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Crighton EJ, Ouédraogo AM, Sawada M, Mestre TA. Patterns and determinants of health care utilization among people with Parkinson's disease: A population-based analysis in Ontario, Canada. PLoS One 2024; 19:e0305062. [PMID: 38905210 PMCID: PMC11192415 DOI: 10.1371/journal.pone.0305062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 05/22/2024] [Indexed: 06/23/2024] Open
Abstract
In Ontario, despite the increasing prevalence of Parkinson's disease (PD), barriers to access-to-care for people with Parkinson's disease (PwP) and their caregivers are not well understood. The objective of this study is to examine spatial patterns of health care utilization among PwP and identify factors associated with PD-related health care utilization of individuals in Ontario. We employed a retrospective, population-based study design involving administrative health data to identify PwP as of March 31, 2018 (N = 35,482) using a previously validated case definition. An enhanced 2-step floating catchment area method was used to measure spatial accessibility to PD care and a descriptive spatial analysis was conducted to describe health service utilization by geographic area and specialty type. Negative binomial regression models were then conducted to identify associated geographic, socioeconomic, comorbidity and demographic factors. There was marked spatial variability in PD-related service utilization, with neurology and all provider visits being significantly higher in urban areas (CMF>1.20; p<0.05) and family physician visits being significantly higher (CMF >1.20; p<0.05) in more rural areas and remote areas. More frequent visits to family physicians were associated with living in rural areas, while less frequent visitation was associated with living in areas of low spatial accessibility with high ethnic concentration. Visits to neurologists were positively associated with living in areas of high spatial accessibility and with high ethnic concentration. Visits to all providers were also positively associated with areas of high spatial accessibility. For all outcomes, less frequent visits were found in women, older people, and those living in more deprived areas as years living with PD increased. This study demonstrates the importance of geographic, socioeconomic and individual factors in determining PwP's likelihood of accessing care and type of care provided. Our results can be expected to inform the development of policies and patient care models aimed at improving accessibility among diverse populations of PwP.
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Affiliation(s)
- Eric J. Crighton
- Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | | | - M. Sawada
- Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
- Laboratory for Applied Geomatics and GIS Science (LAGGISS), Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Tiago A. Mestre
- Parkinson Disease and Movement Disorder Clinic, Department of Medicine, Division of Neurology, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Ibrahim H, Goessmann K, Neuner F, Iffland B. Continuous chains: childhood maltreatment and intimate partner violence victimization among displaced women in a war context. BMC Womens Health 2024; 24:319. [PMID: 38824574 PMCID: PMC11143579 DOI: 10.1186/s12905-024-03156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/24/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement. METHODS This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years. RESULTS Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis. CONCLUSION The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.
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Affiliation(s)
- Hawkar Ibrahim
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany.
- vivo international e.V., Konstanz, Germany.
| | - Katharina Goessmann
- Department of Clinical Psychology and Violence Research, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
- vivo international e.V., Konstanz, Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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McGuire A, Jackson Y, Grasso DJ, Slavich GM, Kingston N. Caregiver Report of Children's Exposure to Adverse Life Events: Concordance Between Questionnaire and Interview Approaches. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241233271. [PMID: 38702867 DOI: 10.1177/08862605241233271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
Assessment practices for measuring adverse life events (ALEs) are often characterized by considerable variability, which is associated with inconsistency and reproducibility issues when conducting research on children with ALE exposure. One aspect of assessment variability for caregiver report of children's ALE history that has received minimal attention is assessment format. To address this issue, the current study evaluated concordance between two main ALE assessment formats: interviews and questionnaires. This involved examining overall endorsement of ALEs and concordance among multiple characteristics of ALE exposure, including type, polyvictimization, frequency, severity, and age of onset. Fifty-eight caregivers (Mage = 33.72; 60% Black; 55% below the federal poverty line) of preschool and school-age children were administered an ALE assessment in both a questionnaire and interview format across two sessions. The sum scores and concordance rates between format responses were compared based on ALE type, polyvictimization, frequency, severity, and age of onset of exposure. Results indicated that most total or sum scores were similar between formats, with the exception of ALE severity scores. However, there was most often low-to-moderate concordance across the 50 types of ALEs examined in the current study, suggesting that a different constellation of events comprised each sum or total score. This was also the case across all characteristics of the ALEs and most notably for the severity of ALE. Based on these findings, the format of assessment may be associated with inconsistent reporting of children's ALE exposure across multiple characteristics of ALE. Researchers may need to utilize multiple types of ALE assessments when relying on caregiver report of a child's ALEs.
