751
|
McElroy E, Shevlin M, Elklit A, Hyland P, Murphy S, Murphy J. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest. Eur J Psychotraumatol 2016; 7:30686. [PMID: 27064976 PMCID: PMC4827144 DOI: 10.3402/ejpt.v7.30686] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/01/2016] [Accepted: 03/07/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. OBJECTIVE This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. METHOD The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. RESULTS There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. CONCLUSIONS The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.
Collapse
Affiliation(s)
- Eoin McElroy
- School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK;
| | - Mark Shevlin
- School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK
| | - Ask Elklit
- National Center of Psychotraumatology, Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - Philip Hyland
- Department of Psychology, National College of Ireland, Dublin, Ireland
| | - Siobhan Murphy
- National Center of Psychotraumatology, Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - Jamie Murphy
- School of Psychology and Psychology Research Institute, Ulster University, Londonderry, UK
| |
Collapse
|
752
|
Disentangling the Association Between Child Abuse and Eating Disorders: A Systematic Review and Meta-Analysis. Psychosom Med 2016; 78:79-90. [PMID: 26461853 DOI: 10.1097/psy.0000000000000233] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to estimate the association between distinct types of child abuse--sexual (CSA), physical (CPA), and emotional (CEA)--and different eating disorders (EDs). METHODS Electronic databases were searched through January 2014. Studies reporting rates of CSA, CPA, and CEA in people with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), as compared with individuals without EDs, were included. Pooled analyses were based on odds ratios (ORs), with relevant 95% confidence intervals (CIs), weighting each study with inverse variance models with random effects. Risk of publication bias was estimated. RESULTS Thirty-two of 1714 studies assessed for eligibility met the inclusion criteria, involving more than 14,000 individuals. The association between EDs and any child abuse showed a random-effects pooled OR of 3.21 (95% CI = 2.29-4.51, p < .001) with moderate heterogeneity (I2 = 57.2%, p = .005), whereas for CSA, this was 1.92 (95% CI = 1.13-3.28, p = .017), 2.73 (95% CI = 1.96-3.79, p < .001), and 2.31 (95% CI = 1.66-3.20, p < .001), for AN, BN, and BED, respectively. However, adjusting for publication bias, the estimate for CSA and AN was not significant (OR = 1.06, 95% CI = 0.59-1.88, p = .85). Although CPA was associated with AN, BN, and BED, CEA was associated just with BN and BED. CONCLUSIONS BN and BED are associated with childhood abuse, whereas AN shows mixed results. Individuals with similar trauma should be monitored for early recognition of EDs. TRIAL REGISTRATION The protocol was registered in PROSPERO (an international prospective register of systematic reviews) with the reference number CRD42014007360.
Collapse
|
753
|
Soares ALG, Howe LD, Matijasevich A, Wehrmeister FC, Menezes AMB, Gonçalves H. Adverse childhood experiences: Prevalence and related factors in adolescents of a Brazilian birth cohort. CHILD ABUSE & NEGLECT 2016; 51:21-30. [PMID: 26707919 PMCID: PMC4710615 DOI: 10.1016/j.chiabu.2015.11.017] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/20/2015] [Accepted: 11/21/2015] [Indexed: 05/12/2023]
Abstract
Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities.
Collapse
Affiliation(s)
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Alicia Matijasevich
- Department of Preventive Medicine, School of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | | | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
754
|
Magruder KM, Kassam-Adams N, Thoresen S, Olff M. Prevention and public health approaches to trauma and traumatic stress: a rationale and a call to action. Eur J Psychotraumatol 2016; 7:29715. [PMID: 26996536 PMCID: PMC4800286 DOI: 10.3402/ejpt.v7.29715] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/01/2016] [Accepted: 01/03/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The field of trauma and traumatic stress is dominated by studies on treatments for those who experience adversity from traumatic experiences. While this is important, we should not neglect the opportunity to consider trauma in a public health perspective. Such a perspective will help to develop prevention approaches as well as extend the reach of early interventions and treatments. The purpose of this paper is to provide an introduction to a public health approach to trauma and traumatic stress and identify key opportunities for trauma professionals and our professional societies (such as the International Society for Traumatic Stress Studies [ISTSS] and the European Society for Traumatic Stress Studies [ESTSS]) to increase our societal impact by adopting such an approach. METHOD This paper reviews and summarizes key findings related to the public health impact of trauma. The special case of children is explored, and a case example of the Norwegian terrorist attacks in 2011 illustrates the potential for improving our response to community level traumatic events. We also discuss how professional organizations such as ESTSS and ISTSS, as well as individual trauma professionals, can and should play an important role in promoting a public health approach. RESULTS Trauma is pervasive throughout the world and has negative impacts at the personal, family, community, and societal levels. A public health perspective may help to develop prevention approaches at all of these levels, as well as extend the reach of early interventions and treatments. CONCLUSIONS Professional organizations such as ESTSS and ISTSS can and should play an important role in promoting a public health approach. They should promote the inclusion of trauma in the global public health agenda and include public health in their activities.
Collapse
Affiliation(s)
- Kathryn M Magruder
- Department of Psychiatry & Behavioral Sciences, Military Science Division, Medical University of South Carolina, Charleston, SC, USA.,Department of Public Health Sciences, Division of Epidemiology, Medical University of South Carolina, Charleston, SC, USA;
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Siri Thoresen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
755
|
Viola TW, Salum GA, Kluwe-Schiavon B, Sanvicente-Vieira B, Levandowski ML, Grassi-Oliveira R. The influence of geographical and economic factors in estimates of childhood abuse and neglect using the Childhood Trauma Questionnaire: A worldwide meta-regression analysis. CHILD ABUSE & NEGLECT 2016; 51:1-11. [PMID: 26704298 DOI: 10.1016/j.chiabu.2015.11.019] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 05/12/2023]
Abstract
This multilevel meta-analysis examined the effects of geographical and economic factors on worldwide childhood maltreatment estimates measured by the Childhood Trauma Questionnaire (CTQ) short-form. The primary outcome extracted was continuous scores on the CTQ subscales - emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect - and total score. Geographical, economical and methodological variables were extracted for use as covariates in meta-regression models. A literature search identified 288 studies suitable for the CTQ total score analysis (N=59,692) and 189 studies suitable for maltreatment subtype analysis (N=44,832). We found that Europe and Asia were associated with lower CTQ estimates while South America presented the highest estimates among continents. Specifically, studies from China, Netherlands and United Kingdom presented the lowest maltreatment estimates. Furthermore, high-income countries presented lower CTQ physical neglect estimates in comparison to low- or middle-income countries, while per-capita gross domestic product of countries was negatively associated with childhood physical neglect estimates. Despite the influence of methodological covariates, these findings indicate that geographical and economic factors could influence variations of childhood maltreatment estimates around the world, particularly when assessed by a structured standardized questionnaire.
Collapse
Affiliation(s)
- Thiago Wendt Viola
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Porto Alegre, Brazil
| | - Bruno Kluwe-Schiavon
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Breno Sanvicente-Vieira
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Mateus Luz Levandowski
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| |
Collapse
|
756
|
Kidman R, Palermo T. The relationship between parental presence and child sexual violence: Evidence from thirteen countries in sub-Saharan Africa. CHILD ABUSE & NEGLECT 2016; 51:172-80. [PMID: 26631421 PMCID: PMC4713304 DOI: 10.1016/j.chiabu.2015.10.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 05/12/2023]
Abstract
There are compelling reasons to believe that orphans - many millions due to the AIDS epidemic - are more likely to be sexually victimized during childhood. Few studies have empirically investigated sexual violence disparities, and those that do suffer from methodological limitations and limited geographic scope. We used nationally representative data on female adolescents (15-17 years) from 13 countries in sub-Saharan Africa. We built multilevel logistic models to test for an association between the dependent variables (orphanhood and parental absence) and sexual violence, both within countries and pooled across all countries. Approximately 10% of adolescent girls reported past experiences of sexual violence; a third of those victimized were 14 years or younger at the time of their first forced encounter. Paternal orphaning (OR 1.36, p≤0.01), double orphaning (OR 1.47, p≤0.05), and paternal absence (OR 1.28; p≤0.05) were significantly associated with experiencing sexual violence in pooled analyses. Fewer findings reached significance within individual countries. Our findings suggest that the lack of a father in the home (due to death or absence) places girls at heightened risk for childhood sexual abuse; further research identifying pathways of vulnerability and resilience specific to this population is needed. Our findings also indicate that abuse often starts at an early age; thus promising programs should be adapted for younger age groups and rigorously tested.
Collapse
Affiliation(s)
- Rachel Kidman
- Stony Brook University, Program in Public Health and Department of Preventative Medicine, Health Sciences Center, Level 3, Stony Brook, NY 11794, USA, phone: 631 444-2645; fax: 631 444-3480
| | - Tia Palermo
- Stony Brook University, Program in Public Health and Department of Preventative Medicine, Health Sciences Center, Level 3, Stony Brook, NY 11794, USA, UNICEF Office of Research—Innocenti, Piazza SS. Annunziata 12, 50122 Florence, Italy, Telephone: +39055 2033282
| |
Collapse
|
757
|
Unlu G, Cakaloz B. Effects of perpetrator identity on suicidality and nonsuicidal self-injury in sexually victimized female adolescents. Neuropsychiatr Dis Treat 2016; 12:1489-97. [PMID: 27382291 PMCID: PMC4922799 DOI: 10.2147/ndt.s109768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Child sexual abuse and sexual dating violence victimization are common problems that are known to have long-term negative consequences. This study aimed to compare the sociodemographic, abuse-related, and clinical features of female adolescents who were sexually abused by different perpetrators, and identify the factors associated with suicidality and nonsuicidal self-injury (NSSI) in these cases. PATIENTS AND METHODS Data of 254 sexually abused female adolescents between the ages of 12-18 years were evaluated. The cases were classified into three groups, namely "sexual dating violence", "incest", and "other child sexual abuse", according to the identity of the perpetrator. The three groups were compared in terms of sociodemographic, abuse-related, and clinical features. RESULTS Major depressive disorder was the most common psychiatric diagnosis, which was present in 44.9% of the cases. Among all victims, 25.6% had attempted suicide, 52.0% had suicidal ideation, and 23.6% had NSSI during the postabuse period. A logistic regression analysis revealed that attempted suicide was predicted by dating violence victimization (adjusted odds ratio [AOR] =3.053; 95% confidence interval [CI] =1.473, 6.330) and depression (AOR =2.238; 95% CI =1.226, 4.086). Dating violence victimization was also the strongest predictor of subsequent suicidal ideation (AOR =3.500; 95% CI =1.817, 6.741). In addition, revictimization was determined to be an important risk factor for both suicidal ideation (AOR =2.897; 95% CI =1.276, 6.574) and NSSI (AOR =3.847; 95% CI =1.899, 7.794). CONCLUSION Perpetrator identity and revictimization are associated with negative mental health outcomes in sexually victimized female adolescents. Increased risk of suicidality and NSSI should be borne in mind while assessing cases with dating violence and revictimization histories, in particular.
