Psychosocial and cognitive functioning of children with specific profiles of maltreatment

Depression in Children and Adolescents Involved in the Child Welfare System

Child maltreatment presents a significant public health challenge and is strongly associated with development of depression during childhood and adolescence. Not all abused or neglected children are in the child welfare system, but most children in the foster care system have a history of maltreatment. Involvement with the child welfare system presents an additional risk for psychopathology. The role of child maltreatment and child welfare involvement in development of depression in children and adolescents is reviewed and effective treatments are discussed. Clinicians working with foster children must collaborate with care providers and other stakeholders to enhance the child's placement permanence.

Clinical outcomes and childhood trauma in bipolar disorder: A community sample of young adults

Childhood trauma is a complex experience, much reported by subjects with bipolar disorder. There are still few studies that assess its consequences in a community sample of bipolar in early stage. The aim of the present study is to assess the association between childhood trauma and clinical outcomes, including the global functioning, in a community sample of young adults with bipolar disorder. This is a cross-sectional study with a community sample of subjects with bipolar disorder, from 23 to 30 years old, with and without childhood trauma. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The functioning was assessed by Functioning Assessment Short Test (FAST). Ninety subjects with bipolar disorder were included in the study (30 with childhood trauma and 60 without childhood trauma). Young adults with bipolar disorder and childhood trauma showed higher prevalence of current suicide risk, higher severity of depressive symptoms, and higher functioning impairment as compared to subjects with bipolar disorder without childhood trauma. The childhood trauma experiences appear to be an environmental risk factor for worse clinical outcomes and higher functional impairment.

Extending poly-victimization theory: Differential effects of adolescents' experiences of victimization on substance use disorder diagnoses upon treatment entry

BACKGROUND

Although victimization is a known contributor to the development of substance use disorders, no research has simultaneously examined how characteristics of victimization experienced over time, such as the type of abuse, the presence of poly-victimization, closeness to perpetrator(s), life threat or fear, and negative social reactions to disclosing victimization, cluster into profiles that predict substance use disorders.

OBJECTIVE

The aim of the current study is to assess how profiles of victimization and trauma characteristics are associated with substance use disorders and assess potential gender differences.

PARTICIPANTS AND SETTING

Participants were 20,092 adolescents entering substance use treatment.

METHODS

We used latent class and multi-group latent class analysis to extract classes of victimization and associated characteristics. Emergent classes were used to predicted substance use disorder status at treatment intake.

RESULTS

Five classes were extracted: poly-victimization + high harmful trauma characteristics, sexual abuse + negative social reaction and perceived life threat, emotional abuse + trusted perpetrator, physical abuse and low all. Similar classes were found for the multi-group model. In both the overall and female-specific models, the poly-victimization + high harmful trauma characteristics class was more severe than all other classes in terms of opioid use disorder, tobacco use disorder, and dual diagnosis. Other class differences were found across gender.

CONCLUSIONS

Adolescents entering treatment can be distinguished by their profiles of victimization experiences and associated characteristics, and these profiles evidence different associations with substance use disorder diagnoses. Results point to a need for more nuanced assessment of victimization experiences and gender-specific interventions.

Identifying maltreatment subgroups with patterns of maltreatment subtype and chronicity: A latent class analysis approach

Maltreatment experiences are complex, and it is difficult to characterize the heterogeneity in types of maltreatment. Subtypes, such as emotional maltreatment, sexual abuse, physical abuse, and neglect commonly co-occur and may persist across development. Therefore, treating individual maltreatment subtypes as independently occurring is not representative of the nature of maltreatment as it occurs in children's lives. Latent class analysis (LCA) is employed herein to identify subgroups of maltreated children based on commonalities in maltreatment subtype and chronicity. In a sample of 674 low-income urban children, 51.6% of whom experienced officially documented maltreatment, our analyses identified four classes of children, with three distinct classes based on maltreatment subtypes and chronicity, and one group of children who did not experience maltreatment. The largest class of maltreated children identified was the chronic, multi-subtype maltreatment class (57% of maltreated children); a second class was characterized by only neglect in a single developmental period (31% of maltreated children), and the smallest class was characterized by a single subtype of maltreatment (emotional maltreatment, physical, or sexual abuse) occurring in a single developmental period (12% of maltreated children). Characterization of these groups confirms the overlapping nature of maltreatment subtypes. There were notable differences between latent classes on child behavioral and socio-emotional outcomes measured by child self-report and camp counselors report during a one-week summer camp. The largest differences were between the non-maltreated class and the chronic maltreatment class. Children who experienced chronic, multi-subtype maltreatment showed higher levels of externalizing behavior, emotion dysregulation, depression, and anxiety.

The co-occurrence of adverse childhood experiences among children investigated for child maltreatment: A latent class analysis

Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N=5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2-5 (preschool age), 6-10 (school age), and 11-18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed.