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Affiliation(s)
- Austen McGuire
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Yo Jackson
- The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Damion J Grasso
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
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Lembke EJ, Linderkamp F, Casale G. Trauma-sensitive school concepts for students with a refugee background: a review of international studies. Front Psychol 2024; 15:1321373. [PMID: 38756485 PMCID: PMC11098281 DOI: 10.3389/fpsyg.2024.1321373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/11/2024] [Indexed: 05/18/2024] Open
Abstract
Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on N = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts' effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.
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Affiliation(s)
- Eva J. Lembke
- School of Education, Institute of Educational Research, University of Wuppertal, Wuppertal, Germany
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Lee AH, Kitagawa Y, Mirhashem R, Rodriguez M, Hilerio R, Bernard K. Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis. Dev Psychopathol 2024:1-31. [PMID: 38584264 DOI: 10.1017/s0954579424000737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.
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Affiliation(s)
- Amy Hyoeun Lee
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | | | - Rebecca Mirhashem
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Micaela Rodriguez
- Department of Psychology, University of North Carolina, Chapel Hill, NC, USA
| | - Romola Hilerio
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Kristin Bernard
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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Sigrist C, Ottaviani C, Baumeister-Lingens L, Bussone S, Pesca C, Kaess M, Carola V, Koenig J. A sex-specific pathway linking early life maltreatment, vagal activity, and depressive symptoms. Eur J Psychotraumatol 2024; 15:2325247. [PMID: 38512074 PMCID: PMC10962311 DOI: 10.1080/20008066.2024.2325247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/08/2023] [Indexed: 03/22/2024] Open
Abstract
Background: Experiences of early life maltreatment (ELM) are alarmingly common and represent a risk factor for the development of psychopathology, particularly depression. Research has focused on alterations in autonomic nervous system (ANS) functioning as a mediator of negative mental health outcomes associated with ELM. Early alterations in autonomic vagal activity (vmHRV) may moderate the relationship between ELM and depression, particularly when considering forms of emotional maltreatment. Recent evidence suggests that the relationships of both ELM and vmHRV with depression may be non-linear, particularly considering females.Objective: Building on and extending theoretical considerations and previous work, the present work aims to further the current understanding of the complex relationships between ELM exposure, vmHRV, and depression.Methods: This study uses an adaptive modelling approach, combining exploratory network-based analyses with linear and quadratic moderation analyses, drawing on a large sample of males and females across adolescence (total N = 213; outpatient at-risk sample and healthy controls) and adulthood (total N = 85; community-based convenience sample).Results: Exploratory network-based analyses reveal that exposure to emotional abuse is particularly central within a network of ELM subtypes, depressive symptoms, and concurrent vmHRV in both adolescents and adults. In adults, emotional neglect shows strong associations with both emotional abuse and vmHRV and is highly central as a network node, which is not observed in adolescents. Moderator analyses reveal significant interactions between emotional maltreatment and vmHRV predicting depressive symptoms in adult females. Significant quadratic relationships of emotional maltreatment and vmHRV with depression are observed in both adolescent and adult females.Conclusions: The present findings contribute to the understanding of the psychological and physiological mechanisms by which ELM acts as a risk factor for the development of depression. Ultimately, this will contribute to the development of targeted and effective intervention strategies to mitigate the detrimental effects of early adversity.
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Affiliation(s)
- Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Cristina Ottaviani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Luise Baumeister-Lingens
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Silvia Bussone
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Pesca
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Valeria Carola
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Hamel K, Bohr Y. Resilience in children and youth in street situations in León, Nicaragua. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:7-26. [PMID: 37477092 DOI: 10.1002/jcop.23079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
There are tens of millions of children and youth in street situations (CYSS) worldwide, the majority of whom are males living in low- and middle-income countries. Many of these children demonstrate impressive adaptability and resilience. The focus of the current research was on the resilience of male CYSS in León, Nicaragua. Qualitative data were collected through individual interviews and focus groups with CYSS, their family members, community members, and staff of a local nonprofit, with the objective of exploring and consolidating local understandings of resilience. Grounded theory analysis of qualitative data yielded a context-specific conceptual model of resilience as it pertains to CYSS in León. Six qualities were identified to represent the experience of resilience in this group: agency, belonging, flexibility, protection, self-regulation, and self-worth. The knowledge generated from this research can serve as a foundation to develop and implement resilience-promoting interventions for CYSS.