Collapse
Affiliation(s)
- Gulsen Unlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Burcu Cakaloz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| |
Collapse
|
758
|
Sherr L, Hensels IS, Skeen S, Tomlinson M, Roberts KJ, Macedo A. Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi. Int Health 2015; 8:36-43. [PMID: 26678567 PMCID: PMC4716801 DOI: 10.1093/inthealth/ihv070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/20/2015] [Indexed: 11/27/2022] Open
Abstract
Background Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings. Methods This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children. Results Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61). Conclusion Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive.
Collapse
Affiliation(s)
- L Sherr
- Department of Infection and Population Health, University College London, London, UK
| | - I S Hensels
- Department of Infection and Population Health, University College London, London, UK
| | - S Skeen
- Department of Psychology, Stellenbosch University, South Africa Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - M Tomlinson
- Department of Psychology, Stellenbosch University, South Africa
| | - K J Roberts
- Department of Infection and Population Health, University College London, London, UK
| | - A Macedo
- Department of Infection and Population Health, University College London, London, UK
| |
Collapse
|
759
|
Sumner SA, Marcelin LH, Cela T, Mercy JA, Lea V, Kress H, Hillis SD. Sentinel events predicting later unwanted sex among girls: A national survey in Haiti, 2012. CHILD ABUSE & NEGLECT 2015; 50:49-55. [PMID: 26297488 PMCID: PMC4702506 DOI: 10.1016/j.chiabu.2015.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 07/03/2015] [Accepted: 07/29/2015] [Indexed: 06/04/2023]
Abstract
Sexual violence against children is a significant global public health problem, yet limited studies exist from low-resource settings. In Haiti we conducted the country's first, nationally representative survey focused on childhood violence to help inform the development of a national action plan for violence against children. The Haiti Violence Against Children Survey was a household-level, multistage, cluster survey among youth age 13-24. In this analysis we sought to determine whether sexual violence sentinel events (unwanted sexual touching or unwanted attempted sex) were predictive of later unwanted, completed, penetrative sex in Haiti. We also sought to explore characteristics of sentinel events and help-seeking behavior among Haitian children. Multivariable logistic regression was used to test associations between sentinel events and later unwanted, completed, penetrative sex. Overall, 1,457 females reported on experiences of sexual violence occurring in childhood (before age 18). A sentinel event occurred in 40.4% of females who experienced subsequent unwanted completed sex. Females experiencing a sentinel event were approximately two and a half times more likely to experience later unwanted completed sex (adjusted odds ratio=2.40, p=.004) compared to individuals who did not experience a sentinel event. The mean lag time from first sentinel event to first unwanted completed sex was 2.3 years. Only half (54.6%) of children experiencing a sentinel event told someone about their experience of sexual violence. Among children, sentinel events occur frequently before later acts of completed unwanted sex and may represent a useful point of intervention. Reporting of sexual violence by children in Haiti is low and can be improved to better act on sentinel events.
Collapse
Affiliation(s)
- Steven A Sumner
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention (CDC), USA; Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), USA
| | - Louis H Marcelin
- Interuniversity Institute for Research and Development (INURED), Haiti; University of Miami, USA
| | - Toni Cela
- Interuniversity Institute for Research and Development (INURED), Haiti
| | - James A Mercy
- Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), USA
| | - Veronica Lea
- Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), USA
| | - Howard Kress
- Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), USA
| | - Susan D Hillis
- Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention (CDC), USA
| |
Collapse
|
760
|
Devries KM, Child JC, Elbourne D, Naker D, Heise L. "I never expected that it would happen, coming to ask me such questions":Ethical aspects of asking children about violence in resource poor settings. Trials 2015; 16:516. [PMID: 26558829 PMCID: PMC4642767 DOI: 10.1186/s13063-015-1004-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/08/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND International epidemiological research into violence against children is increasing in scope and frequency, but little has been written about practical management of the ethical aspects of conducting such research in low and middle-income countries. In this paper, we describe our study procedures and reflect on our experiences conducting a survey of more than 3,700 primary school children in Uganda as part of the Good Schools Study, a cluster randomised controlled trial of a school-based violence prevention intervention. Children were questioned extensively about their experiences of physical, sexual, and emotional violence from a range of different perpetrators. We describe our sensitisation and consent procedures, developed based on our previous research experience and requirements for our study setting. To respond to disclosures of abuse that occurred during our survey, we describe a referral algorithm developed in conjunction with local services. We then describe our experience of actually implementing these procedures in our 2012 survey, based on reflections of the research team. Drawing on 40 qualitative interviews, we describe children's experiences of participating in the survey and of being referred to local child protection services. RESULTS Although we were able to implement much of our protocol in a straightforward manner, we also encountered major challenges in relation to the response of local services to children's disclosures of violence. The research team had to intervene to ensure that children were provided with appropriate support and that our ethical obligations were met. CONCLUSIONS In resource poor settings, finding local services that can provide appropriate support for children may be challenging, and researchers need to have concrete plans and back-up plans in place to ensure that obligations can be met. The merits of mandatory reporting of children's disclosures to local services need to be considered on a case by case basis-in some places this has the potential to do harm. Research teams also must agree on what level of ancillary care will be provided, and budget accordingly. Further practical examples of how to address the challenges encountered in this work are needed, in order to build a consensus on best practices. TRIAL REGISTRATION NCT01678846 (clinicaltrials.gov), August 24, 2012.
Collapse
Affiliation(s)
- Karen M Devries
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Jennifer C Child
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Diana Elbourne
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Dipak Naker
- Raising Voices, Plot 16, Tufnell Drive, Kampala, Uganda.
| | - Lori Heise
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| |
Collapse
|
761
|
Fonagy P, Butler S, Baruch G, Byford S, Seto MC, Wason J, Wells C, Greisbach J, Ellison R, Simes E. Evaluation of multisystemic therapy pilot services in Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B): study protocol for a randomized controlled trial. Trials 2015; 16:492. [PMID: 26525144 PMCID: PMC4631080 DOI: 10.1186/s13063-015-1017-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinically effective and cost-effective methods for managing problematic sexual behaviour in adolescents are urgently needed. Adolescents who show problematic sexual behaviour have a range of negative psychosocial outcomes, and they and their parents can experience stigma, hostility and rejection from their community. Multisystemic therapy (MST) shows some evidence for helping to reduce adolescent sexual reoffending and is one of the few promising interventions available to young people who show problematic sexual behaviour. This paper describes the protocol for Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B), a feasibility trial of MST for problem sexual behaviour (MST-PSB) in antisocial adolescents at high risk of out-of-home placement due to problematic sexual behaviour. METHODS/DESIGN Eighty participants and their families recruited from five London boroughs will be randomized to MST-PSB or management as usual with follow-up to 20 months post-randomization. The primary outcome is out-of-home placement at 20 months. Secondary outcomes include sexual and non-sexual offending rates and antisocial behaviours, participant well-being, educational outcomes and total service and criminal justice sector costs. Feasibility outcomes include mapping the clinical service pathways needed to recruit adolescents displaying problematic sexual behaviour, acceptability of a randomized controlled trial to the key systems involved in managing these adolescents, and acceptability of the research protocol to young people and their families. Data will be gathered from police computer records, the National Pupil Database and interviews and self-report measures administered to adolescents and parents and will be analysed on an intention-to-treat basis. DISCUSSION The STEPS-B feasibility trial aims to inform policymakers, commissioners of services and professionals about the potential for implementing MST-PSB as an intervention for adolescents showing problem sexual behaviour. Should MST-PSB show potential, STEPS-B will determine what would be necessary to implement the programme more fully and at a scale that would warrant a full trial. TRIAL REGISTRATION ISRCTN28441235 (registered 25 January 2012).