Associations of specific and multiple types of childhood abuse and neglect with personality pathology among adolescents referred for mental health services

The present study investigated the unique association between five types of childhood abuse and neglect and 18 lower-order dimensions of personality pathology, and using latent classes analysis (LCA) explored patterns of childhood abuse or neglect experiences. Further differences across latent classes on personality pathology traits, personality disorder symptom count and a diagnosis of personality disorder were examined. Participants were 178 adolescents and young adults (12-22 years; M = 16.02, 65.7% girls; 83% Axis I/II disorder) from the Netherlands referred for mental health services. Emotional abuse was uniquely associated with 11 personality pathology traits; sexual and physical were associated with three and four traits, respectively. LCA yielded three classes, namely, severe maltreatment (class 1), low-moderate emotional maltreatment and sexual abuse (class 2), and least maltreatment (class 3). After controlling for age, gender, presence of any Axis I disorder, multivariate analysis of covariance indicated that classes with more types of maltreatment experiences and higher severity (classes 1 and 2) endorsed more personality pathology traits, personality disorder symptom counts and a diagnosis of a personality disorder than the least maltreatment class. Findings have theoretical and clinical implications entailing the identification of patterns of maltreatment types and related personality pathology traits among youth.

Is childhood maltreatment associated with murderous ideation and behaviors in adolescents in China?

Previous research has revealed associations between childhood maltreatment (CM) and adverse health behaviors. However, little is known about the relationship between CM and adolescent murderous ideation and behaviors. A total of 5726 middle and high school students completed the Childhood Trauma Questionnaire-Short Form and the Murderous Ideation and Behaviors Questionnaire. The findings revealed that the prevalence rates for murderous ideation, plans, preparation, and attempts were 9.9%, 2.8%, 1.3%, and 0.6%, respectively. The results of multinomial logistic regression models indicated that adolescents who experienced CM were more likely to exhibit murderous ideation and behaviors, with adjusted odds ratios (AORs) ranging from 2.55 to 22.31. Additionally, a significant dose-response relationship was found between the number of CM types experienced and murderous ideation and behaviors (AORs ranging from 1.52 to 2.45). The odds of participants who had experienced three or five types of CM were significantly associated with murderous ideation and behaviors, with AORs ranging from 4.55 to 28.30 and from 5.26 to 85.45, respectively. The findings highlighted that adolescents who engaged in murderous ideation and behaviors were more likely to have a personal history of CM and revealed a dose-response relationship between the number of CM types and murderous ideation and behaviors.

Executive functions and clinical symptoms in children exposed to maltreatment

There is evidence of an association between childhood maltreatment and lifelong cognitive impairment. Few studies investigate cognitive functioning in maltreated children. The objective of this study was to investigate whether there are differences in executive processing between maltreated and nonmaltreated children. Additionally, clinical symptoms were compared between groups and possible associations between clinical symptoms, and deficits in executive functions were investigated. The sample consisted of 55 children (8-12 years), 30 with a history of maltreatment and 25 with no history of maltreatment. An interview was conducted with the child's legal guardian and instruments were administered: Juvenile Victimization Questionnaire (JVQ), Child Behavior Checklist (CBCL), and Spence Children's Anxiety Scale (SCAS). The following clinical instruments were administered to the children: JVQ, Trauma Symptom Checklist for Children (TSCC), and Children's Depression Inventory (CDI). Children underwent neuropsychological assessment. Data were analyzed by comparing the groups for clinical and cognitive variables. Differences were found between the groups in all executive functions. Most clinical symptomatology scales showed differences between the groups. Few associations were found between clinical and executive impairment profiles. Cognitive stimulation interventions, focused on inhibitory control, should be proposed in combination with psychotherapy.

How are parental functioning and single parenthood associated with court outcomes? An analysis of child protection cases

Impaired parental functioning and single parenthood are considered risk factors for child maltreatment and being involved in the child protection context. Past research has shown that an impaired mental functioning and being a single parent are indicators of limited parenting resources. These risk factors are likely to be considered by family judges, which might lead to more intrusive court decisions concerning parental custody. To date, court data have rarely been investigated. The present study examined parental mental health and single parenthood using data from family law proceedings. The role of the fathers has been understudied and the few existing studies yielded contradictory results with respect to fathers' involvement as risk or protective factor. Therefore, the study included both fathers' data and mothers' data. A total of 220 child protection court files with 343 affected children were coded using a category system. Parental mental health was coded as parental functioning in daily life and was significantly associated with the court outcome. Multilevel mediation analyses showed a significant indirect effect of maternal functioning on the intrusiveness of the court decisions via child maltreatment. Single motherhood moderated the effect: The indirect effect was more pronounced for single mothers. This study contributes to a better understanding of the population getting before court and the judicial process. Psychological attributes do play a role in the decision-making of judges; and taking the role of the fathers into account is necessary.

Child Abuse and Neglect

Physical, sexual, and emotional abuse and various forms of neglect of children are associated with substantially increased risk for concurrent and subsequent psychopathology and are among the common problems encountered by clinicians in many clinical settings. Such cases pose additional challenges for clinicians because of the many complex family and system forces that engulf these children and their families. Assessing maltreated children generally requires more time than evaluations of children who have not experienced maltreatment. Young children, who experience the highest rates of maltreatment, present especially complex assessments because they are so dependent upon their caregiving environments. Treatment of psychopathology associated with maltreatment, which is often multimodal, requires addressing a variety of external factors that may perpetuate or exacerbate symptoms and impaired functioning. We suggest that the more clinicians understand the different cultures of the legal and child protective services systems will help them advocate more effectively for maltreated children's bests interests so that the complexity of their problems is matched by the comprehensiveness of our efforts to minimize their suffering, enhance their development, and promote their competence.

Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years

OBJECTIVE

Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study.

METHODS

Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census-defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models.

