted decreases in emotional clarity, whereas emotional abuse did not. Further, mediational analyses revealed that decreases in emotional clarity mediated the relationship between emotional neglect and increases in depressive symptoms. The current study suggests that emotional neglect (more so than emotional abuse) may hinder an individual's ability to identify his or her own emotions, which may increase the risk of depressive symptoms during adolescence. These findings have significant implications for the development of intervention and prevention programs for depression.

The neural correlates of childhood maltreatment and the ability to understand mental states of others

Background: Emotional abuse and emotional neglect are related to impaired interpersonal functioning. One underlying mechanism could be a developmental delay in mentalizing, the ability to understand other people's thoughts and emotions. Objective: This study investigates the neural correlates of mentalizing and the specific relationship with emotional abuse and neglect whilst taking into account the level of sexual abuse, physical abuse and physical neglect. Method: The RMET was performed in an fMRI scanner by 46 adolescents (Age: M = 18.70, SD = 1.46) who reported a large range of emotional abuse and/or emotional neglect. CM was measured using a self-report questionnaire (CTQ). Results: Neither severity of emotional abuse nor neglect related to RMET accuracy or reaction time. The severity of sexual abuse was related to an increased activation of the left IFG during mentalization even when controlled for psychopathology and other important covariates. This increased activation was only found in a group reporting both sexual abuse and emotional maltreatment and not when reporting isolated emotional abuse or neglect or no maltreatment. Functional connectivity analysis showed that activation in the left IFG was associated with increased activation in the right insula and right STG, indicating that the IFG activation occurs in a network relevant for mentalizing. Conclusions: Being sexually abused in the context of emotional abuse and neglect is related to an increase in activation of the left IFG, which may indicate a delayed development of mirroring other people's thoughts and emotions. Even though thoughts and emotions were correctly decoded from faces, the heightened activity of the left IFG could be an underlying mechanism for impaired interpersonal functioning when social situations are more complex or more related to maltreatment experiences.

Harsh parenting and peer acceptance in Chinese early adolescents: Three child aggression subtypes as mediators and child gender as moderator

This study examined the mediating roles of three types of child aggression in the relation between harsh parenting and Chinese early adolescents' peer acceptance as well as the moderating role of child gender on this indirect relation. 833 children (mean age=13.58, 352 girls) with their parents were recruited as participants from two junior high schools in Shandong Province, People's Republic of China. The results showed that paternal harsh parenting was only associated with boys' aggressive behaviors and maternal harsh parenting was only associated with boys' and girls' verbal aggression. Adolescents' verbal and relational aggressions were negatively associated with their peer acceptance. Verbal aggression was more strongly and negatively associated with girls' peer acceptance. The results imply that in the Chinese cultural context, paternal harsh parenting may compromise boys' peer acceptance through boys' verbal and relational aggression as mediators, whereas maternal harsh parenting may impair children's peer acceptance through children's verbal aggression as a mediator, especially for girls. These results provide a theoretical basis for ameliorating the negative effect of harsh parenting on early adolescents' peer acceptance by reducing their aggressive behaviors, with different strategies between boys and girls.

PSYCHOLOGY OF BOYS AT RISK: INDICATORS FROM 0-5

In utero and during the first 5 years of life, boys face unique risks as a result of neurobiological and environmental factors. This introductory article to the Special Issue describes the background of this gender-specific inquiry and outlines some of those risks, drawing attention to the areas that will be covered in depth in the following contributions. We also describe the basis of this inquiry as the link between early life and the subsequent difficulties that adolescent boys and many young men face, and pay particular attention to the circumstances of young men of color and to the growing knowledge about the contributions of fathers to boys' development.

Specificity of childhood maltreatment and emotion deficit in nonsuicidal self-injury in an inpatient sample of youth

The present study investigated the function of two specific emotion-related skills, emotion expressivity and emotion coping, as potential mediators in the relations between childhood sexual, physical, and emotional abuse and NSSI. A robust body of work supports the role of emotion regulation in nonsuicidal self-injury, but additional research is warranted to tease apart the role of specific emotion regulation deficits as predictors of NSSI. Participants included 95 youth (Mage=14.22, SDage=1.67; 58% female) hospitalized on one of two acute care psychiatric inpatient units. Participants completed self-report questionnaires related to childhood experiences of trauma, current emotion expressivity and coping, and lifetime frequency of NSSI. Path analytic models indicated that only child emotional abuse was directly associated with NSSI when all abuse subtypes were examined simultaneously. Results also indicated that poor emotion expressivity, but not emotion coping, mediated the relation between childhood experiences of emotional abuse and NSSI.