Collapse
Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | | | - Sarah Byford
- Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London, London, UK.
| | - Michael C Seto
- Royal Ottawa Health Care Group, Ottawa, Ontario, Canada.
| | - James Wason
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
| | | | - Jessie Greisbach
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Rachel Ellison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| |
Collapse
|
762
|
Inter-relationships between sexual abuse, female sexual function and childbirth. Midwifery 2015; 31:1087-95. [DOI: 10.1016/j.midw.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 06/13/2015] [Accepted: 07/20/2015] [Indexed: 12/31/2022]
|
763
|
Ziegenhain U, Künster AK, Besier T. Gewalt gegen Kinder. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 59:44-51. [DOI: 10.1007/s00103-015-2271-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
764
|
C MP, M CJ, Elias A, I OO, Awoere CT. Child sexual abuse among adolescents in southeast Nigeria: A concealed public health behavioral issue. Pak J Med Sci 2015; 31:827-32. [PMID: 26430412 PMCID: PMC4590391 DOI: 10.12669/pjms.314.7115] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: Child sexual abuse among adolescents is an often overlooked issue in pediatrics, yet it is a major cause of low self esteem and stigmatization in adolescents. The objective of this study was to determine the socioeconomic determinant and pattern of child sexual abuse among adolescent attending secondary schools in South East Nigeria. Methods: This was a cross-sectional study that was carried out among children in three secondary schools in Enugu and Ebonyi states of Nigeria. Five hundred and six adolescents who met inclusion criteria were consecutively recruited into our prospective study between June and October, 2014. Results: One hundred and ninety nine (40 %) of the respondents had been abused and the commonest form of abuse was to look at pornographic pictures, drawings, films, videotapes or magazine 93(18.4%). Fifty eight (11.5%) adolescents stated that they were abused once with age at first exposure being 7-12 years 57 (11.4%). When grouped together, family members and relatives are perpetrators of child sexual abuse. There was significant difference in sex abuse between males and females (p=0.014) while there were no significant difference for age (p=0.157) and social class (p=0.233). Conclusion: Overall prevalence and one time prevalence rates of sexual abuse among adolescents in south east Nigeria was 40% and 11.5% respectively with male perpetrators. There is no link between socioeconomic class, age and child sexual abuse among adolescents.
Collapse
Affiliation(s)
- Manyike Pius C
- Manyike Pius C, College of Medicine, Department of Pediatrics, Federal Teaching Hospital Abakiliki, Nigeria
| | - Chinawa Josephat M
- Chinawa Josephat M, College of Medicine, Department of Pediatrics, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Aniwada Elias
- Aniwada Elias, Department Of Community Medicine, University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Odutola Odetunde I
- Odutola Odetunde I, College of Medicine, Department of Pediatrics, University of Nigeria/University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| | - Chinawa T Awoere
- Chinawa T. Awoere, Department Of Community Medicine, University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria
| |
Collapse
|
765
|
Moore SE, Scott JG, Ferrari AJ, Mills R, Dunne MP, Erskine HE, Devries KM, Degenhardt L, Vos T, Whiteford HA, McCarthy M, Norman RE. Burden attributable to child maltreatment in Australia. CHILD ABUSE & NEGLECT 2015; 48:208-220. [PMID: 26056058 DOI: 10.1016/j.chiabu.2015.05.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 05/01/2015] [Accepted: 05/06/2015] [Indexed: 06/04/2023]
Abstract
Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies.
Collapse
Affiliation(s)
- Sophie E Moore
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - James G Scott
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD 4029 Australia; The University of Queensland Centre for Clinical Research, Herston, QLD 4029 Australia
| | - Alize J Ferrari
- School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ryan Mills
- Department of Paediatrics, Logan Hospital, Metro South Hospital and Health Service, QLD, Australia; School of Medicine, University of Queensland, Herston, QLD, Australia
| | - Michael P Dunne
- Children and Youth Research Centre, School of Public Health and Social Work, Queensland University of Technology, QLD, Australia
| | - Holly E Erskine
- School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Karen M Devries
- Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, NSW, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Harvey A Whiteford
- School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Molly McCarthy
- School of Criminology and Criminal Justice, Griffith University, Australia
| | - Rosana E Norman
- Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia; School of Public Health and Social Work, Queensland University of Technology, QLD, Australia
| |
Collapse
|
766
|
Wosu AC, Gelaye B, Williams MA. History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review. Arch Womens Ment Health 2015; 18:659-71. [PMID: 25956589 PMCID: PMC4565760 DOI: 10.1007/s00737-015-0533-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/22/2015] [Indexed: 01/22/2023]
Abstract
The objective of this review is to summarize the literature (and to the extent possible, report the magnitude and direction of the association) concerning history of childhood sexual abuse (CSA) and depression or depressive symptoms among pregnant and postpartum women. Publications were identified through literature searches of seven databases (PubMed, EMBASE, PyscINFO, CINAHL, Web of Science, BIOSIS, and Science Direct) using keywords including "child abuse," "depression," "pregnancy," "prenatal," "pregnancy," and "postpartum." The literature search yielded seven eligible studies on the prenatal period and another seven studies on the postpartum period. All but one prenatal study observed statistically significant positive associations of CSA with depression or depressive symptoms during pregnancy. Findings on the association of CSA with postpartum depression or depressive symptoms were inconsistent; pooled unadjusted and adjusted odds ratios were 1.82 (95 % confidence interval (CI) 0.92, 3.60) and 1.20 (95 % CI 0.81, 1.76). In sum, findings suggest a positive association of history of CSA with depression and depressive symptoms in the prenatal period. Findings on the postpartum period were inconsistent. Clinical and public health implications of evidence from the available literature are discussed, as are desirable study design characteristics of future research.
Collapse
Affiliation(s)
- Adaeze C. Wosu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Michelle A. Williams
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| |
Collapse
|
767
|
Ramo-Fernández L, Schneider A, Wilker S, Kolassa IT. Epigenetic Alterations Associated with War Trauma and Childhood Maltreatment. BEHAVIORAL SCIENCES & THE LAW 2015; 33:701-721. [PMID: 26358541 DOI: 10.1002/bsl.2200] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Survivors of war trauma or childhood maltreatment are at increased risk for trauma-spectrum disorders such as post-traumatic stress disorder (PTSD). In addition, traumatic stress has been associated with alterations in the neuroendocrine and the immune system, enhancing the risk for physical diseases. Traumatic experiences might even affect psychological as well as biological parameters in the next generation, i.e. traumatic stress might have transgenerational effects. This article outlines how epigenetic processes, which represent a pivotal biological mechanism for dynamic adaptation to environmental challenges, might contribute to the explanation of the long-lasting and transgenerational effects of trauma. In particular, epigenetic alterations in genes regulating the hypothalamus-pituitary-adrenal axis as well as the immune system have been observed in survivors of childhood and adult trauma. These changes could result in enduring alterations of the stress response as well as the physical health risk. Furthermore, the effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and postnatal environment, as well as by epigenetic marks transmitted via the germline. While epigenetic research has a high potential of advancing our understanding of the consequences of trauma, the findings have to be interpreted with caution, as epigenetics only represent one piece of a complex puzzle of interacting biological and environmental factors. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
| | - Anna Schneider
- Clinical and Biological Psychology, Ulm University, Germany
| | - Sarah Wilker
- Clinical and Biological Psychology, Ulm University, Germany
| | | |
Collapse
|
768
|
Chiang LF, Chen J, Gladden MR, Mercy JA, Kwesigabo G, Mrisho F, Dahlberg LL, Nyunt MZ, Brookmeyer KA, Vagi K. HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:474-87. [PMID: 26485236 PMCID: PMC6126531 DOI: 10.1521/aeap.2015.27.5.474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13-24 year old respondents (n=3,739). Analyses show that females aged 19-24 (n=579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR=3.0, CI [1.5, 6.1], p=0.0017) and multiple sex partners in the past 12 months (AOR=2.3, CI [1.0, 5.1], p=0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV.
Collapse
Affiliation(s)
- Laura F Chiang
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jieru Chen
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - James A Mercy
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Fatma Mrisho
- Tanzania Commission for AIDS, Dar es Salaam, Tanzania
| | | | | | | | - Kevin Vagi
- Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
769
|
Madowitz J, Matheson BE, Liang J. The relationship between eating disorders and sexual trauma. Eat Weight Disord 2015; 20:281-93. [PMID: 25976911 DOI: 10.1007/s40519-015-0195-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/29/2015] [Indexed: 01/01/2023] Open
Abstract
Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED-body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004-2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included "sexual assault", "sexual abuse", "sexual trauma", and "rape" in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED.
Collapse
Affiliation(s)
- Jennifer Madowitz
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University / University of California, San Diego, California, USA,
| | | | | |
Collapse
|
770
|
van der Kooij IW, Nieuwendam J, Bipat S, Boer F, Lindauer RJL, Graafsma TLG. A national study on the prevalence of child abuse and neglect in Suriname. CHILD ABUSE & NEGLECT 2015; 47:153-161. [PMID: 25937450 DOI: 10.1016/j.chiabu.2015.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 03/20/2015] [Accepted: 03/26/2015] [Indexed: 06/04/2023]
Abstract
The prevalence of child maltreatment in Suriname has never been subjected to a reliable assessment. The only data available include rough estimates of a range of internationally comparable indicators extrapolated from child protection and police corps statistics for offenses against children. This study aimed to provide a reliable estimate of the prevalence of all forms of child maltreatment in Suriname. One thousand three hundred and ninety-one (1,391) adolescents and young adults of different ethnicities completed a questionnaire about child maltreatment. The study sample, obtained by random probability sampling, consisted of students (ages 12 through 22) from five districts in Suriname. A significant proportion of Surinamese children experienced maltreatment. In total, 86.8% of adolescents and 95.8% of young adults reported having been exposed to at least one form of child maltreatment during their lives. Among the adolescents, 57.1% were exposed to child maltreatment in the past year. When the definition of the National Incidence Study was applied, 58.2% of adolescents and 68.8% of young adults had been exposed to at least one form of maltreatment. Among adolescents, 36.8% reported having experienced at least one form of maltreatment in the past year. The results indicate the (extremely) high lifetime and year prevalence of child maltreatment in Suriname. The serious and often lifelong consequences of such maltreatment indicate that a national approach to child abuse and neglect, including the development of a national strategic plan, a national surveillance system and changes to the state's programmatic and policy response, is urgently needed.