RESULTS

Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled 'misconduct risk' ( N = 4368; 6.5%); (2) 'pervasive risk' ( N = 2668; 4.0%); (3) 'mild generalised risk' ( N = 7822; 11.6%); and (4) 'no risk' ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates.

CONCLUSION

Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

Social Cognition, Child Neglect, and Child Injury Risk: The Contribution of Maternal Social Information Processing to Maladaptive Injury Prevention Beliefs Within a High-Risk Sample

Objective

Inadequate supervision has been linked to children's injuries. Parental injury prevention beliefs may play a role in supervision, yet little theory has examined the origins of such beliefs. This study examined whether mothers who perpetrated child neglect, who as a group provide inadequate supervision, have more maladaptive beliefs. Then, it tested a social information processing (SIP) model for explaining these beliefs.

Methods

SIP and injury prevention beliefs were assessed in disadvantaged mothers of preschoolers (N  =  145), half with child neglect histories.

Results

The neglect group exhibited significantly more maladaptive injury prevention beliefs than comparisons. As predicted, SIP was linked to beliefs that may increase injury risk, even after accounting for relevant sociodemographic variables.

Conclusions

Findings support the link of beliefs to injury risk and suggest that specific cognitive problems may underlie these beliefs. Future work should further validate this model, which may inform enhancements to prevention efforts.

Polyvictimization and externalizing symptoms in foster care children: The moderating role of executive function

Prior research has identified the role of childhood maltreatment in externalizing problems and executive function (EF) deficits, but minimal work has been done to characterize the effects of co-occurring maltreatment types, defined as polyvictimization. Here, we sought to characterize the association between polyvictimization and externalizing problems in a sample of foster care children aged 3-4 years (N = 84) and examine how EF may mediate or moderate that relationship. A moderation model was supported in that only polyvictimized children with EF scores 1.62 or more standard deviations below the mean were at heightened risk for clinically severe externalizing problems, while no association between polyvictimization and externalizing problems were observed for children who scored at the mean or above on the EF measure. Findings highlight that EF may serve as a resilience factor indicating that individual differences in polyvictimized children's EF skills help to predict variability in externalizing problems. Future research on designing and optimizing intervention programs that target EF skills may mitigate the development of maladaptive outcomes for polyvictimized children.

Kindesmisshandlung bei Pflegekindern

Zusammenfassung. Theoretischer Hintergrund: Pflegekinder erleben signifikant mehr Misshandlung und Vernachlässigung als andere Kinder und leiden häufiger unter deren langfristigen Auswirkungen. Methode: In dem vom BMBF geförderten Forschungsprojekt GROW&TREAT wurden 94 Pflegekinder hinsichtlich der Auswirkungen unterschiedlicher Misshandlungsformen auf ihre Entwicklung untersucht. Als Vergleichsstichprobe dienten 157 in der Herkunftsfamilie lebende Kinder ohne bekannte Misshandlungserfahrung. Mithilfe standardisierter Verfahren wurden emotionale und Verhaltensprobleme, die Beziehungsgestaltung zwischen den Kindern und ihren (Pflege–) Eltern, sowie die kognitive Entwicklung der Kinder erfasst. Ergebnisse: Die Ergebnisse zeigen wie erwartet, dass Pflegekinder eine ungünstigere Entwicklung aufweisen und dass unterschiedliche Misshandlungsformen spezifische Auswirkungen auf die kognitive Entwicklung der Kinder haben. Diskussion: Die Limitationen der Studie und Implikationen für weitere Forschungsansätze werden kritisch reflektiert.

Differential associations between patterns of child maltreatment and comorbidity in adult depressed patients

BACKGROUND

Types of maltreatment often co-occur and it is unclear how maltreatment patterns impact on comorbidity in depressed patients.

METHODS

We analysed associations of maltreatment patterns with a broad range of comorbidities assessed with diagnostic interviews in 311 treatment-seeking depressed outpatients.

RESULTS

Latent class analyses identified a "no maltreatment class" (39%), a "mild to moderate abuse and neglect class" (34%), a "severe abuse and neglect class" (14%) and a "severe neglect class" (13%). We found a dose-response association for the first three classes with comorbid disorders, a general psychopathology factor and an interpersonal insecurity factor. Patients in the "severe abuse and neglect" class had increased odds ratios (OR) of suffering from an anxiety disorder (OR 3.58), PTSD (OR 7.09), Borderline personality disorder (OR 7.97) and suicidality (OR 10.04) compared to those without child maltreatment. Patients in the "severe neglect" class did not have a higher risk for comorbidity than those in the "no maltreatment" class.

LIMITATIONS

Class sizes in the "severe abuse and neglect" and the "severe neglect" classes were small and findings should be replicated with other clinical and population samples.

CONCLUSIONS

A higher severity rather than the constellation of types of child abuse and neglect was associated with more comorbid disorders. An exception were patients reporting solely severe emotional and physical neglect who had a similar risk for comorbidity as patients without a history of child maltreatment. This may be associated with distinct learning experiences and may inform treatment decisions.

Patterns of psychological health problems and family maltreatment among United States Air Force members

OBJECTIVES

We sought to identify subgroups of individuals based on patterns of psychological health problems (PH; e.g., depressive symptoms, hazardous drinking) and family maltreatment (FM; e.g., child and partner abuse).

METHOD

We analyzed data from very large surveys of United States Air Force active duty members with romantic partners and children.