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Affiliation(s)
- Kayla Hamel
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Yvonne Bohr
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
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Maneiro L, Llerena N, López-Romero L. Adverse childhood experiences and residential care environment: The mediating role of trauma-related symptoms and psychological maladjustment in adolescents. CHILD ABUSE & NEGLECT 2023; 146:106528. [PMID: 37939417 DOI: 10.1016/j.chiabu.2023.106528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Research has consistently found poorer outcomes in adolescents who have been exposed to early interpersonal adversities, especially those in out-of-home placements. The presence of mental health problems also contributes to the perception of a more negative group climate and peer interactions through cascading effects. OBJECTIVE To analyze the sequential relationships between exposure to adverse childhood experiences (ACEs), trauma-related symptoms, psychological maladjustment, and the perception of group climate and peer interactions. In addition, the study analyzes the mediating role of trauma-related symptoms and psychological maladjustment. PARTICIPANTS AND SETTING The sample comprised 161 adolescents in out-of-home care (46.6 % males, 49.7 % females, 3.7 % non-binary), aged 12-18 (M = 15.22, SD = 1.59) from 24 residential facilities in Spain. METHODS This study is part of the VRINEP project. Group care workers reported about ACEs and trauma-related symptoms through online questionnaires, whereas adolescents self-reported about psychological maladjustment, group climate, and peer interactions. RESULTS Differential associations between ACEs with trauma-related symptoms and internalizing problems were found. The relationship between certain ACEs and externalizing problems was fully mediated by trauma-related symptoms. Likewise, psychological maladjustment was related to a more negative perception of the group climate and peer interactions. Although trauma-related symptoms were not directly associated with the perception of the residential environment, they were indirectly associated with peer relational aggression through externalizing problems. CONCLUSIONS Mental health has a significant impact on the perception of the group climate and peer interactions among adolescents in residential care who have been exposed to ACEs.
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Affiliation(s)
- Lorena Maneiro
- University of Santiago de Compostela, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
| | - Nerea Llerena
- University of Santiago de Compostela, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain
| | - Laura López-Romero
- University of Santiago de Compostela, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain
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Unhjem L, McWey LM, Ledermann T, Farley TM. Quality of the Parent-Child Relationship as a Moderator of Witnessing Violence and Youth Trauma Symptoms. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:869-879. [PMID: 38045838 PMCID: PMC10689639 DOI: 10.1007/s40653-023-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 12/05/2023]
Abstract
Traumatic event exposure affects two in every three adolescents in the United States and there is the potential for numerous deleterious effects including higher levels of youth depression, anxiety, posttraumatic stress symptoms, and emotional and behavioral problems. Witnessing violence is one of the more common experiences associated with trauma exposure. Despite the ample research on mental health outcomes associated with witnessing violence, less is known about the extent to which parent-child relationships play a role in youth mental health outcomes when youth are exposed to violence. With a clinically relevant, diverse sample of 806 youth ages 12 years old who experienced maltreatment or were at risk of being maltreated, we tested hypotheses that the parent-child relationship quality would moderate the associations between witnessing violence and youth mental health outcomes. Results supported hypotheses for youths' symptoms of anxiety, depression, dissociation, and posttraumatic stress. The study contributes to the trauma literature by determining that the quality of the parent-child relationship moderated the effects of witnessing violence on trauma outcomes.