Collapse
Affiliation(s)
- Inger W van der Kooij
- Academic Medical Center, Department of Child and Adolescent Psychiatry, University of Amsterdam, The Netherlands
| | - Josta Nieuwendam
- Institute for Graduate Studies & Research, Anton de Kom University, Suriname
| | - Shandra Bipat
- Academic Medical Center, Department of Radiology, University of Amsterdam, The Netherlands
| | - Frits Boer
- Academic Medical Center, Department of Child and Adolescent Psychiatry, University of Amsterdam, The Netherlands; The Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Ramón J L Lindauer
- Academic Medical Center, Department of Child and Adolescent Psychiatry, University of Amsterdam, The Netherlands; The Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Tobi L G Graafsma
- Institute for Graduate Studies & Research, Anton de Kom University, Suriname; The Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| |
Collapse
|
771
|
Pereda N, Abad J, Guilera G, Arch M. Victimización sexual autorreportada en adolescentes españoles comunitarios y en colectivos de riesgo. GACETA SANITARIA 2015; 29:328-34. [DOI: 10.1016/j.gaceta.2015.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/12/2015] [Accepted: 05/13/2015] [Indexed: 10/23/2022]
|
772
|
Wosu AC, Gelaye B, Williams MA. Maternal history of childhood sexual abuse and preterm birth: an epidemiologic review. BMC Pregnancy Childbirth 2015; 15:174. [PMID: 26276498 PMCID: PMC4537581 DOI: 10.1186/s12884-015-0606-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/04/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND History of childhood sexual abuse (CSA) is highly prevalent with as many as one in four American women being victims. Exposure to CSA or other early life traumatic experiences has been associated with adverse reproductive and pregnancy outcomes. However, the effects of CSA on preterm delivery (PTB), a leading cause of neonatal mortality, remain poorly understood. The objectives of this review are (i) to synthesize the available research investigating the relationship between maternal history of childhood sexual abuse (CSA) and preterm delivery (PTB); (ii) to provide suggestions for improving future research on this topic; and (iii) to highlight implications for clinical practice and public health. METHODS Relevant articles were identified through searches of four electronic databases (PubMed, CINAHL, Web of Science Core Collection and BIOSIS Online) for studies published before March 2014, as well as through reviewing references of published articles. RESULTS A total of six studies published from 1992 to 2010 were included in this review. Overall, findings were inconsistent. Three studies reported statistically significant associations of CSA with PTB (<37 weeks gestation) or shorter mean gestational age at birth. Women with a history of CSA had 2.6 to 4.8-fold increased odds of PTB as compared with women without a history of CSA. Three other studies did not observe statistically significant differences in rates of PTB or mean gestational age at birth in relation to a history of CSA. CONCLUSIONS Available evidence on this topic is sparse and inconsistent, and limited by a number of methodological challenges. Given the ubiquity of CSA, as well as the clinical and public health significance of PTB, more rigorously designed epidemiologic studies on the association between CSA and PTB are warranted.
Collapse
Affiliation(s)
- Adaeze C Wosu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| |
Collapse
|
773
|
Niveau G, Lacasa MJ, Berclaz M, Germond M. Inter-rater Reliability of Criteria-Based Content Analysis of Children's Statements of Abuse. J Forensic Sci 2015; 60:1247-52. [PMID: 26272453 DOI: 10.1111/1556-4029.12816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 08/27/2014] [Accepted: 08/29/2014] [Indexed: 10/23/2022]
Abstract
The evaluation of children's statements of sexual abuse cases in forensic cases is critically important and must and reliable. Criteria-based content analysis (CBCA) is the main component of the statement validity assessment (SVA), which is the most frequently used approach in this setting. This study investigated the inter-rater reliability (IRR) of CBCA in a forensic context. Three independent raters evaluated the transcripts of 95 statements of sexual abuse. IRR was calculated for each criterion, total score, and overall evaluation. The IRR was variable for the criteria, with several being unsatisfactory. But high IRR was found for the total CBCA scores (Kendall's W=0.84) and for overall evaluation (Kendall's W=0.65). Despite some shortcomings, SVA remains a robust method to be used in the comprehensive evaluation of children's statements of sexual abuse in the forensic setting. However, the low IRR of some CBCA criteria could justify some technical improvements.
Collapse
Affiliation(s)
- Gérard Niveau
- HUG, Unité de psychiatrie Légale, rue Gabrielle-Perret-Gentil 4, 1211, Lausanne, Geneve 14, Switzerland
| | | | | | - Michèle Germond
- Faculté de médecine, avenue de Champel 9, 1206, Genève, Switzerland
| |
Collapse
|
774
|
Langevin R, Hébert M, Cossette L. Emotion regulation as a mediator of the relation between sexual abuse and behavior problems in preschoolers. CHILD ABUSE & NEGLECT 2015; 46:16-26. [PMID: 25712046 DOI: 10.1016/j.chiabu.2015.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 01/24/2015] [Accepted: 02/02/2015] [Indexed: 06/04/2023]
Abstract
Maltreated children show poor emotion regulation competencies compared to non-maltreated children. Emotion regulation has been found to mediate the association between maltreatment and behavior problems in children. The aim of the present study was to examine the relationships among child sexual abuse (CSA), emotion regulation (ER), and internalized and externalized behavior problems in preschoolers using conditional process analyses. ER competencies were assessed in 127 children aged 41-79 months (62 abused, 65 non-abused) by their parents (N=124) and early childhood educators (N=88) using the Emotion Regulation Checklist (Shields & Cicchetti, 1995, 1997). Behavior problems were evaluated by parents using the Child Behavior Checklist (Achenbach & Rescorla, 2000, 2001). ER was found to completely mediate the relation between CSA and internalized behavior problems and partially mediate the relation between CSA and externalized behavior problems. Parents' and educators' evaluations of ER were also found to differ as a function of child gender. The discussion focuses on the relationships among CSA, ER, behavior problems, and child gender. The clinical implications of these findings are also examined. Promoting the optimal development of ER could prevent the emergence and exacerbation of behavior problems in these at-risk children and, in turn, foster resilience.
Collapse
Affiliation(s)
- Rachel Langevin
- Department of Psychology, Université du Québec à Montréal, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Canada
| | - Louise Cossette
- Department of Psychology, Université du Québec à Montréal, Canada
| |
Collapse
|
775
|
Rumble L, Mungate T, Chigiji H, Salama P, Nolan A, Sammon E, Muwoni L. Childhood sexual violence in Zimbabwe: evidence for the epidemic against girls. CHILD ABUSE & NEGLECT 2015; 46:60-66. [PMID: 25986577 DOI: 10.1016/j.chiabu.2015.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/16/2015] [Accepted: 04/27/2015] [Indexed: 06/04/2023]
Abstract
Sexual abuse during childhood is a public health and human rights concern throughout the world, including Sub-Saharan Africa. In 2011, Zimbabwe initiated national prevalence data collection on violence against children to inform government policy and programs. We interviewed 567 females and 589 males, aged 18-24 years following standardized and previously tested survey methods from the region. Of females 32.5%, and of males 8.9%, reported experiencing sexual violence before age 18. Most female (62.7%) and male (47.9%) victims of sexual violence experienced more than one incident of sexual violence prior to age 18 years. Three in four females (77.7%) and one in four males (26.7%) of those who experienced sexual violence reported that the first incident was perpetrated by a boyfriend or girlfriend. Few victims received professional help (2.7% of females and 2.4% of males who had reported experiencing sexual violence). Violence against girls is at epidemic levels in Zimbabwe. Most sexual violence against girls occurs within the context of peer relationships. Child victims who seek potentially life-saving support tend not to receive it. This study is evidence of a national public health and child rights emergency in the country and a case for increased, longer-term investment by the government and its development partners in policy reform for enhancing adolescent girls' empowerment and protection.
Collapse
Affiliation(s)
- Lauren Rumble
- United Nations Children's Fund (UNICEF) Indonesia, Wisma Metropolitan II, 11th Floor, Jl. Jend. SudirmanKav. 31, Jakarta 12920, Indonesia
| | - Taizivei Mungate
- Zimbabwe National Statistics Agency (ZIMSTAT), 20th Floor, Kaguvi Building, Cnr 4th Central Avenue, Harare, Zimbabwe
| | - Handrick Chigiji
- Zimbabwe National Statistics Agency (ZIMSTAT), 20th Floor, Kaguvi Building, Cnr 4th Central Avenue, Harare, Zimbabwe
| | - Peter Salama
- United Nations Children's Fund (UNICEF), Ethiopia, P.O. Box 1169, Africa Hall, Addis Ababa, Ethiopia
| | - Anthony Nolan
- United Nations Children's Fund (UNICEF) Sudan, UNICEF Totto Chan Compound, P.O. Box 45, Juba, South Sudan
| | - Elayn Sammon
- UNICEF Mozambique, 1440 Zimbabwe Avenue, Maputo, Mozambique
| | - Leon Muwoni
- Child Protection Specialist, UNICEF Zimbabwe, 6 Fairbridge Avenue, Belgravia, Zimbabwe
| |
Collapse
|
776
|
Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study. Epidemiol Psychiatr Sci 2015; 24:353-63. [PMID: 24786388 PMCID: PMC7192193 DOI: 10.1017/s2045796014000274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking). METHODS Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n = 1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex. RESULTS In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample. CONCLUSIONS This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes.
Collapse
|
777
|
Seto MC, Babchishin KM, Pullman LE, McPhail IV. The puzzle of intrafamilial child sexual abuse: A meta-analysis comparing intrafamilial and extrafamilial offenders with child victims. Clin Psychol Rev 2015; 39:42-57. [DOI: 10.1016/j.cpr.2015.04.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 03/04/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
|
778
|
Duhig M, Patterson S, Connell M, Foley S, Capra C, Dark F, Gordon A, Singh S, Hides L, McGrath JJ, Scott J. The prevalence and correlates of childhood trauma in patients with early psychosis. Aust N Z J Psychiatry 2015; 49:651-9. [PMID: 25722463 DOI: 10.1177/0004867415575379] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. METHOD Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. RESULTS Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms; however, it had no impact on social or vocational functioning or recent substance use. CONCLUSION Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported.