Emergence of social behavior deficit, blunted corticolimbic activity and adult depression-like behavior in a rodent model of maternal maltreatment

Disrupted social behavior is a core symptom of multiple psychiatric and neurodevelopmental disorders. Many of these disorders are exacerbated by adverse infant experiences, including maltreatment and abuse, which negatively affect amygdala development. Although a link between impaired social behavior, abnormal amygdala function and depressive-like behavior following early adversity has been demonstrated in humans and animal models, the developmental emergence of maltreatment-related social deficits and associated amygdala neural activity are unknown. We used a naturalistic rodent model of maternal maltreatment during a sensitive period, postnatal days 8-12 (PN8-12), which produces social behavior deficits that precede adolescent depressive-like behavior and amygdala dysfunction, to examine social behavior in infancy, periweaning and adolescence. Neural activity in response to the social behavior test was assessed via c-Fos immunohistochemistry at these ages. A separate group of animals was tested for adult depressive-like behavior in the forced swim test. Maltreatment spared infant (PN16-18) social behavior but disrupted periweaning (PN20-22) and adolescent (PN42-48) social behavior. Maltreated rats exhibited blunted neural activation in the amygdala and other areas implicated in social functioning, including the medial prefrontal cortex and nucleus accumbens, at these ages and increased adult depressive-like behavior. These findings may suggest corticolimbic involvement in the emergence of maltreatment-induced social deficits that are linked to adult depressive-like behavior, thereby highlighting potential targets for therapeutic intervention. Understanding how infant experiences influence social behavior and age-specific expression across development may provide insights into basic neural mechanisms of social behaviors and disease-relevant social dysfunction exacerbated by early-life stress.

Maternal Childhood Maltreatment History and Child Mental Health: Mechanisms in Intergenerational Effects

The objectives of this study were to examine whether a maternal history of maltreatment in childhood has a detrimental impact on young children's mental health and to test theoretically and empirically informed pathways by which maternal history may influence child mental health. Mother-child dyads (N = 187) were evaluated between birth and 64 months of age via home and laboratory observations, medical and child protection record reviews, and maternal interviews to assess maternal history of childhood maltreatment and microsystem and exosystem measures of the caregiving context, including child maltreatment, maternal caregiving quality, stress exposures, and social support. When the children were 7 years of age, mothers and teachers reported on child emotional and behavioral problems. Analyses examined whether the caregiving context variables linked maternal maltreatment history with child emotional and behavioral problems, controlling for child sex (54% male), race/ethnicity (63% White), and family sociodemographic risk at birth. Maltreated mothers experienced greater stress and diminished social support, and their children were more likely to be maltreated across early childhood. By age 7, children of maltreated mothers were at increased risk for clinically significant emotional and behavioral problems. A path analysis model showed mediation of the effects of maternal childhood maltreatment history on child symptoms, with specific effects significant for child maltreatment. Interventions that reduce child maltreatment risk and stress exposures and increase family social support may prevent deleterious effects of maternal childhood maltreatment history on child mental health.

Social skills and psychopathic traits in maltreated adolescents

Child maltreatment has frequently been associated with impaired social skills and antisocial features, but there are still controversies about the effect of each type of maltreatment on social behaviour. The aim of this study was to compare the social functioning and psychopathic traits of maltreated adolescents (MTA) with a control group (CG) and to investigate what types of maltreatments and social skills were associated with psychopathic traits in both groups. The types and intensity of maltreatment were evaluated through the Childhood Trauma Questionnaire (CTQ) in 107 adolescents, divided into the MTA group (n = 66) and non-maltreated youths (n = 41), our CG. The Hare Psychopathy Checklist: Youth Version (PCL: YV) and a detailed inventory for evaluation of social skills in adolescents were also applied in all individuals. MTA presented more psychopathic traits than the CG, in all domains measured by PCL: YV, independently of IQ levels and the presence of psychiatric disorders. Interestingly, the groups did not differ significantly from each other on indicators of social skills. Multiple regression analysis revealed that emotional neglect was the only maltreatment subtype significantly associated with psychopathic traits, more specifically with the PCL: YV interpersonal factor (F1), and that some social skills (empathy, self-control and social confidence) were related to specific psychopathic factors. The results highlight that emotional neglect may be more detrimental to social behaviours than physical and sexual abuse, and that neglected children require more specific and careful attention.

