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

Childhood trauma and factors influencing primary school teachers' reporting of child abuse: Insights from Italy

BACKGROUND

Childhood traumatic experiences can profoundly impact individuals, posing risks to the physical and psychological well-being of children and influencing their psychological development. Teachers in primary schools play a critical role in identifying and reporting suspected cases of child abuse and maltreatment (CAM), which initiates child protection interventions. However, the psychological factors that influence teachers' likelihood of reporting suspected CAM cases remain largely unexplored.

AIM

This study investigates the influence of teachers' childhood traumatic experiences and psychological factors (i.e., cognitive empathy and psychological detachment) on their reporting behavior regarding child abuse and maltreatment, addressing an important social issue.

PARTICIPANTS

The study involved 1380 primary school teachers from Italy (88.3 % female; aged 21-69, Mage 46.7, DS 10.3).

RESULTS

The results reveal that teachers with a history of childhood emotional abuse tend to report a higher number of suspected child abuse and maltreatment cases. Other forms of traumatic childhood experiences were not significantly associated with teachers' reporting suspected cases of CAM. Additionally, cognitive empathy and psychological detachment emerge as significant predictors of teachers' reporting behavior.

CONCLUSIONS

This research contributes to the existing literature by providing unique insights into actual reporting behavior within an unexplored cultural context.

Childhood Trauma and PTSD Symptoms: Disentangling the Roles of Emotion Regulation and Distress Tolerance

Research documents that a history of childhood trauma increases risk for post-traumatic stress disorder (PTSD), greater emotion regulation difficulties (ERD), and reduced distress tolerance (DT). Independent lines of research implicate ERD and DT as transdiagnostic risk factors and link them to PTSD. To elucidate how such mechanisms may influence the etiology, maintenance, and treatment of PTSD, the current study investigates the distinct mediating roles of emotion regulation and DT, exploring which explains a larger indirect effect from childhood trauma to PTSD symptom severity. Participants (N = 385, aged 18-48) who endorsed a history of childhood trauma provided retrospective report of cumulative childhood trauma exposure, and of current ERD, DT, and PTSD symptom severity. Single and dual mediation analyses were used to assess indirect effects through ERD and DT in the relation between cumulative childhood trauma exposure and current PTSD symptom severity. ERD and DT were significantly and inversely related. Higher current self-ratings of PTSD symptom severity were explained by cumulative childhood trauma through ERD (B = 0.93, p < 0.001) and DT (B = 0.50, p < 0.05). The full model explained 36% of the variance in PTSD symptom severity. Current findings provide preliminary evidence of DT and emotion regulation (with specific facets identified) as distinct mechanisms in the development of PTSD. Of clinical relevance, current findings support post-trauma processing theories that contend individuals' recovery requires accepting and learning to modulate trauma-related emotional states. Implications for methods of treatment and prevention are discussed.

Strong Father-Child Relationships and Other Positive Childhood Experiences, Adverse Childhood Experiences, and Sexual Risk Factors for HIV among Young Adults Aged 19-24 Years, Namibia, 2019: A Cross-Sectional Study

Using cross-sectional data from the 2019 Namibia Violence Against Children and Youth Survey and sex-stratified multivariable models, we assessed the associations between four different positive childhood experiences (PCEs) and having ≥3 adverse childhood experiences (ACEs), including ≥3 ACE-PCE interaction terms, and seven sexual risk factors for HIV acquisition among young adults aged 19-24 years. One PCE, having a strong father-child relationship, was inversely associated with two risk factors among women (lifetime transactional sex (OR, 0.4; 95% CI, 0.2-0.7) and recent age-disparate sexual relationships (OR, 0.3; 95% CI, 0.2-0.5)), and significantly interacted with having ≥3 ACEs for three risk factors among women (not knowing a partner's HIV status, infrequently using condoms, and ever having an STI) and one among men (having multiple sexual partners in the past year). The other PCEs were significantly associated with ≤1 HIV risk factor and had no significant interaction terms. Strong father-child relationships may reduce HIV acquisition risk and mitigate the effect of childhood adversity on HIV risk among young adults in Namibia.