Collapse
Affiliation(s)
- Michael Duhig
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia The University of Queensland Centre for Clinical Research, Herston, QLD, Australia School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Sue Patterson
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia
| | - Melissa Connell
- The University of Queensland Centre for Clinical Research, Herston, QLD, Australia
| | - Sharon Foley
- Metro South Mental Health, Princess Alexandra Hospital, Wooloongabba, QLD, Australia
| | - Carina Capra
- Metro South Mental Health, Princess Alexandra Hospital, Wooloongabba, QLD, Australia
| | - Frances Dark
- Metro South Mental Health, Princess Alexandra Hospital, Wooloongabba, QLD, Australia
| | - Anne Gordon
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Saveena Singh
- Early Psychosis Service, Gold Coast Health Service District, Burleigh Heads, Gold Coast, QLD, Australia
| | - Leanne Hides
- School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD, Australia Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - James Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia The University of Queensland Centre for Clinical Research, Herston, QLD, Australia Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia Discipline of Psychiatry, University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
779
|
Greger HK, Myhre AK, Lydersen S, Jozefiak T. Previous maltreatment and present mental health in a high-risk adolescent population. CHILD ABUSE & NEGLECT 2015; 45:122-134. [PMID: 26003821 DOI: 10.1016/j.chiabu.2015.05.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 04/28/2015] [Accepted: 05/01/2015] [Indexed: 06/04/2023]
Abstract
Childhood maltreatment is known to increase the risk of future psychiatric disorders. In the present study, we explored the impact of experienced maltreatment on the prevalence and comorbidity of psychiatric disorders in a high-risk population of adolescents in residential care units. We also studied the impact of poly-victimization. The participants of the study were adolescents in residential care units in Norway (n=335, mean age 16.8 years, girls 58.5%). A diagnostic interview (Child and Adolescent Psychiatric Assessment Interview) was used, yielding information about previous maltreatment (witnessing violence, victim of family violence, community violence, sexual abuse) and DSM-IV diagnoses present in the last three months. Exposure to maltreatment was reported by 71%, and in this group, we found significantly more Asperger's syndrome (AS) (p=.041), conduct disorder (CD) (p=.049), major depressive disorder (MDD) (p=.001), dysthymia (p=.030), general anxiety disorder (GAD) (p<.001), and having attempted suicide (p=.006). We found significantly more comorbid disorders in the maltreated group. Poly-victimization was studied by constructing a scale comprised of witnessing violence, victim of family violence, victim of sexual abuse and household dysfunction. We found that poly-victimization was associated with significantly increased risk of MDD, GAD, AS, CD, and having attempted suicide (p<.01). The complexity of the clinical outcomes revealed in this study suggest that longer-term treatment plans and follow-up by psychiatric services might be needed to a greater extend than for the rest of the child and adolescent population, and that trauma informed care is essential for adolescents in residential youth care.
Collapse
Affiliation(s)
- Hanne Klæboe Greger
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433 Trondheim, Norway; Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905, MTFS, N-7491 Trondheim, Norway
| | - Arne Kristian Myhre
- Regional Center on Violence, Traumatic Stress and Suicide Prevention, Region Mid-Norway, Schwachs Gate 1, 7030 Trondheim, Norway; Children's Clinic, St. Olavs Hospital, Pb 3250 Sluppen, 7006 Trondheim, Norway
| | - Stian Lydersen
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905, MTFS, N-7491 Trondheim, Norway
| | - Thomas Jozefiak
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433 Trondheim, Norway; Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905, MTFS, N-7491 Trondheim, Norway
| |
Collapse
|
780
|
Fitzhenry M, Harte E, Carr A, Keenleyside M, O'Hanrahan K, White MD, Hayes J, Cahill P, Noonan H, O'Shea H, McCullagh A, McGuinness S, Rodgers C, Whelan N, Sheppard N, Browne S. Child maltreatment and adult psychopathology in an Irish context. CHILD ABUSE & NEGLECT 2015; 45:101-107. [PMID: 26026360 DOI: 10.1016/j.chiabu.2015.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/14/2015] [Accepted: 04/27/2015] [Indexed: 06/04/2023]
Abstract
One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered.
Collapse
Affiliation(s)
- Mark Fitzhenry
- School of Psychology, University College Dublin, Ireland; Health Service Executive, Ireland
| | - Elizabeth Harte
- School of Psychology, University College Dublin, Ireland; Health Service Executive, Ireland
| | - Alan Carr
- School of Psychology, University College Dublin, Ireland; Clanwilliam Institute, Dublin, Ireland
| | | | - Kevin O'Hanrahan
- School of Psychology, University College Dublin, Ireland; Health Service Executive, Ireland
| | - Megan Daly White
- School of Psychology, University College Dublin, Ireland; Health Service Executive, Ireland
| | | | - Paul Cahill
- School of Psychology, University College Dublin, Ireland; Health Service Executive, Ireland
| | | | | | | | | | | | | | | | | |
Collapse
|
781
|
Hébert M, Lavoie F, Blais M. Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors. CIENCIA & SAUDE COLETIVA 2015; 19:685-94. [PMID: 24714884 DOI: 10.1590/1413-81232014193.15972013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/11/2013] [Indexed: 11/22/2022] Open
Abstract
This analysis examined the contribution of personal, family (maternal and paternal support; sibling support) and extra-familiar (peer support; other adults) resilience to the prediction of clinical levels of PTSD symptoms in adolescents reporting sexual abuse. Controls were established for abuse-related variables (type of abuse, severity and multiple abuse) in a representative sample of high schools students in the province of Quebec. A total of 15.2% of adolescent females and 4.4% adolescent males in high school reported a history of sexual abuse in childhood. Sexually abused adolescent females (27.8%) were more likely than adolescent males (14.9%) to achieve scores with high clinical levels of PTSD. Hierarchical logistic regression revealed that over and above the characteristics of the sexual abuse experienced, resilience factors (maternal and peer support) contributed to the prediction of symptoms of PTSD attaining the clinical threshold. Alternative intervention and prevention practices geared to adolescent victims of sexual assault are discussed.
Collapse
|
782
|
Mathews B, Walsh K, Coe S, Kenny MC, Vagenas D. Child protection training for professionals to improve reporting of child abuse and neglect. Hippokratia 2015. [DOI: 10.1002/14651858.cd011775] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ben Mathews
- Queensland University of Technology; Faculty of Law, Australian Centre for Health Law Research; GPO Box 2434 Brisbane Queensland Australia 4001
| | - Kerryann Walsh
- Queensland University of Technology; Faculty of Education; Victoria Park Road Brisbane Queensland Australia 4059
| | - Sandra Coe
- Queensland University of Technology; Faculty of Law; GPO Box 2434 Brisbane Queensland Australia 4004
| | - Maureen C Kenny
- Florida International University; College of Education; University Park Miami Florida USA 33199
| | - Dimitrios Vagenas
- Queensland University of Technology; Institute of Health and Biomedical Innovation; 60 Musk Avenue Kelvin Grove Brisbane Queensland Australia 4059
| |
Collapse
|
783
|
Craner JR, Martinson AA, Sigmon ST, McGillicuddy ML. Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students. JOURNAL OF CHILD SEXUAL ABUSE 2015; 24:484-505. [PMID: 26090864 DOI: 10.1080/10538712.2015.1026014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as "rape" or "abuse" as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general "label" questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.
Collapse
|
784
|
van Hoof MJ, van Lang NDJ, Speekenbrink S, van IJzendoorn MH, Vermeiren RRJM. Adult Attachment Interview differentiates adolescents with Childhood Sexual Abuse from those with clinical depression and non-clinical controls. Attach Hum Dev 2015; 17:354-75. [PMID: 26047034 DOI: 10.1080/14616734.2015.1050420] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although attachment representation is considered to be disturbed in traumatized adolescents, it is not known whether this is specific for trauma, as comparative studies with other clinical groups are lacking. Therefore, attachment representation was studied by means of the Adult Attachment Interview in adolescents with Childhood Sexual Abuse (CSA) (N = 21), clinical depression (N = 28) and non-clinical controls (N = 28). Coherence of mind and unresolved loss or trauma, as well as the disorganized attachment classification differentiated the CSA group from the clinical depression group and controls, over and above age, IQ, and psychiatric symptomatology. In the current era of sustained criticism on criteria-based classification, this may well carry substantial clinical relevance. If attachment is a general risk or vulnerability factor underlying specific psychopathology, this may guide diagnostic assessment as well as treatment.
Collapse
Affiliation(s)
- Marie-José van Hoof
- a Psychotraumacenter and Department of Child and Adolescent Psychiatry , GGZ Kinderen en Jeugd Rivierduinen , Leiden , The Netherlands
| | | | | | | | | |
Collapse
|
785
|
Sigurdardottir S, Halldorsdottir S, Bender SS, Agnarsdottir G. Personal resurrection: female childhood sexual abuse survivors’ experience of theWellness-Program. Scand J Caring Sci 2015; 30:175-86. [DOI: 10.1111/scs.12238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 03/17/2015] [Indexed: 12/16/2022]
Affiliation(s)
| | - Sigridur Halldorsdottir
- Faculty of Graduate Studies; School of Health Sciences; University of Akureyri; Akureyri Iceland
| | - Soley S. Bender
- Research and Development regarding Sexual and Reproductive Health; School of Health Sciences; University Hospital; University of Iceland; Reykjavik Iceland
| | | |
Collapse
|
786
|
Dion J, Cantinotti M, Ross A, Collin-Vézina D. Sexual abuse, residential schooling and probable pathological gambling among Indigenous Peoples. CHILD ABUSE & NEGLECT 2015; 44:56-65. [PMID: 25816756 DOI: 10.1016/j.chiabu.2015.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 02/23/2015] [Accepted: 03/03/2015] [Indexed: 06/04/2023]
Abstract
Sexual abuse leads to short-term and long-lasting pervasive outcomes, including addictions. Among Indigenous Peoples, sexual abuse experienced in the context of residential schooling may have led to unresolved grief that is contributing to social problems, such as pathological (disordered) gambling. The aim of this study is to investigate the link between child sexual abuse, residential schooling and probable pathological gambling. The participants were 358 Indigenous persons (54.2% women) aged between 18 and 87 years, from two communities and two semi-urban centers in Quebec (Canada). Probable pathological gambling was evaluated using the South Oaks Gambling Screen (SOGS), and sexual abuse and residential schooling were assessed with dichotomous questions (yes/no). The results indicate an 8.7% past-year prevalence rate of pathological gambling problems among participants, which is high compared with the general Canadian population. Moreover, 35.4% were sexually abused, while 28.1% reported having been schooled in a residential setting. The results of a logistic regression also indicate that experiences of child sexual abuse and residential schooling are associated with probable pathological gambling among Indigenous Peoples. These findings underscore the importance of using an ecological approach when treating gambling, to address childhood traumas alongside current addiction problems.