RESULTS

Latent class analyses indicated six replicable patterns of PH problems and FM. Five of these classes, representing ∼98% of survey participants, were arrayed ordinally, with increasing risk of multiple PH problems and FM. A sixth group defied this ordinal pattern, with pronounced rates of FM and externalizing PH problems, but without correspondingly high rates/levels of internalizing PH problems.

CONCLUSIONS

Ramifications of these results for intervention are discussed.

How Childhood Maltreatment Profiles of Male Victims Predict Adult Perpetration and Psychosocial Functioning

This study used latent class analysis to empirically identify subgroups of men based on their exposure to childhood maltreatment (i.e., emotional neglect and abuse, physical neglect and abuse, and sexual abuse). It then examined subgroups' differential perpetration of adult intimate partner violence (IPV; both psychological and physical), violence against peers, and sexual assault. Finally, we compared sociodemographic variables and psychosocial functioning across profiles to characterize the adult experiences of men in different maltreatment groups. The community sample consisted of 626 heterosexually active 21- to 30-year-old men. We identified four subgroups: Low Maltreatment (80% of the sample), Emotional and Physical Maltreatment (12%), Emotional and Sexual Maltreatment (4%), and Poly-Victimized (4%). The Low Maltreatment group had significantly lower IPV perpetration rates than the Emotional and Physical Maltreatment group, but groups did not significantly differ on peer violence or sexual assault perpetration rates. Overall, Poly-Victimized men were significantly worse off than the Low Maltreatment group regarding income, education level, and incarceration history. Their rates of recent anxiety and depression symptoms were also higher than those of Low Maltreatment men. Findings support the use of person-oriented techniques for deriving patterns of childhood maltreatment and how these patterns relate to psychological, behavioral, and social factors in adulthood.

FOOD NEGLECT AND INFANT DEVELOPMENT

The impact of food insecurity on child development in the general U.S. population is well-established, yet little is known about the harm of food neglect relative to other types of maltreatment. Due to the harmful physiological impact of inadequate nutrients and the social impact of food-related stress, it was hypothesized that food neglect would be more likely to impair infant cognitive and language development than physical abuse, sexual abuse, and other forms of neglect. Families of infants (N = 1,951) investigated by Child Protective Services were studied using the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II; NSCAW Research Group, 2002). Results from multivariable logistic regression models that controlled for likely confounding variables showed that the odds of impairment in cognition and language were significantly greater when food neglect was the most serious form of maltreatment. Considering that both food insecurity and child neglect are associated with poverty and parental mental health problems, it will be important for child welfare and mental health professionals to work collaboratively to better the health of these vulnerable children.

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

BACKGROUND

Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.

OBJECTIVES

To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.

STUDY DESIGN

For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.

PARTICIPANTS

Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.

INTERVENTIONS

Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.

MAIN OUTCOME MEASURES

Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.

METHODS

Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.

RESULTS

We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.

CONCLUSIONS

It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.

LIMITATIONS

Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.

FUTURE WORK

Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.

STUDY REGISTRATION

This study is registered as PROSPERO CRD42013003889.

FUNDING

The National Institute for Health Research Health Technology Assessment programme.

Latent Classes of Maltreatment: A Systematic Review and Critique

This article reviews and critically evaluates available research on latent classes of maltreatment. Three major databases (PsycINFO, Web of Knowledge, and Academic Search Complete) were used to identify studies on latent classes of maltreatment published before June 1, 2016. Of 365 potentially relevant studies, 14 met inclusion criteria for review. Our analysis was guided by the following questions: (a) What observed indicators are being used to model classes of maltreatment? (b) What are the most commonly identified classes of maltreatment? and (c) What are the predictors and outcomes of classes of maltreatment? Across the studies, findings demonstrated how person-centered methods (i.e., latent class/profile analysis) may facilitate the study of maltreatment by concurrently addressing several methodological limitations common to the study of maltreatment, while also addressing heterogeneity in experiences of maltreatment. After providing an account of existing trends within the literature employing person-centered methodology in the study of maltreatment, we offer a critique of extant research, note recent methodological developments, and make numerous recommendations for future research using person-centered approaches to understanding maltreatment.

Child strengths and placement stability among racial/ethnic minority youth in the child welfare system

While all children deserve a stable living environment, national data illustrate that many states struggle to achieve placement stability for youth in the child welfare system as a significant number of children in foster care continue to experience multiple placements while in state custody. Prior research has not considered the impact of youth protective factors or strengths on the frequency of placement changes that youth experience while in the child welfare system. This study examined the association between strengths measured at multiple levels (i.e., individual, family, and community) and placement stability among 4022 minority youth (aged 10-18) using administrative and clinical data from the Illinois child welfare system. Negative binomial regressions at the family level revealed that youth with at least one loving and supportive family member experienced 16% fewer placement changes than youth without family strengths. At the community level, youth attending schools that work to create an environment that meets its students' needs experienced 13% fewer placement changes than youth without educational supports. These findings can inform the quality of treatment and services provided to minority youth in the child welfare system.