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Affiliation(s)
- Lexie Unhjem
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Lenore M. McWey
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Tatjana M. Farley
- Department of Human Development and Psychological Counseling, Appalachian State University, Boone, NC USA
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10
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Chopin J, Beauregard E, DeLisi M. Adverse childhood experience trajectories and individual high risk-behaviors of sexual offenders: A developmental victimology perspective. CHILD ABUSE & NEGLECT 2023; 146:106457. [PMID: 37725879 DOI: 10.1016/j.chiabu.2023.106457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Developmental victimology theory suggests that developmental features of risk and impact stemming from various types of victimization depend on the age of the child or adolescent. OBJECTIVE A next step is studying the developmental victimization trajectories of individuals involved in sexual crimes by focusing on traumatic events occurring during childhood and adolescence respectively. Building on the developmental victimology perspective, the study's specific aims encompass two key objectives: 1) exploring the diverse trajectories of Adverse Childhood Experiences (ACEs) within a sample of individuals involved in sexual crimes, and 2) assessing whether these ACEs trajectories influence the emergence of distinct high-risk behaviors. PARTICIPANTS AND SETTING 252 individuals convicted of sexual crimes were selected from a federal penitentiary in Quebec, Canada. METHODS Semi-structured interviews with a computerized questionnaire produced data on numerous aspects of the participant's life history, criminal career, and victimization experiences that were analyzed via latent class modeling. RESULTS Four classes (no ACEs trajectory, poly exposure and victimization trajectory, childhood exposure trajectory, and poly victimization trajectory) were identified. CONCLUSIONS Consistent with hypotheses, developmental ACEs trajectories are heterogeneous and associated with the criminal careers, adolescent problematic behaviors, substance use disorders, and violence history among individuals involved in sexual offending.
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Affiliation(s)
- Julien Chopin
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada; School of Criminal Justice, University of Lausanne, Batochime CH - 1015 Lausanne, Switzerland; School of Social Work and Criminology, Laval University, 1030, avenue des Sciences-Humaines, Québec, Québec, G1V 0A6, Canada.
| | - Eric Beauregard
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada.
| | - Matt DeLisi
- Department of Sociology, Iowa State University, 203A East Hall, Ames, IA, United States of America.
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Pollmann A, Fritz J, Barker E, Fuhrmann D. Networks of Adversity in Childhood and Adolescence and Their Relationship to Adult Mental Health. Res Child Adolesc Psychopathol 2023; 51:1769-1784. [PMID: 36331717 PMCID: PMC10661796 DOI: 10.1007/s10802-022-00976-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Adverse experiences before the age of eighteen are common and include diverse events ranging from sexual abuse to parental divorce. These stressful experiences have been linked to physical and mental health issues. Previous research has focused mainly on childhood adversity, such as experiences in the family environment. Little consideration has been given to adversities that may be particularly harmful in adolescence. To understand adolescents' adverse experiences, this project used data from the Avon Longitudinal Study of Parents and Children (ALSPAC, total N = 14,901, N ≈ 1,200 - 10,000 per measure). We modelled interrelations of adversities in childhood (1-11 years) and adolescence (11-23 years) and examined adversity clusters using network analysis. We found two similar clusters in the childhood and adolescence networks: (1) direct abuse and (2) adverse family factors. We identified a third cluster of (3) educational and social adversities for adolescence. For both age groups, emotional abuse in the family environment was closely linked to mental health in early adulthood and most adversities were linked with depression in early adulthood. In adolescence, housing and academic issues and abuse by a romantic partner were particularly central to the network of adversities. Thus, we found commonalities and differences in the relevance of adverse experiences at different developmental stages. These findings highlight the need to develop age-dependent frameworks for adversity research and policymaking.
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Affiliation(s)
- Ayla Pollmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK.
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Edward Barker
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, Henry Wellcome Building for Psychology, Denmark Hill Campus, SE5 8AF, London, UK
| | - Delia Fuhrmann
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, Addison House, Guy's Campus, SE1 1UL, London, UK
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Tsunga L, Lake M, Halligan SL, Malcolm-Smith S, Hoffman N, Heron J, Zar H, Fraser A, Donald K, Stein DJ. Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS). Wellcome Open Res 2023; 8:36. [PMID: 37781446 PMCID: PMC10534083 DOI: 10.12688/wellcomeopenres.18598.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Background: Research has highlighted high rates of exposure to violence among South African youth. However, work to date has been largely cross-sectional, focused on violence exposure during the adolescence period, and has been limited to specific types of violence exposure. We examined violence exposure in South African preschool children between 3 and 6 years of age, capturing both direct and indirect forms of violence, and tested for potential sex differences across the several types of exposures. Methods: Lifetime direct and indirect exposure to domestic and community violence was measured by parental report when children were 3.5 years (N = 530), 4.5 years (N = 749) and 6 years of age (N= 417) in a South African birth cohort located in a peri-urban community. Results: There are three main findings. First, a large proportion of children (72%-75%) were reported as having been exposed to some form of direct or indirect violent experience in their homes or communities from a young age. Second, there was significant polyvictimization, with 49% of the children being exposed to more than one type of violence by age 6. Third, by 4.5 years of age, there was evidence that boys were more likely than girls to be exposed to domestic victimisation (28% vs. 17%) and polyvictimization (38% vs. 28%). Conclusions: These findings highlight the high levels of violence exposure in young South African children, particularly among boys, and the need for prevention at both the community and individual levels.