Collapse
Affiliation(s)
- Jacinthe Dion
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada; CRIPCAS (Interdisciplinary Research Centre on Conjugal Problems and Sexual Abuse), Canada
| | | | - Amélie Ross
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada; CRIPCAS (Interdisciplinary Research Centre on Conjugal Problems and Sexual Abuse), Canada
| | - Delphine Collin-Vézina
- CRIPCAS (Interdisciplinary Research Centre on Conjugal Problems and Sexual Abuse), Canada; School of Social Work, McGill University, Canada
| |
Collapse
|
787
|
Postmus JL, Hoge GL, Davis R, Johnson L, Koechlein E, Winter S. Examining gender based violence and abuse among Liberian school students in four counties: An exploratory study. CHILD ABUSE & NEGLECT 2015; 44:76-86. [PMID: 25529859 DOI: 10.1016/j.chiabu.2014.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/28/2014] [Accepted: 11/04/2014] [Indexed: 06/04/2023]
Abstract
The purpose of this article is to uncover the extent of sexual gender based violence (GBV) experienced by a convenience sample of students from select counties in Liberia and to understand the disclosure experiences of those victims willing to come forward. Girls (n=758) and boys (n=1,100) were asked about their sexual GBV experiences including their disclosure experiences, if applicable. Results indicated that sexual violation (i.e., peeping or inappropriate touching) was found among both girls and boys. Sexual coercion (i.e., forced sex) was more prevalent than transactional sex (i.e., trading sex for grades or money). Both sexual coercion and transactional sex were reported by more girls than boys, yet the rates for the most severe form of sexual violence (i.e., sexual coercion) were high for both girls (30%) and boys (22%). When students were asked if they told anyone, 38% reported that they did disclose their experiences. This study contributes to a small but growing body of research to document the prevalence and types of sexual violence against children in Liberia. Consistent with other studies, the evidence shows that sexual violence against boys and girls is occurring at alarming rates.
Collapse
Affiliation(s)
- Judy L Postmus
- Center on Violence Against Women & Children, Rutgers University, School of Social Work, 390 George Street, Suite 408, New Brunswick, NJ 08901, USA
| | - Gretchen L Hoge
- Center on Violence Against Women & Children, Rutgers University, School of Social Work, 390 George Street, Suite 408, New Brunswick, NJ 08901, USA
| | - Rebecca Davis
- Center for International Social Work, Rutgers University, School of Social Work, 536 George Street, New Brunswick, NJ 08901, USA
| | - Laura Johnson
- Center on Violence Against Women & Children, Rutgers University, School of Social Work, 390 George Street, Suite 408, New Brunswick, NJ 08901, USA
| | - Elizabeth Koechlein
- United Nations Research Institute for Social Development, Palais des Nations, 1211 Geneva 10, Switzerland
| | - Samantha Winter
- Center on Violence Against Women & Children, Rutgers University, School of Social Work, 390 George Street, Suite 408, New Brunswick, NJ 08901, USA
| |
Collapse
|
788
|
Meinck F, Cluver LD, Boyes ME. Household illness, poverty and physical and emotional child abuse victimisation: findings from South Africa's first prospective cohort study. BMC Public Health 2015; 15:444. [PMID: 25924818 PMCID: PMC4418047 DOI: 10.1186/s12889-015-1792-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Physical and emotional abuse of children is a large scale problem in South Africa, with severe negative outcomes for survivors. Although chronic household illness has shown to be a predictor for physical and emotional abuse, no research has thus far investigated the different pathways from household chronic illness to child abuse victimisation in South Africa. Methods Confidential self-report questionnaires using internationally utilised measures were completed by children aged 10-17 (n = 3515, 56.7% female) using door-to-door sampling in randomly selected areas in rural and urban locations of South Africa. Follow-up surveys were conducted a year later (96.7% retention rate). Using multiple mediation analyses, this study investigated direct and indirect effects of chronic household illness (AIDS or other illness) on frequent (monthly) physical and emotional abuse victimisation with poverty and extent of the ill person’s disability as hypothesised mediators. Results For children in AIDS-ill families, a positive direct effect on physical abuse was obtained. In addition, positive indirect effects through poverty and disability were established. For boys, a positive direct and indirect effect of AIDS-illness on emotional abuse through poverty were detected. For girls, a positive indirect effect through poverty was observed. For children in households with other chronic illness, a negative indirect effect on physical abuse was obtained. In addition, a negative indirect effect through poverty and positive indirect effect through disability was established. For boys, positive and negative indirect effects through poverty and disability were found respectively. For girls, a negative indirect effect through poverty was observed. Conclusions These results indicate that children in families affected by AIDS-illness are at higher risk of child abuse victimisation, and this risk is mediated by higher levels of poverty and disability. Children affected by other chronic illness are at lower risk for abuse victimisation unless they are subject to higher levels of household disability. Interventions aiming to reduce poverty and increase family support may help prevent child abuse in families experiencing illness in South Africa. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1792-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
| | - Lucie D Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. .,Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa.
| | - Mark E Boyes
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK. .,Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
| |
Collapse
|
789
|
Ji K, Finkelhor D. A meta-analysis of child physical abuse prevalence in China. CHILD ABUSE & NEGLECT 2015; 43:61-72. [PMID: 25498804 DOI: 10.1016/j.chiabu.2014.11.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/15/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
This study estimated the prevalence of child physical abuse in China, compared Chinese prevalence with international and Asian estimates, and ascertained whether some differences in sample characteristics and methodological factors (e.g., time prevalence, definitional or regional difference) help explain variations in Chinese rates. Based on a meta-analysis of 47 studies found in English- and Chinese-language peer-reviewed journals that involved general populations of students or residents reporting child physical abuse prior to age 18, the life time prevalence of any child physical abuse in China was estimated at 36.6% (95% CI: 30.4-42.7), which was significantly higher than either the international or the Asian estimate in Stoltenborgh et al.'s (2013) study. Chinese prevalence was estimated at 43.1% (95% CI: 36.6-52.5) for minor physical abuse, 26.6% (95% CI: 21.4-31.8) for severe physical abuse, and 7.8% (95% CI: 5.0-10.5) for very severe physical abuse. Subgroup analysis found a significant difference between lifetime and 12-month or less prevalence only for minor physical abuse. The prevalence of any and minor child physical abuse in mainland China was significantly higher than that in non-mainland China. The mainland and non-mainland difference was significant even controlling for definitional and methodological factors as well as sample characteristics. The findings suggested the need to develop educational programs to promote non-violent parenting particularly in mainland China.
Collapse
Affiliation(s)
- Kai Ji
- Crimes against Children Research Center, University of New Hampshire, Durham, NH, USA
| | - David Finkelhor
- Crimes against Children Research Center, University of New Hampshire, Durham, NH, USA
| |
Collapse
|
790
|
Collin-Vézina D, De La Sablonnière-Griffin M, Palmer AM, Milne L. A preliminary mapping of individual, relational, and social factors that impede disclosure of childhood sexual abuse. CHILD ABUSE & NEGLECT 2015; 43:123-34. [PMID: 25846196 DOI: 10.1016/j.chiabu.2015.03.010] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 03/10/2015] [Accepted: 03/16/2015] [Indexed: 05/08/2023]
Abstract
Uncovering the pathways to disclosures of child sexual abuse (CSA) and the factors influencing the willingness of victims to talk about the abuse is paramount to the development of powerful practice and policy initiatives. Framed as a long interview method utilizing a grounded theory approach to analyze data, the objective of the current study was to provide a preliminary mapping of the barriers to CSA disclosures through an ecological systemic lens, from a sample of 67 male and female CSA adult survivors, all of whom had recently received counselling services. The current project led to the identification of three broad categories of barriers that were each comprised of several subthemes, namely: Barriers from Within (internalized victim-blaming, mechanisms to protect oneself, and immature development at time of abuse); Barriers in Relation to Others (violence and dysfunction in the family, power dynamics, awareness of the impact of telling, and fragile social network); and Barriers in Relation to the Social World (labelling, taboo of sexuality, lack of services available, and culture or time period). This study points to the importance of using a broad ecological framework to understand the factors that inhibit disclosure of CSA, as barriers to disclosure do not constrain solely the victims. Results are discussed in light of their implications for research, prevention and intervention programs, and social policies and media campaigns, as the burden is on the larger community to create a climate of safety and transparency that makes the telling of CSA possible.