Promoting the development of resilient academic functioning in maltreated children

This study examined (a) the extent of heterogeneity in the patterns of developmental trajectories of language development and academic functioning in children who have experienced maltreatment, (b) how maltreatment type (i.e., neglect or physical abuse) and timing of abuse explained variation in developmental trajectories, and (c) the extent to which individual protective factors (i.e., preschool attendance, prosocial skills), relationship protective factors (i.e., parental warmth, absence of past-year depressive episode, cognitive/verbal responsiveness) and community protective factors (i.e., neighborhood safety) promoted the development of resilient language/academic functioning trajectories. Longitudinal data analyses were conducted using cohort sequential Growth Mixture Model (CS-GMM) with a United States national representative sample of children reported to Child Protective Services (n=1,776). Five distinct developmental trajectories from birth to age 10 were identified including two resilient groups. Children who were neglected during infancy/toddlerhood or physically abused during preschool age were more likely to be in the poorer language/academic functioning groups (decreasing/recovery/decreasing and high decreasing) than the resilient high stable group. Child prosocial skills, caregiver warmth, and caregiver cognitive stimulation significantly predicted membership in the two resilient academic functioning groups (low increasing and high stable), after controlling for demographics and child physical abuse and neglect. Results suggest that it is possible for a maltreated child to successfully achieve competent academic functioning, despite the early adversity, and identifies three possible avenues of intervention points. This study also makes a significant contribution to the field of child development research through the novel use of CS-GMM, which has implications for future longitudinal data collection methodology.

Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model

Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999-2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n=280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.

Childhood Maltreatment and Early Developmental Vulnerabilities at Age 5 Years

This study examined associations between maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (M_age  = 5.62 years, SD = .37) drawn from the Australian state of New South Wales, using linked administrative data for the children and their parents (collected 2001-2009). Associations were estimated between (a) any maltreatment, (b) the number of maltreatment types, and (c) the timing of first reported maltreatment and vulnerability and risk status on multiple developmental domains (i.e., physical, social, emotional, cognitive, and communication). Pervasive associations were revealed between maltreatment and all developmental domains; children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple domains, relative to nonmaltreated children.

What do we know about child abuse and neglect patterns of co-occurrence? A systematic review of profiling studies and recommendations for future research

Latent class (LCA) and latent profile (LPA) analysis represent methodological approaches to identify subgroups of maltreated individuals. Although research examining child abuse and neglect (CAN) profiles is still rare, the application of person-centered techniques to clarify CAN types co-occurrence has substantially increased in recent years. Therefore, the aim of the present study was to provide a summary and critical evaluation of the findings of LCA/LPA child maltreatment research to: (a) systemize the current understanding of patterns of maltreatment across populations and (b) elucidate interactive effects of CAN types on psychosocial functioning. A search in PsychInfo, Eric, PubMed, Scopus, and Science Direct, and Google Scholar was performed. Sixteen studies examining the co-occurrence between child physical abuse, emotional abuse, sexual abuse, neglect, and/or exposure to domestic violence were identified. A critical review of the studies revealed inconsistent findings as to the number of CAN classes, but most research uncovered a poly-victimized and a low abuse group. Further, multiple victimization was associated with most adverse internalizing and externalizing outcomes, especially when sexual abuse was present. Exposure to physical and emotional abuse was frequently reported to lead to behavioural problems. Based on the present study results, we provide a set of recommendations for surpassing the current methodological and conceptual limitations in future research.

Intergenerational associations in executive function between mothers and children in the context of risk

Executive functioning (EF) is critical for school readiness and other important life skills. Previous investigations have often neglected the important influence of parental EF skills in shaping their own children's EF. This study attempted to replicate recent empirical work that has shown that maternal EF is positively related to child EF. An ecological theoretical framework was used to examine the maternal EF-child EF link in family environments characterized by significant risk and socioeconomic adversity. Data from 38 mother-child dyads revealed that larger maternal working memory capacity was associated with greater child accuracy and slower reaction times on a child-friendly Go/No-Go task of response inhibition but not on an Emotional Go/No-Go task. This finding suggests that in contexts of risk and adversity, slower reaction times, instead of reflecting weaker EF skills, might reflect an adaptive skill-that is, exercising appropriate caution and careful responding on a challenging task. Results provide additional evidence of an intergenerational link between maternal EF and child EF and yield new insights into the nature of EF in adverse environments.

The blind men and the elephant: Identification of a latent maltreatment construct for youth in foster care

Child maltreatment is a major public health concern due to its impact on developmental trajectories and consequences across mental and physical health outcomes. Operationalization of child maltreatment has been complicated, as research has used simple dichotomous counts to identification of latent class profiles. This study examines a latent measurement model assessed within foster youth inclusive of indicators of maltreatment chronicity and severity across four maltreatment types: physical, sexual, and psychological abuse, and neglect. Participants were 500 foster youth with a mean age of 12.99 years (SD=2.95years). Youth completed survey questions through a confidential audio computer-assisted self-interview program. A two-factor model with latent constructs of chronicity and severity of maltreatment revealed excellent fit across fit indices; however, the latent constructs were correlated 0.972. A one-factor model also demonstrated excellent model fit to the data (χ² (16, n=500)=28.087, p=0.031, RMSEA (0.012-0.062)=0.039, TLI=0.990, CFI=0.994, SRMR=0.025) with a nonsignificant chi-square difference test comparing the one- and two-factor models. Invariance tests across age, gender, and placement type also were conducted with recommendations provided. Results suggest a single-factor latent model of maltreatment severity and chronicity can be attained. Thus, the maltreatment experiences reported by foster youth, though varied and complex, were captured in a model that may prove useful in later predictions of outcome behaviors. Appropriate identification of both the chronicity and severity of maltreatment inclusive of the range of maltreatment types remains a high priority for future research.