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Affiliation(s)
- Lucinda Tsunga
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Marilyn Lake
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | | | - Susan Malcolm-Smith
- ACSENT Laboratory Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jon Heron
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Heather Zar
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- The SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Abigail Fraser
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Kirsten Donald
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Godoy SM, Perris GE, Thelwell M, Osuna-Garcia A, Barnert E, Bacharach A, Bath EP. A Systematic Review of Specialty Courts in the United States for Adolescents Impacted by Commercial Sexual Exploitation. TRAUMA, VIOLENCE & ABUSE 2023; 24:1344-1362. [PMID: 35001766 PMCID: PMC9262992 DOI: 10.1177/15248380211061403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nationwide efforts to enhance services for adolescents experiencing commercial sexual exploitation (CSE) in the judicial system have led to the emergence of specialty courts, including human trafficking and girls' courts. Given that prior research has documented competing stances on the effectiveness of specialty courts for CSE-impacted populations, we conducted a systematic review of the literature to identify key characteristics of programming, profiles of adolescents served, and effectiveness of these courts. To identify relevant research and information, we systematically searched scholarly databases and information sources, conducted reference harvesting, and forwarded citation chaining. Articles presenting primary data with quantitative, qualitative, or mixed methodologies or programmatic descriptions of specialty courts serving adolescents at risk or with confirmed histories of CSE that were published after 2004 were included. We identified 39 articles on 21 specialty courts serving adolescents at risk or with confirmed histories of CSE, including seven specialty courts with evaluation or outcome data. Across specialty courts, adolescents benefited from an increase in linkage to specialized services, improved residential placement stability, and reduction in recidivism-measured by new criminal charges. Specialty court participation was also associated with improved educational outcomes and decreased instances of running away. A lack of empirical data, specifically of evaluation studies, emerged as a weakness in the literature. Still, findings support that specialty courts can be an integral judicial system response to CSE. Multidisciplinary collaboration can help target and respond to the multifaceted needs of adolescents, encourage healthy behaviors, and promote their overall wellness.
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Affiliation(s)
- Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC United States, 27599
| | - Georgia E. Perris
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Mikiko Thelwell
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Antonia Osuna-Garcia
- Health and Life Sciences Library, UCLA Science Libraries, 12-077 Center for Health Sciences, Los Angeles, CA, United States, 90095
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children’s Hospital, Los Angeles, CA, UCLA Pediatrics, Box 951752, 12-467 MDCC, Los Angeles, CA, United States, 90095-1752
| | - Amy Bacharach
- Center for Families, Children, and the Courts, Judicial Council of California, 455 Golden Gate Avenue, San Francisco, CA 94102
| | - Eraka P. Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, United States, 90024
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14
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Ronis S, Guyon-Harris KL, Burkhart K, Gabriel M, Cipolla K, Riggs JL, Huth-Bocks A. Profiles of Early Childhood Adversity in an Urban Pediatric Clinic: Implications for Pediatric Primary Care. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1023. [PMID: 37371255 DOI: 10.3390/children10061023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/27/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019-January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%). Among those who also completed the Adverse Childhood Experiences Questionnaire (ACE-Q, n = 1373) and the Protective and Compensatory Experiences Scale (PACES, n = 1377), belonging to the L class was associated with lower ACE-Q and higher PACES scores. For parent-respondents only, ACE-Q scores were significantly greater for the CSD class compared to the CS and L classes. Pediatricians should attend to the needs of caregivers reporting both stress and depression, as these families may face especially high levels of adversity and low levels of protective factors.