Collapse
Affiliation(s)
- Delphine Collin-Vézina
- McGill University, School of Social Work, Centre for Research on Children and Families, 3506, University, Suite 321A, Montreal, Quebec H3A 2A7, Canada
| | | | - Andrea M Palmer
- McGill University, School of Social Work, Centre for Research on Children and Families, Canada
| | - Lise Milne
- McGill University, School of Social Work, Centre for Research on Children and Families, Canada
| |
Collapse
|
791
|
Jewkes R, Flood M, Lang J. From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls. Lancet 2015; 385:1580-9. [PMID: 25467578 DOI: 10.1016/s0140-6736(14)61683-4] [Citation(s) in RCA: 297] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Violence perpetrated by and against men and boys is a major public health problem. Although individual men's use of violence differs, engagement of all men and boys in action to prevent violence against women and girls is essential. We discuss why this engagement approach is theoretically important and how prevention interventions have developed from treating men simply as perpetrators of violence against women and girls or as allies of women in its prevention, to approaches that seek to transform the relations, social norms, and systems that sustain gender inequality and violence. We review evidence of intervention effectiveness in the reduction of violence or its risk factors, features commonly seen in more effective interventions, and how strong evidence-based interventions can be developed with more robust use of theory. Future interventions should emphasise work with both men and boys and women and girls to change social norms on gender relations, and need to appropriately accommodate the differences between men and women in the design of programmes.
Collapse
Affiliation(s)
- Rachel Jewkes
- Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa.
| | - Michael Flood
- Department of Sociology, University of Wollongong, Wollongong, NSW, Australia
| | - James Lang
- United Nations Development Programme, Asia-Pacific Regional Centre, Bangkok, Thailand
| |
Collapse
|
792
|
Michalopoulos LTM, Murray LK, Kane JC, Skavenski van Wyk S, Chomba E, Cohen J, Imasiku M, Semrau K, Unick J, Bolton PA. Testing the validity and reliability of the shame questionnaire among sexually abused girls in Zambia. PLoS One 2015; 10:e0123820. [PMID: 25879658 PMCID: PMC4399983 DOI: 10.1371/journal.pone.0123820] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 03/07/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of the current study is to test the validity and reliability of the Shame Questionnaire among traumatized girls in Lusaka, Zambia. Methods The Shame Questionnaire was validated through both classical test and item response theory methods. Internal reliability, criterion validity and construct validity were examined among a sample of 325 female children living in Zambia. Sub-analyses were conducted to examine differences in construct validity among girls who reported sexual abuse and girls who did not. Results All girls in the sample were sexually abused, but only 61.5% endorsed or reported that sexual abuse had occurred. Internal consistency was very good among the sample with alpha = .87. Criterion validity was demonstrated through a significant difference of mean Shame Questionnaire scores between girls who experienced 0–1 trauma events and more than one traumatic event, with higher mean Shame Questionnaire scores among girls who had more than one traumatic event (p = .004 for 0–1 compared to 2 and 3 events and p = .016 for 0–1 compared to 4+ events). Girls who reported a history of witnessing or experiencing physical abuse had a significantly higher mean Shame Questionnaire score than girls who did not report a history of witnessing or experiencing physical abuse (p<.0001). There was no significant difference in mean Shame Questionnaire score between girls who reported a sexual abuse history and girls who did not. Exploratory factor analysis indicated a two-factor model of the Shame Questionnaire, with an experience of shame dimension and an active outcomes of shame dimension. Item response theory analysis indicated adequate overall item fit. Results also indicate potential differences in construct validity between girls who did and did not endorse sexual abuse. Conclusions This study suggests the general utility of the Shame Questionnaire among Zambian girls and demonstrates the need for more psychometric studies in low and middle income countries.
Collapse
Affiliation(s)
- Lynn T. M. Michalopoulos
- Social Intervention Group, Global Health Research Center of Central Asia, School of Social Work, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Laura K. Murray
- Center for Refugee and Disaster Response, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jeremy C. Kane
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Stephanie Skavenski van Wyk
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Elwyn Chomba
- Ministry of Community Development, Mother Child Health (MCDMCH), Lusaka, Zambia
| | - Judith Cohen
- Center for Traumatic Stress in Children & Adolescents, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Mwiya Imasiku
- School of Medicine, University of Zambia, Lusaka, Zambia
| | - Katherine Semrau
- Center for Global Health & Development, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Jay Unick
- School of Social Work, University of Maryland, Baltimore, Maryland, United States of America
| | - Paul A. Bolton
- Center for Refugee and Disaster Response, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| |
Collapse
|
793
|
Walsh K, Zwi K, Woolfenden S, Shlonsky A. School-based education programmes for the prevention of child sexual abuse. Cochrane Database Syst Rev 2015; 2015:CD004380. [PMID: 25876919 PMCID: PMC9805791 DOI: 10.1002/14651858.cd004380.pub3] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. OBJECTIVES To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students' protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. SEARCH METHODS In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE and 11 other databases. We also searched two trials registers and screened the reference lists of previous reviews for additional trials. SELECTION CRITERIA We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias. We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. MAIN RESULTS This is an update of a Cochrane Review that included 15 trials (up to August 2006). We identified 10 additional trials for the period to September 2014. We excluded one trial from the original review. Therefore, this update includes a total of 24 trials (5802 participants). We conducted several meta-analyses. More than half of the trials in each meta-analysis contained unit of analysis errors.1. Meta-analysis of two trials (n = 102) evaluating protective behaviours favoured intervention (odds ratio (OR) 5.71, 95% confidence interval (CI) 1.98 to 16.51), with borderline low to moderate heterogeneity (Chi² = 1.37, df = 1, P value = 0.24, I² = 27%, Tau² = 0.16). The results did not change when we made adjustments using intraclass correlation coefficients (ICCs) to correct errors made in studies where data were analysed without accounting for the clustering of students in classes or schools.2. Meta-analysis of 18 trials (n = 4657) evaluating questionnaire-based knowledge favoured intervention (standardised mean difference (SMD) 0.61, 95% CI 0.45 to 0.78), but there was substantial heterogeneity (Chi² = 104.76, df = 17, P value < 0.00001, I² = 84%, Tau² = 0.10). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.66, 95% CI 0.51 to 0.81; ICC: 0.2 SMD 0.63, 95% CI 0.50 to 0.77).3. Meta-analysis of 11 trials (n =1688) evaluating vignette-based knowledge favoured intervention (SMD 0.45, 95% CI 0.24 to 0.65), but there was substantial heterogeneity (Chi² = 34.25, df = 10, P value < 0.0002, I² = 71%, Tau² = 0.08). The results did not change when adjusted for clustering (ICC: 0.1 SMD 0.53, 95% CI 0.32 to 0.74; ICC: 0.2 SMD 0.60, 95% CI 0.31 to 0.89).4. We included four trials in the meta-analysis for retention of knowledge over time. The effect of intervention seemed to persist beyond the immediate assessment (SMD 0.78, 95% CI 0.38 to 1.17; I² = 84%, Tau² = 0.13, P value = 0.0003; n = 956) to six months (SMD 0.69, 95% CI 0.51 to 0.87; I² = 25%; Tau² = 0.01, P value = 0.26; n = 929). The results did not change when adjustments were made using ICCs.5. We included three studies in the meta-analysis for adverse effects (harm) manifesting as child anxiety or fear. The results showed no increase or decrease in anxiety or fear in intervention participants (SMD -0.08, 95% CI -0.22 to 0.07; n = 795) and there was no heterogeneity (I² = 0%, P value = 0.79; n=795). The results did not change when adjustments were made using ICCs.6. We included three studies (n = 1788) in the meta-analysis for disclosure of previous or current sexual abuse. The results favoured intervention (OR 3.56, 95% CI 1.13 to 11.24), with no heterogeneity (I² = 0%, P value = 0.84). However, adjusting for the effect of clustering had the effect of widening the confidence intervals around the OR (ICC: 0.1 OR 3.04, 95% CI 0.75 to 12.33; ICC: 0.2 OR 2.95, 95% CI 0.69 to 12.61).Insufficient information was provided in the included studies to conduct planned subgroup analyses and there were insufficient studies to conduct meaningful analyses.The quality of evidence for all outcomes included in the meta-analyses was moderate owing to unclear risk of selection bias across most studies, high or unclear risk of detection bias across over half of included studies, and high or unclear risk of attrition bias across most studies. The results should be interpreted cautiously. AUTHORS' CONCLUSIONS The studies included in this review show evidence of improvements in protective behaviours and knowledge among children exposed to school-based programmes, regardless of the type of programme. The results might have differed had the true ICCs or cluster-adjusted results been available. There is evidence that children's knowledge does not deteriorate over time, although this requires further research with longer-term follow-up. Programme participation does not generate increased or decreased child anxiety or fear, however there is a need for ongoing monitoring of both positive and negative short- and long-term effects. The results show that programme participation may increase the odds of disclosure, however there is a need for more programme evaluations to routinely collect such data. Further investigation of the moderators of programme effects is required along with longitudinal or data linkage studies that can assess actual prevention of child sexual abuse.
Collapse
Affiliation(s)
- Kerryann Walsh
- Queensland University of TechnologyFaculty of EducationVictoria Park RoadBrisbaneQueenslandAustralia4059
| | - Karen Zwi
- University of New South Wales & Sydney Children's HospitalSchool of Women's and Children's HealthSydney Children's HospitalHigh Street RandwickSydneyNSWAustralia2031
| | - Susan Woolfenden
- Sydney Children's Community Health CentreSydney Children's Hospitals Networkcnr Avoca and Barker StRandwickNSWAustralia2031
| | - Aron Shlonsky
- The University of MelbourneDepartment of Social Work, Melbourne School of Health SciencesAlan Gilbert Building161 Barry Street, CarltonMelbourneVictoriaAustralia3053
| | | |
Collapse
|
794
|
Daigneault I, Hébert M, McDuff P, Michaud F, Vézina-Gagnon P, Henry A, Porter-Vignola É. Effectiveness of a sexual assault awareness and prevention workshop for youth: A 3-month follow-up pragmatic cluster randomization study. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2015. [DOI: 10.3138/cjhs.2626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sexual violence and other forms of sexual assault and coercion have a pervasive presence in the lives of many young people. School and community services and programs that are geared toward sexual assault awareness and prevention of sexual violence have thus been offered to youth in high-school settings. The goal of the present study was to assess the effectiveness of one such sexual assault awareness and prevention workshop designed and presented specifically for male and female youth aged 15 to 17 over a three month follow-up. A sample of 794 youth recruited from two schools were randomly assigned to two experimental conditions. Participants completed self-report outcome measures that assessed their knowledge of sexual assault, awareness of available resources, attitudes toward sexual assault, ability to identify sexual assault and to respond appropriately to a disclosure of sexual assault as well as sexual victimization. The data were analyzed using random coefficient analyses, which revealed that the workshop was effective in improving general knowledge regarding sexual assault, awareness of resources in the event of experiencing sexual assault, and attitudes regarding sexual assault. Participation in the program was also shown to enhance youth's ability to recognize sexual assault in a dating context and to diminish hypothetical responses that deny or minimize sexual assault in a dating situation disclosed by a peer. With one exception, these improvements were similar for male and female youth. The results indicate that the workshop was effective and that revision of some aspects of the implementation could further maximize its impact.