Utility of the cumulative stress and mismatch hypotheses in understanding the neurobiological impacts of childhood abuse and recent stress in youth with emerging mental disorder

Childhood abuse has an enduring impact on the brain's stress system. Whether the effects of childhood abuse and adulthood stress are additive (cumulative stress hypothesis) or interactive (mismatch hypothesis) is widely disputed, however. The primary aim of this study was to test the utility of the cumulative stress and mismatch hypotheses in understanding brain and behaviour. We recruited 64 individuals (aged 14-26) from a specialised clinic for assessment and early intervention of mental health problems in young people. A T1-weighted MRI, a resting state fMRI and clinical assessment were acquired from each participant. Grey matter estimates and resting state functional connectivity (rsFC) of the hippocampus, amygdala and anterior cingulate cortex (ACC) were determined using segmentation and seed-to-voxel rsFC analyses. We explored the effects of childhood abuse and recent stress on the structure and function of the regions of interest within general linear models. Worse psychiatric symptoms were significantly related to higher levels of life time stress. Individuals with mismatched childhood and recent stress levels had reduced left hippocampal volume, reduced ACC-ventrolateral prefrontal cortex rsFC and greater ACC-hippocampus rsFC, compared to individuals with matched childhood and recent stress levels. These results show specific utility of the cumulative stress hypothesis in understanding psychiatric symptomatology and of the mismatch hypothesis in modelling hippocampal grey matter, prefrontal rsFC, and prefrontal-hippocampal rsFC. We provide novel evidence for the enduring impact of childhood abuse on stress reactivity in a clinical population, and demonstrate the distinct effects of stress in different systems. Hum Brain Mapp 38:2709-2721, 2017. © 2017 Wiley Periodicals, Inc.

Usage of a Responsible Gambling Tool: A Descriptive Analysis and Latent Class Analysis of User Behavior

Gambling is a common pastime around the world. Most gamblers can engage in gambling activities without negative consequences, but some run the risk of developing an excessive gambling pattern. Excessive gambling has severe negative economic and psychological consequences, which makes the development of responsible gambling strategies vital to protecting individuals from these risks. One such strategy is responsible gambling (RG) tools. These tools track an individual's gambling history and supplies personalized feedback and might be one way to decrease excessive gambling behavior. However, research is lacking in this area and little is known about the usage of these tools. The aim of this article is to describe user behavior and to investigate if there are different subclasses of users by conducting a latent class analysis. The user behaviour of 9528 online gamblers who voluntarily used a RG tool was analysed. Number of visits to the site, self-tests made, and advice used were the observed variables included in the latent class analysis. Descriptive statistics show that overall the functions of the tool had a high initial usage and a low repeated usage. Latent class analysis yielded five distinct classes of users: self-testers, multi-function users, advice users, site visitors, and non-users. Multinomial regression revealed that classes were associated with different risk levels of excessive gambling. The self-testers and multi-function users used the tool to a higher extent and were found to have a greater risk of excessive gambling than the other classes.

Child abuse and neglect profiles and their psychosocial consequences in a large sample of incarcerated males

Research examining child abuse and neglect (CAN) profiles among adult offender populations is lacking. Therefore, the primary aim of the present study was to address this limitation by using latent class analysis (LCA) to identify meaningful classes of individuals who have experienced physical abuse, emotional abuse, sexual abuse, as well as neglect. Another aim was to estimate the association between CAN class membership and external criteria (psychopathy factors, self-esteem, attitudes towards male sexual violence in dating relationships, child sexual abuse myth acceptance, violent offending, and age). Data were collected among a large systematically selected sample of adult male inmates (N=1261). Based on LCA, three unique classes of CAN were distinguished, including a 'low abuse' group (43.4% of the sample), a 'high physical and emotional abuse' group (51.3%), and a 'poly-victimized' group (5.3%). The analysis revealed that the CAN classes were differentially associated with affective responsiveness, cognitive responsiveness, personal self-esteem, prison self-esteem, attitudes towards male sexual violence in dating relationships, and violent offending. Findings highlight the unique nature of CAN constellations among criminal justice involved participants. The significance of the present results is discussed in relation to past and future research. Potential contributions to treatment strategies are also presented.

The distal consequences of physical and emotional neglect in emerging adults: A person-centered, multi-wave, longitudinal study

Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (Age_Mean=18.25; Age_SD=0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years. For our analyses, we used both variable-centered (mixed-level modeling) and person-centered (latent profile analysis) analyses to best understand a) how physical and emotional neglect relate to other forms of maltreatment and b) to determine physical and emotional neglect's unique impact on prospective mental health functioning. Our person-centered analyses revealed that a three-profile model provided the best solution for our data ("No Trauma," "Abuse", and "Neglect"). In longitudinal analyses, the "the neglect" group had significantly elevated scores compared to the "no trauma" group on all outcomes except alcohol use (p<0.01). Results from our variable-centered analyses showed comparable findings between physical and emotional neglect, with higher scores corresponding to elevated symptoms of depression, PTSD, illicit substance use, and cigarette use over time (p<0.01). In conclusion, our results suggest that early neglect-exposure poses a risk for the subsequent development of internalizing symptoms and substance use behaviors among emerging adults.