Widening epidemiological data on the prevalence of child maltreatment: Validation of the German ICAST-R in a student sample and national household survey

BACKGROUND

A number of instruments for measuring child maltreatment (CM) prevalence have repeatedly been used across different countries. Although they hold the potential for providing benchmarks to tackle the gap of lacking comparability of CM prevalence across countries, contextual information about the adverse experiences such as perpetrator, chronicity, frequency, or severity are rarely covered. The ISPCAN Child Abuse Screening Tool - Retrospective (ICAST-R) covers these important dimensions. The German version increases the number of available versions to 21 different languages. Spoken by about 120 million people, German is one of the 20 most prevalent languages around the world. Moreover, the ICAST-R is intended to be used with young adults. This study further aims at adding towards the gap of psychometrics in older age groups.

METHODS

Analyses are based on both a sample of German students (n = 333) and a nationally representative household survey (n = 2515). The validation process covered six steps: (1) Analyses of missing data on single items, (2) calculation of descriptive statistics to estimate the prevalence CM as well as subjective severity and main perpetrators. (3) Structural validity of the four conceptualized subtypes of CM (neglect, physical abuse, emotional abuse and sexual abuse) was tested using confirmatory factor analyses (CFA). Next (4), equivalence testing by multigroup confirmatory factor analyses (MGCFA) on age groups was conducted within the representative sample; (5) reliability was tested by determining internal consistencies for each subscale via the McDonald's Omega, Kuder-Richardson 20 (KR-20), and Cronbach's alpha. Lastly (6), criterion validity was tested in regression models comparing depressive/anxious symptomatology for single victimization and polyvictimization.

RESULTS

The German ICAST-R yielded low missing values items in both samples. 16 % of the participants in the national household survey reported neglect, 20.3 % physical abuse, 22.2 % emotional abuse, and 8.6 % sexual abuse. Polyvictimization was prevalent with 20.6 % of subjects reporting >2 types of CM. Students in the pilot-survey reported much higher prevalence estimates than participants in the nationally representative sample. The types of CM subjectively rated as most harmful were emotional abuse and sexual abuse. In both samples, structural validity was similarly confirmed as CFA was reproducing the four conceptualized subtypes of CM with adequate fit (household survey: CFI 0.919, TLI 0.907, RMSEA 0.017, SRMR 0.046). Internal consistency achieved acceptable and comparable values for all three types of coefficients; criterion validity was established with a significant dose-response effect of CM experiences on both anxiety and depressive symptoms/diagnoses. Age dependent analyses on structural validity (MGCFA) and reliability in the household survey revealed potential weaknesses of items.

CONCLUSION

The German version of the ICAST-R both widens the possibility of international CM prevalence comparison and provides novel epidemiological data for Germany on subjective severity of CM and CM perpetrators. Even in the presence of a marked selection bias, the ICAST-R had similarly good psychometric properties in the student and nationally representative household sample. Except for issues with two items, equivalence testing was comparable across age groups.

Childhood emotional abuse and cyberbullying perpetration among Chinese university students: The chain mediating effects of self-esteem and problematic social media use

Childhood abuse has been shown to have a range of adverse physical and psychological consequences, including aggression and bullying. While researchers have explored the relationship between childhood abuse and cyberbullying, little is known about the impact of emotional abuse on cyberbullying. This study examined the link between childhood emotional abuse (CEA) and cyberbullying perpetration among university students in the Chinese cultural context, as well as the chain mediating effect of self-esteem and Problematic Social Media Use (PSMU). A total of 835 university students (18-25 years old; 293 males, 542 females; M _age = 19.44 years, SD = 1.28) completed the Childhood Trauma Questionnaire Short-Form (CTQ-SF), Rosenberg Self-Esteem Scale (RSES), the Social Media Use Questionnaire (SMUQ), and Cyberbullying Inventory (CBI). The results showed that CEA and PSMU were positively correlated with cyberbullying; self-esteem was negatively correlated with cyberbullying. Besides, self-esteem and PSMU sequentially mediated the relationship between CEA and cyberbullying perpetration. The findings indicate that childhood emotional abuse may lower self-esteem and cause problematic social media use, which increases cyberbullying perpetration.

Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care

Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.