Collapse
Affiliation(s)
- Isabelle Daigneault
- Psychology Departement Université de Montréal, Montréal QC
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Interdisciplinary research center for conjugal problems and sexual abuse. University. Montréal, Montréal QC
- Équipe Violence Sexuelle et Santé (EVISSA). Sexual violence and Health Team. Department of Sexology, University du Quebec a Montréal, Montréal QC
| | - Martine Hébert
- Sexology Departement, Université du Québec a Montréal, Montréal QC
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Interdisciplinary research center for conjugal problems and sexual abuse. University. Montréal, Montréal QC
- Équipe Violence Sexuelle et Santé (EVISSA). Sexual violence and Health Team. Department of Sexology, University du Quebec a Montréal, Montréal QC
| | - Pierre McDuff
- Psychology Departement Université de Montréal, Montréal QC
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Interdisciplinary research center for conjugal problems and sexual abuse. University. Montréal, Montréal QC
| | - Francine Michaud
- Agence de la santé et des services sociaux de la Capitale-Nationale, Québec QC
| | - Pascale Vézina-Gagnon
- Psychology Departement Université de Montréal, Montréal QC
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Interdisciplinary research center for conjugal problems and sexual abuse. University. Montréal, Montréal QC
- Équipe Violence Sexuelle et Santé (EVISSA). Sexual violence and Health Team. Department of Sexology, University du Quebec a Montréal, Montréal QC
| | - Anne Henry
- Psychology Departement Université de Montréal, Montréal QC
| | - Élyse Porter-Vignola
- Psychology Departement Université de Montréal, Montréal QC
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Interdisciplinary research center for conjugal problems and sexual abuse. University. Montréal, Montréal QC
| |
Collapse
|
795
|
Bogolyubova O, Skochilov R, Smykalo L. Childhood victimization experiences of young adults in St. Petersburg, Russia. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:1153-1167. [PMID: 25012953 DOI: 10.1177/0886260514539849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to assess the prevalence of childhood victimization experiences in a sample of young adults in St. Petersburg, Russia. The study sample included 743 students aged 19 to 25 from 15 universities in St. Petersburg, Russia. All of the study participants completed a reliable questionnaire assessing the following types of childhood victimization: conventional crime, child maltreatment, peer victimization, sexual victimization, and witnessing violence. Participation in the study was anonymous. High rates of victimization and exposure to violence were reported by the study participants. The majority of the sample experienced at least one type of victimization during childhood or adolescence, and poly-victimization was reported frequently. The most common type of victimization reported was peer or sibling assault (66.94%), followed by witnessing an assault without weapon (63.91%), personal theft (56.19%), vandalism (56.06%), and emotional bullying (49.99%). Sexual assault by a known adult was reported by 1.45% males and 5.16% of females. This study provides new information on the scope of childhood victimization experiences in Russia. Further research is warranted, including epidemiological research with representative data across the country and studies of the impact of trauma and victimization on mental health and well-being of Russian adults and children.
Collapse
|
796
|
Feng JY, Chang YT, Chang HY, Fetzer S, Wang JD. Prevalence of different forms of child maltreatment among Taiwanese adolescents: a population-based study. CHILD ABUSE & NEGLECT 2015; 42:10-19. [PMID: 25477233 DOI: 10.1016/j.chiabu.2014.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies.
Collapse
Affiliation(s)
- Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Yi-Ting Chang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Yi Chang
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - Susan Fetzer
- Department of Nursing, University of New Hampshire, NH, USA
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| |
Collapse
|
797
|
Euser S, Alink LRA, Tharner A, van IJzendoorn MH, Bakermans-Kranenburg MJ. The Prevalence of Child Sexual Abuse in Out-of-home Care: Increased Risk for Children with a Mild Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:83-92. [PMID: 25779085 DOI: 10.1111/jar.12160] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children without disabilities in out-of-home care have a higher risk of child sexual abuse [CSA (Euser et al. 2013)]. In this study, we examined the year prevalence of CSA in out-of-home care for children with a mild intellectual disability, and compared it with the prevalence in out-of-home care for non-disabled children and children in the general population. MATERIALS AND METHODS Professionals (N = 104) from out-of-home care facilities reported cases of CSA that occurred in 2010 for the children they worked with (N = 1650). RESULTS In out-of-home care for children with a mild intellectual disability, 9.8 per 1000 children were victims of CSA. This prevalence was significantly higher than in regular out-of-home care and in the general population. CONCLUSION Children with a mild intellectual disability in out-of-home care have an increased risk of CSA. Adequate education and support for both children and caregivers is necessary to recognize and prevent further sexual abuse.
Collapse
Affiliation(s)
- Saskia Euser
- Centre for Child and Family Studies, Leiden University, Leiden, the Netherlands
| | - Lenneke R A Alink
- Centre for Child and Family Studies, Leiden University, Leiden, the Netherlands
| | - Anne Tharner
- Centre for Child and Family Studies, Leiden University, Leiden, the Netherlands
| | | | | |
Collapse
|
798
|
Nadan Y, Spilsbury JC, Korbin JE. Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research. CHILD ABUSE & NEGLECT 2015; 41:40-48. [PMID: 25466427 DOI: 10.1016/j.chiabu.2014.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/17/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review "Sociocultural Factors in Child Maltreatment" (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality - the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) - as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework.
Collapse
Affiliation(s)
- Yochay Nadan
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
| | - James C Spilsbury
- Center for Clinical Investigation, Case School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Jill E Korbin
- Department of Anthropology and, Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
799
|
Zhu Q, Gao E, Cheng Y, Chuang YL, Zabin LS, Emerson MR, Lou C. Child Sexual Abuse and Its Relationship With Health Risk Behaviors Among Adolescents and Young Adults in Taipei. Asia Pac J Public Health 2015; 27:643-51. [DOI: 10.1177/1010539515573075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study explores the association of child sexual abuse (CSA) with subsequent health risk behaviors among a cross-section of 4354 adolescents and young adults surveyed in urban and rural Taipei. Descriptive analysis and logistic regressions were employed. The overall proportion of CSA was 5.15%, with more females (6.14%) than males (4.16%) likely to experience CSA. CSA was differently associated with multiple adverse health outcomes, after adjusting other factors, such as age, residence, economic status, education, employment status, and household instability. Both males and females with CSA experience were more likely to report drinking, gambling, and suicidal ideation compared with those who had no history of CSA. However, the significant association between CSA and smoking, fighting, and suicidal attempt was not observed among females. Effective interventions are needed to reduce CSA and its adverse effects on adolescent well-being.
Collapse
Affiliation(s)
- Qianqian Zhu
- Fudan University, Shanghai, People’s Republic of China
- Shanghai Institute of Planned Parenthood Research, Shanghai, People’s Republic of China
| | - Ersheng Gao
- Shanghai Institute of Planned Parenthood Research, Shanghai, People’s Republic of China
| | - Yan Cheng
- Shanghai Institute of Planned Parenthood Research, Shanghai, People’s Republic of China
| | - Yi-Li Chuang
- Bureau of Health Promotion, Department of Health, Taipei, Taiwan
| | - Laurie S. Zabin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark R. Emerson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chaohua Lou
- Shanghai Institute of Planned Parenthood Research, Shanghai, People’s Republic of China
| |
Collapse
|
800
|
Vaillancourt-Morel MP, Godbout N, Labadie C, Runtz M, Lussier Y, Sabourin S. Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse. CHILD ABUSE & NEGLECT 2015; 40:48-59. [PMID: 25435106 DOI: 10.1016/j.chiabu.2014.10.024] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/24/2014] [Accepted: 10/06/2014] [Indexed: 06/04/2023]
Abstract
The main objectives of this study were to test a theory-based mediation model in which the relation between childhood sexual abuse (CSA) and dyadic adjustment is mediated through adult sexual avoidance and sexual compulsivity and to examine the gender-invariance of this model. A sample of 686 adults currently involved in a close relationship completed online self-report computerized questionnaires. Prevalence of CSA was 20% in women and 19% in men. In line with our hypotheses, path analyses and structural equation analyses showed that, for both women and men, CSA was associated with more sexual avoidance and sexual compulsivity, which, in turn, predicted lower couple adjustment. Overall, these findings suggest that both avoidant and compulsive sexuality are relevant intervention targets with couples in which one or both partners are CSA survivors.
Collapse
Affiliation(s)
| | - Natacha Godbout
- Université du Québec à Montréal, Département de sexologie, 455 René-Levesque Est, local W-R165, Montréal, QC, Canada H2L 4Y2
| | - Chloé Labadie
- Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec, QC, Canada G1V 0A6
| | - Marsha Runtz
- University of Victoria, Department of Psychology, P.O. Box 2050, Victoria, BC, Canada V8W 3P5
| | - Yvan Lussier
- Université de Québec à Trois-Rivières, Département de psychologie, C.P. 500, Trois-Rivières, QC, Canada G9A 5H7
| | - Stéphane Sabourin
- Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec, QC, Canada G1V 0A6
| |
Collapse
|