Children's Executive Function in a CPS-Involved Sample: Effects of Cumulative Adversity and Specific Types of Adversity

Prior research has identified the presence of executive function (EF) deficits in child protective service (CPS) involved (versus non-involved) children but minimal work has examined predictors that might explain individual differences within these CPS-involved children. Here, we sought to characterize EF in a large sample (N=694) of CPS-involved children and examine how specific adversities (physical abuse, neglect, caregiver domestic violence, and caregiver substance dependence) and cumulative adversity (at ages 0-3 and 3-6 years) predict EF (at approximately 5-6 years). It was expected that the sample would exhibit low EF overall based on previous research in maltreated children. Specific adversity and cumulative adversity analyses were largely exploratory given the limited previous work in this area. Results indicated poor EF overall, with 43.5% of children performing worse than chance. Amongst children who performed greater than chance, higher cumulative adversity, physical abuse, and caregiver substance use (at ages 3-6 years) predicted better EF. These findings join literature documenting that, within CPS-involved children, the presence of certain adversities predicts variable cognitive function. Findings highlight the potential relevance of evolutionary psychology to understanding how alterations in behavior linked to harsh and unpredictable early environments may cue accelerated brain development underlying relative cognitive advantages, within at-risk, low performing samples. Longitudinal studies are critical to determine if the relative EF advantages linked to higher adversity persist over time or result in lower EF later on, reflecting a more rapid, but overall limited, trajectory of cognitive development.

Reversal learning deficits in criminal offenders: Effects of psychopathy, substance use, and childhood maltreatment history

Deficits in reinforcement learning are presumed to underlie the impulsive and incorrigible behavior exhibited by psychopathic criminals. However, previous studies documenting reversal learning impairments in psychopathic individuals have not investigated this relationship across a continuous range of psychopathy severity, nor have they examined how reversal learning impairments relate to different psychopathic traits, such as the interpersonal-affective and lifestyle-antisocial dimensions. Furthermore, previous studies have not considered the role that childhood maltreatment and substance use may have in this specific cognitive deficit. Using a standard reversal learning task in a sample of N = 114 incarcerated male offenders, we demonstrate a significant relationship between psychopathy severity and reversal learning errors. Furthermore, we show a significant interaction between psychopathy and childhood maltreatment, but not substance use, such that individuals high in psychopathy with an extensive history of maltreatment committed the greatest number of reversal learning errors. These findings extend the current understanding of reversal learning performance among psychopathic individuals, and highlight the importance of considering childhood maltreatment when studying psychopathy.

Victimization Profiles, Non-Suicidal Self-Injury, Suicide Attempt, and Post-Traumatic Stress Disorder Symptomology: Application of Latent Class Analysis

Few studies have incorporated multiple dimensions of victimization or examined whether victimization profiles differ by gender. Consequently, the present study sought to extend prior research by using latent class analysis (LCA) to identify naturally occurring subgroups of individuals who have experienced victimization, and to test for sex differences. Data from 4,016 females and 3,032 males in the Adult Psychiatric Morbidity Survey (APMS) were analyzed. Evidence of the existence of similar victimization subtypes for both males and females emerged, with a three-class solution providing the best fit to the data for both sexes. Furthermore, the classes were labeled "low victimization" (the baseline class; Class 3), the "high victimization class" (Class 1), and "the bullying and domestic violence class" (Class 2) for both males and females. Multinomial logistic regression was used to interpret the nature of the latent classes, or groups, by estimating the associations with post-traumatic stress disorder (PTSD) dimensions, suicide attempt, and non-suicidal self-injury. Although different constellations of victimization experiences did not emerge through the gender-specific analyses, the nature of the associations between class membership and external variables differed between males and females. Findings highlight the heterogeneity of victimization experiences and their relations to functioning, and have implications for policy and practice implications.

Mental Health and Behavioral Outcomes of Sexual and Nonsexual Child Maltreatment Among Child Welfare-Involved Youth

Our research team used the nationally representative National Survey of Child and Adolescent Well-Being II to explore the differences in mental health and behavioral outcomes between children who enter the child welfare system with substantiated sexual abuse and those who enter with exclusively nonsexual maltreatment. The sample included 380 children between the ages of 8 to 17.5 who were substantiated for maltreatment (sexual and nonsexual) and had the same caregivers at both wave 1 and 2 (n = 380). Results show that the average age of children in the sample was 11 years old, and the results corroborate literature that has indicated children and youth with histories of childhood sexual abuse experience significantly more post-traumatic stress disorder symptoms than children with histories of nonsexual maltreatment. This finding held after controlling for baseline trauma symptoms and all covariates, including race, age, placement type, and caregiver characteristics. Childhood sexual abuse was not significantly related to an increase in behavioral symptoms after controlling for covariates. Implications for research and practice are offered.

Experience by children and adolescents of more than one type of maltreatment: Association of different classes of maltreatment profiles with clinical outcome variables

Most victims of child abuse have experienced more than one type of maltreatment, yet there is a lack of understanding of the impact of specific combinations of types of maltreatment. This study aimed to identify meaningful classes of maltreatment profiles and to associate them with short-term clinical outcomes. A total of 358 German children and adolescents aged 4-17 with a known history of child maltreatment were included in the study. Through interviews and questionnaires, information was obtained from participants and their primary caregivers on history of maltreatment, sociodemographics, psychopathology, level of psychosocial functioning, and health-related quality of life. Types of abuse were categorized into six major groups: sexual abuse in general, sexual abuse with penetration, physical abuse, emotional abuse, neglect, and exposure to domestic violence. A latent class analysis (LCA) was performed to determine distinct multi-type maltreatment profiles, which were then assessed for their associations with the sociodemographic and clinical outcome variables. The LCA revealed that participants could be categorized into three meaningful classes according to history of maltreatment: (1) experience of multiple types of maltreatment excluding sexual abuse (63.1%), (2) experience of multiple types of maltreatment including sexual abuse (26.5%), and (3) experience of predominantly sexual abuse (10.3%). Members of Class 2 showed significantly worse short-term outcomes on psychopathology, level of functioning, and quality of life compared to the other classes. Three distinct profiles of multiple types of maltreatment were empirically identified in this sample. Exposure to multiple types of abuse was associated with poorer outcomes.