Psychological Abuse and Social Support in Chinese Adolescents: The Mediating Effect of Self-Esteem

Although previous studies have explored relationships between psychological abuse and social support, the pathways from psychological abuse to social support are still unclear, particularly in Chinese adolescents. This cross-sectional study attempts to delineate the prevalence of psychological abuse and explore the relationships between psychological abuse, social support, and self-esteem under the Chinese cultural context. Data were obtained from 417 Chinese adolescents aged 15-18 years old. All of them completed the Child Psychological Abuse and Neglect Scale, Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). Results indicated that the prevalence of psychological abuse in Chinese adolescents was 25.66%, and psychological abuse was negatively associated with self-esteem and social support, respectively. Self-esteem partially mediated the relationships between psychological abuse and social support. Findings highlight the importance of improving self-esteem in survivors of psychological abuse for decreasing the negative effects on social support. Additionally, the significance and limitations of the results were discussed.

How Plausible are the Accounts of Child Victims of Sexual Abuse? A Study of Bizarre and Unusual Scripts Reported by Children

Child sexual abuse is a serious social problem. In reports of sexually abused children, victims' narratives often contain elements that suggest the abuse was recorded to create images for child pornography with sadistic, bizarre, or perverted details. The presence of unusual or bizarre elements in the accounts of abused children affects their credibility. The purpose of this paper is to assess the presence and prevalence of these elements in the reports of children with suspected sexual abuse and to examine their consistency with verified cases of child abuse. We conducted two studies. In Study 1, we developed a list of 16 categories of unusual and bizarre scripts reported by children in reports of sexual abuse. In Study 2, we validated the list by examining the presence of the identified scripts in the actual experiences of both individuals convicted of crimes related to child pornography and Italian police officers who were involved with child pornography as part of their official duties. Our findings suggest that children's accounts of sexual abuse should be considered credible even if they contain unusual or bizarre elements that also occur in child pornography and therefore may reflect events actually experienced rather than merely the child's fantasy or imagination.

Developing the Concept of Adverse Childhood Experiences: A Global Perspective

BACKGROUND

The relationship between health and adverse childhood experiences (ACEs) has been a major topic in the field of healthcare. In recent years, the study ACEs and health has expanded internationally.

PURPOSE

The purpose of this study was to further develop the concept of ACEs using a global perspective.

METHOD

Rodgers' Evolutionary Model guided the study. PubMed, CINAHL, and PsychINFO databases were searched. A total of 39 publications were selected for review.

FINDINGS

Development of the concept was achieved using a wide global lens. ACEs are influenced by diverse cultural, social, environmental, and economic factors that affect individuals' health worldwide.

DISCUSSION

The developed ACEs concept described in this paper includes a global perspective, adding context to the existing definition, thus broadening its application, and expanding its usefulness in international research. A clear concept for ACEs is valuable to nurses who care for children, adolescents and young adults around the world, who have suffered from ACEs and seek health care.

Physical, Emotional, and Sexual Victimization Across Three Generations: a Cross-Sectional Study

Using data gathered from grandparents (G1), parents (G2), and young adults (G3), this study examines the continuity of intergenerational victimization (physical, emotional, and sexual) across three generations. The study included data from 168 participants within three generations: grandparents, G1 (19.2% male, 80.8% female, M = 78.13 years old); parents, G2 (25.5% male, 74.5% female, M = 50.13 years old); and young adults, G3 (40% male, 60% female, M = 21.10 years old). The data is analyzed at two levels: (1) bivariate analyses to address relationships between the variables studied by Spearman's correlations, and (2) a path model to examine the intergenerational abuse simultaneously considering all variables. Overall, path modeling showed that experienced abuse demonstrated continuity from G1 to G2 and from G2 to G3. Specifically, findings indicated that grandparents' physical and psychological victimization has a direct effect on parents' sexual and physical abuse victimization, respectively. Additionally, parents' physical victimization has a direct effect on young adults' psychological and sexual victimization, while parents' psychological victimization has a direct effect on young adults' physical and sexual victimization. These findings highlight the need for preventive interventions focused on breaking intergenerational cycles of abuse.

Sexual violence victimisation among university students in Italy: a gendered intersectional quantitative approach

There is rising attention in Italy and Europe to the occurrence, consequences, and factors related to sexual violence. The focus on women as the primary victims of sexual violence has, however, left data collection and research on young men and sexual minorities in the background. Moreover, young people’s experiences of sexual abuse in the context of their relationships with peers are hardly recognised as a policy concern. The ultimate aim of this paper is to disentangle intersectionalities between gender, migration background, sexual orientation, and sexual experience in shaping the risk of experiencing sexual violence among university students in Italy.