Child Psychological Maltreatment and Its Correlated Factors in Chinese Families

The present study aimed to explore the prevalence and frequency of child psychological maltreatment and its correlated factors in Chinese families. A cross-sectional investigation was conducted among 1,002 parents of primary school students in Yuncheng City, China. Data were collected using the self-report questionnaire anonymously. Results showed that 696 (69.5%) surveyed parents had different extents of psychological maltreatment toward their children in the past 3 months. The high prevalence of parental psychology maltreatment was significantly associated with high scores on parental over-reactivity and low scores on recognition of child psychology maltreatment. These findings indicate that it is urgent to develop cultural interventions to raise parents' awareness of preventing child psychological maltreatment and to help parents use nonviolent child rearing in China.

Emotional Rejection of the Infant: Status of the Concept

Emotional rejection of the infant is a morbid, clinical phenomenon, central to mother-infant psychiatry. It occurs in about 1% of births in the general population, but much more often in mothers referred to specialist services. It has severe consequences for children, but responds well to treatment. It is now better recognized, but research is required, especially cohort studies and neuroscientific investigations.

Childhood Abuse and Aggression in Adolescent Girls Involved in Child Welfare: The Role of Depression and Posttraumatic Stress

This study investigated the relationship between histories of childhood abuse and aggressive behaviors among adolescent girls involved in child welfare, and determined whether symptoms of post-traumatic stress and depression mediated this relationship. Participants were 237 girls ages 12-19 years. Overall, results indicated 89 % of the adolescents endorsed at least one aggressive behavior towards others. Specifically, 72.0 % engaged in physical aggression, 78.5 % engaged in non-physical aggression, and 51.5 % endorsed relational aggression. Greater severity of emotional and physical abuse were significantly associated with a higher frequency of aggressive behaviors. Sexual abuse was not significantly related to aggression. Post-traumatic stress and depression fully mediated the relationship between emotional abuse and aggression, controlling for race, service use, and living situation. The linkages between physical abuse and aggression were not mediated by either post-traumatic stress or depression. Findings suggest that among adolescent girls with histories of emotional abuse, post-traumatic stress and depression represent potential modifiable risk factors to target for reducing aggression.

Childhood psychological maltreatment subtypes and adolescent depressive symptoms

The aim of this study was to understand how subtypes and the timing of psychological maltreatment contribute to adolescent depressive symptoms at age 14. The sample included 638 youth from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). At age 12, youth reported experiences of psychological maltreatment (degradation, isolating, and terrorizing), physical abuse (endangerment and physical injury), and sexual abuse that occurred before and during elementary school/last year. Multivariable regression models were conducted separately for females and males at each of the two time periods and accounted for demographics, primary caregiver depressive symptoms, other maltreatment subtypes, and youth-reported age 12 depressive symptoms. For girls, caregiver degradation was the only maltreatment subtype that contributed unique variance to depressive symptoms. Degradation before elementary school and chronic degradation had a stronger impact on depression symptoms. Only caregiver isolating behaviors during elementary school/last year and chronic isolation predicted depressive symptoms in boys. These results suggest that childhood psychological maltreatment is multi-dimensional and is implicated in the etiology of adolescent depressive symptoms. Future prevention efforts should consider parental psychological maltreatment in reducing risk for adolescent depression.

Association Between Intimate Partner Violence and Child Maltreatment in a Representative Student Sample in Hong Kong

The study examined the prevalence of the co-occurrence of intimate partner violence (IPV) and child maltreatment (CM) to determine whether IPV is a factor associated with the latter. A total of 5,841 students from a representative sample of schools in Hong Kong were surveyed. The results show that the lifetime and preceding-year co-occurrence rates of IPV and CM were 12.3% and 3.6%, respectively. IPV and parents’ use of psychological aggression and corporal punishment led to increased odds of physical violence. This study suggests a need for the comprehensive assessment of IPV and CM.