Intergenerational transmission of maltreatment: A multilevel examination

Despite the commonly held belief that there is a high degree of intergenerational continuity in maltreatment, studies to date suggest a mixed pattern of findings. One reason for the variance in findings may be related to the measurement approach used, which includes a range of self-report and official indicators of maltreatment and both cross-sectional and longitudinal designs. This study attempted to shed light on the phenomenon of intergenerational continuity of maltreatment by examining multiple indicators of perpetration of maltreatment in young adults and multiple risk factors across different levels within an individual's social ecology. The sample included 166 women who had been placed in out-of-home care as adolescents (>85% had a substantiated maltreatment incident) and followed into young adulthood, and included three waves of adolescent data and six waves of young adult data collected across 10 years. The participants were originally recruited during adolescence as part of a randomized controlled trial examining the efficacy of the Treatment Foster Care Oregon intervention. Analyses revealed weak to modest associations among the three indicators of perpetration of maltreatment in young adulthood, that is, official child welfare records, self-reported child welfare system involvement, and self-reported maltreatment (r = .03-.51). Further, different patterns of prediction emerged as a function of the measurement approach. Adolescent delinquency was a significant predictor of subsequent self-reported child welfare contact, and young adult partner risk was a significant predictor of perpetration of maltreatment as indexed by both official child welfare records and self-reported child welfare contact. In addition, women who were originally assigned to the intervention condition reported perpetrating less maltreatment during young adulthood. Implications for measurement and interventions related to reducing the risk for intergenerational transmission of risk are discussed.

Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early

Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents' addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18–24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing EF and adopting a trauma-focused approach.

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3-17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7-16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.

Multidimensional assessment of neuroendocrine and psychopathological profiles in maltreated youth

It has been debated whether children who have experienced early life stress (ELS), such as early caregiver separation show elevated risk for stress-related psychiatric disorders and a multi-symptom psychopathological profile that is not fully reflected in categorical assessments. In this study, we investigated dimensional measures of stress-related psychopathology in children in permanent out-of-home care, taking into account potential neuroendocrine interactions. In the current study, 25 children who had been placed in permanent out-of-home care before age 3 (years) and 26 controls (aged 10.6 ± 1.75 years) were investigated with categorical (DSM-IV) and dimensional assessments (CBCL) of psychopathology and diurnal salivary cortisol levels were assessed. Semi-structured interviews (K-DIPS) revealed no significant group differences in full-scale psychiatric diagnoses, whereas dimensional assessment (CBCL) revealed significant group differences in externalizing and total problem behaviours within the clinical range for children with ELS. Only children with ELS showed a combined symptom profile of clinical-range internalizing and externalizing problems. Lower morning cortisol values and subsequent flatter decline was found in subjects with ELS children compared to controls, showing group differences in diurnal cortisol secretion. Lower morning cortisol values were associated with more problem behaviour in the ELS group. Results show that ELS children exhibited increased psychopathological symptom severity and complexity associated with lower morning cortisol levels, which was not fully reflected in categorical assessments. This highlights the importance of incorporating dimensional assessments and neurobiological factors into psychopathological evaluations of children in out-of-home care in order to facilitate early identification of children at high risk for stress-related disorders.

Lifetime Prevalence and Characteristics of Child Sexual Victimization in a Community Sample of Spanish Adolescents

The purpose of this study was to investigate the lifetime prevalence and characteristics of self-reported child sexual victimization and associations between sexual victimization and sociodemographic characteristics and victimological profiles in community adolescents in Spain. The Juvenile Victimization Questionnaire (Finkelhor, Hamby, Ormrod, & Turner, 2005) was applied to a sample of 1,105 community adolescents (M = 14.52 years, SD = 1.76). Experience of sexual victimization (with or without physical contact) was reported by 8.8% of the sample, at a mean age of 13 years old. Sexual victimization was more prevalent in girls (14.2%) and in older adolescents (10.6%). Offenders were mainly male (87.6%) and were mostly friends, neighbors, or schoolmates (52.6%). No injuries resulted from victimization (4.3%), although the percentage of penetration or attempted penetration was very high (30.6%). Only 9.3% of victims reported the incident to the police or the justice system. In regard to victimological profiles, sexual victims also experienced other forms of victimization (M = 7.16; SD = 3.39): boys reported more conventional crimes, peer and sibling victimization, and witnessing community violence than other victims, whereas sexually victimized girls reported more caregiver victimization and property crimes. Sexually victimized youth present a distinctive sociodemographic and victimological profile. Professionals need to be aware of these characteristics in order to conduct adequate prevention programs. We also need to assess a wide range of victimization experiences when treating sexual abuse victims in order to make adolescents less vulnerable to violence.

Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder

Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children.