We use data from the Sexual and Emotional LiFe of Youths (SELFY) survey carried out in Italy in 2017. Our data confirm that women and foreign-born students are at higher risk of sexual violence. Our data also support previous evidence that bisexual women are at a higher risk of sexual violence victimisation compared with peer students with other sexual orientations. Previous same-sex sexual experience is more relevant than sexual orientation in shaping the risk. The effect is gendered: the risk of sexual violence is lower for women with previous same-sex sexual experience compared with their male peers. The intersection between gender, sexual orientation, and same-sex sexual experience generate specific high-risk profiles whose needs should be targeted by support services.

Childhood abuse as a risk factor for injection drug use: A systematic review of observational studies

ISSUES

Childhood abuse is a public health challenge with lifelong impacts, including future drug use. However, previous research has been mixed regarding impacts on injection drug use. This systematic review examines the impact of childhood abuse (sexual, physical and emotional) on adult injection drug use.

APPROACH

We searched MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science and grey literature to identify relevant studies from database inception to 26 September 2018. Studies were eligible if: (i) they were empirical original research published in English; (ii) considered childhood abuse as potential risk factors for lifetime history of injection drug use; and (iii) included adult participants. Risk of bias was assessed using the modified Newcastle-Ottawa Scale.

KEY FINDINGS

Of the 1994 articles screened, 17 studies met the inclusion criteria. Most studies were conducted in the USA and utilised cross-sectional research designs. All of the 17 studies measured sexual abuse, six studies measured physical abuse and three studies measured emotional abuse; most (N = 11) of which reported a statistically significant and positive association between at least one sub-scale of childhood abuse and injection drug use.

IMPLICATIONS

Our findings highlight the need for devising interventions to reduce the harms associated with childhood abuse.

CONCLUSIONS

The evidence base suggests a significant positive association between experiences of childhood physical abuse and elevated risks of injection drug initiation with mixed results for sexual and emotional abuse.

Elder Mistreatment in an Italian Population: Prevalence and Correlates

This study aimed to examine the prevalence of elder mistreatment (EM) in an Italian population and to determine the risk factors. The sample consisted of 393 older adults (M_age = 77.07; standard deviation = 9.45) of whom 60.1% were females. The prevalence of EM was of 20.1%. Older elders who were separated, divorced, with a poor state of health, and problems of autonomy were more likely to experience EM. The most common forms of EM were physical/sexual (9.9%) and emotional mistreatment (9.9%). The most common perpetrators were paid caregivers and members of the victim's family. A path analysis model suggested that limited autonomy and poor perceived health status appeared to be predictors of EM. We conclude that the results of this study have important implications in terms of reducing mistreatment of older adults. Understanding EM is essential to promoting equality, tolerance, and supportive attitudes and developing better prevention policies and practices.

Prevalence of child abuse in Kerala, India: An ICAST-CH based survey

BACKGROUND

Child abuse is a major concern in India with frequent reports of extreme maltreatment and fatalities. A dearth of robust and methodologically sound studies has resulted in ambiguity regarding the extent of child abuse in the general population.

OBJECTIVES

To estimate the one-year and lifelong prevalence of exposure to violence, physical abuse, emotional abuse, sexual abuse, and neglect using a validated instrument-the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool - Child, Home Version (ICAST-CH).

PARTICIPANTS AND SETTING

Adolescents (n = 6957) attending randomly selected schools in one city in Kerala, India.

METHODS

Cross-sectional survey using self-report instrument.

RESULTS

The one-year prevalence of any abuse was 89.9% (95% CI: 89.1-90.7) suggesting that child maltreatment was widespread. Physical and emotional abuses were also very common. Although sexual abuse was least common, a considerable proportion of adolescents reported it; one-year prevalence of sexual abuse was 16.7% and lifetime prevalence was 19.9%. Boys reported more abuse than girls across all the categories of abuse (including sexual abuse). Abuse was more frequent in the higher age groups and classes at school. Abuse was also more frequent in nuclear families and families that reported alcohol use. Children who reported an abusive experience usually faced more than one category of abuse; abuse in one category was significantly associated with abuse in other categories.

CONCLUSIONS

Abuse of children is alarmingly common. There is an urgent need for improving the awareness surrounding this issue as it is a major public health challenge faced by the country. The priority should be on setting up easily accessible support services for children.