Developmental transitions in presentations of externalizing problems among boys and girls at risk for child maltreatment

The present study examined the impact of children's maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems ("well adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking") and transitions between groups from ages 4, 8, and 12. A "defiant/deceitful" group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children.

Identification of child maltreatment in Iranian children with the parent-child conflict tactics scale

Background:

Child abuse and neglect is a worldwide problem and varies across many sociodemographic characteristics.

Aim:

The aim of this study was to examine the prevalence of different types of child maltreatment in Iranian kids according to the reports of their caregivers.

Subjects and Methods:

In this cross-sectional study, 562 mothers with the last child aged between 1 and 12 years were recruited based on purposeful sampling method in one pediatric referent Mazandaran province, Iran. Child maltreatment among eligible participants was assessed by a validated version of conflict tactics scale for parent and child. Data were analyzed using Pearson Correlation coefficient and one-way ANOVA.

Results:

Prevalence of emotional assault, physical assault, and child neglect were respectively 90.6% (509/562), 82.9% (466/562) and 78.8% (443/562), which were more frequent in preschool age children. Furthermore, different kinds of child maltreatments were correlated with each other (P < 0.001).

Conclusion:

Assessment of all forms of child maltreatment should be an important focus of evaluation in cases with one kind of child maltreatment. This is an important issue in preschool age children. Furthermore, this paper has some implications for health care providers in order to check some simple items to identify child abuse.

The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample

Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N=72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.

Sociodemographic risk, developmental competence, and PTSD symptoms in young children exposed to interpersonal trauma in early life

Young children are disproportionately exposed to interpersonal trauma (maltreatment, witnessing intimate partner violence [IPV]) and appear particularly susceptible to negative sequelae. Little is known about the factors influencing vulnerability to traumatic stress responses and other negative outcomes in early life. This study examined associations among interpersonal trauma exposure, sociodemographic risk, developmental competence, and posttraumatic stress disorder (PTSD) symptoms in 200 children assessed from birth to first grade via standardized observations, record reviews, and maternal and teacher interviews. More severe PTSD symptoms were predicted by greater trauma exposure (r = .43), greater sociodemographic risk (r = .22), and lower developmental competence (rs=−.31 and −.54 for preschool and school-age developmental competence, respectively). Developmental competence partially mediated the association between trauma exposure and symptoms. Trauma exposure fully mediated the association between sociodemographic risk and symptoms. Neither sociodemographic risk nor developmental competence moderated trauma exposure effects on symptoms. The findings suggest that (a)exposure to maltreatment and IPV has additive effects on posttraumatic stress risk in early life, (b) associations between sociodemographic adversity and poor mental health may be attributable to increased trauma exposure in disadvantaged populations, and (c) early exposures have a negative cascade effect on developmental competence and mental health.

Violência psicológica e contexto familiar de adolescentes usuários de serviços ambulatoriais em um hospital pediátrico público terciário

Buscou-se investigar a associação da violência psicológica (VP) na adolescência com fatores sociodemográficos, estrutura/relacionamento familiar e com outras formas de maus-tratos. Aplicou-se em 229 adolescentes (11-18 anos) um questionário, em serviços ambulatoriais de um hospital pediátrico público terciário. Encontrou-se que 26,4% dos entrevistados sofrem VP severa no contexto familiar, sendo que apenas cinco relataram não sofrer qualquer tipo de VP familiar, sugerindo que essa violência é considerada como uma forma corriqueira de relacionamento familiar. Comportamentos de VP familiares mais relatados: ser criticado pelo que faz ou diz, não ser encorajado quando tenta atuar de forma autônoma, ser chamado por nomes desagradáveis e ter adulto dizendo que está errado ao tentar agir. Insatisfação dos responsáveis com o adolescente, a estrutura familiar nuclear, a posição da criança entre os irmãos e o compartilhamento dos mesmos pais pelos irmãos mostraram-se associados à VP que ocorre no contexto familiar. O setor saúde, capacitando-se para detectar os sinais de VP, pode promover o direito à saúde integral de adolescentes, confirmando ser um dos principais setores sociais capazes de atuar preventivamente sobre as formas de violência sofridas e praticadas pelo grupo familiar.