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Affiliation(s)
- Sarah Ronis
- UH Rainbow Center for Child Health and Policy, Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH 44106, USA
| | - Katherine L Guyon-Harris
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Kimberly Burkhart
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH 44106, USA
| | - Mary Gabriel
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Kristin Cipolla
- Department of Pediatrics, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Jessica L Riggs
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alissa Huth-Bocks
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Merrill Palmer Skillman Institute, Division of Research, Wayne State University, Detroit, MI 48202, USA
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15
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Zhu Y, Zhan S, Anme T, Zhang G. Maternal adverse childhood experiences and behavioral problems in Chinese preschool children: The moderated mediating role of emotional dysregulation and self-compassion. CHILD ABUSE & NEGLECT 2023; 141:106226. [PMID: 37150119 DOI: 10.1016/j.chiabu.2023.106226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/23/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND The negative effects of maternal adverse childhood experiences (ACEs) may have a direct intergenerational effect on a child's behavior. This topic has been widely examined, but few studies have explored the underlying mechanism and protective factors influencing maternal ACEs and offspring's behavioral problems in the Chinese context. OBJECTIVE This study aims to investigate the mediating effect of emotional dysregulation on the relationship between maternal ACEs and offspring behavior and examine whether self-compassion can moderate this association. PARTICIPANTS AND SETTING The participants were 2282 preschoolers (52 % male) with a mean age of M = 62.63 months (SD = 9.28) and their mothers. They were from northern, central, and southern Anhui Province China, and data were collected in relation to the family's socioeconomic status by population density of children in the region. METHODS Data were collected from the mothers with respect to maternal ACEs, emotional dysregulation, and self-compassion. Mothers provided information regarding children's behavior and demographic characteristics. A moderated mediation model was analyzed through SPSS. RESULTS First, the presence of maternal ACEs was positively associated with offspring behavioral problems. Second, maternal emotional dysregulation mediated the relationship between ACEs and offspring behavioral problems. Third, mothers' self-compassion moderated the indirect relationship between ACEs and offspring behavioral problems via emotional dysregulation. CONCLUSIONS Our findings highlight the critical role of emotional dysregulation and self-compassion in the relationship between maternal ACEs and offspring behavioral problems. Interventions should target maternal emotional dysregulation and self-compassion to minimize the risk of intergeneration transmission of negative effects.
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Affiliation(s)
- Yantong Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
| | - Shuwei Zhan
- School of Education, Central China Normal University, Wuhan, China
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Gengli Zhang
- Faculty of Educational Science, Anhui Normal University, Wuhu, China.
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16
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Oei A, Li D, Chu CM, Ng I, Hoo E, Ruby K. Disruptive behaviors, antisocial attitudes, and aggression in young offenders: Comparison of Adverse Childhood Experience (ACE) typologies. CHILD ABUSE & NEGLECT 2023; 141:106191. [PMID: 37084615 DOI: 10.1016/j.chiabu.2023.106191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young offenders' antisocial attitudes, disruptive behaviors and aggression, risk factors for delinquency and reoffending. OBJECTIVE This study examined ACE patterns and their association with the above factors in young offenders. PARTICIPANTS AND SETTING 1130 youth offenders (964 males; Mage = 17.57 years), provided self-reports on ACEs, antisocial attitudes, disruptive behavior ratings and aggression. METHOD Latent Class Analysis was performed on 12 self-reported ACEs, followed by Analyses of Covariance on each of the measures. RESULTS Four classes - Low ACE, Indirect Victims, Abusive Environment, and Polyvictimized - were identified. Polyvictimized youths had the highest levels of conduct problems (M = 70.35, ps < .05) and proactive aggression (M = 0.45, ps < .05) but did not differ from youths in Abusive Environment in reactive aggression (M = 1.02, p = .69), oppositional problems (M = 65.15, p = .18), and antisocial attitudes (M = 26.95, p = .21). Indirect Victims had lower levels of conduct problems (M = 64.80, p < .05) and antisocial attitudes (M = 24.35, p < .05) than Polyvictimized youths but higher levels of these outcomes than the Low ACE group. CONCLUSIONS Our findings showed that ACEs patterns vary in their effects on antisociality and disruptive behaviors. The novel finding was that childhood victimization does not have to be direct, as indirect victimization significantly impacted factors important to delinquency and reoffending.
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Affiliation(s)
- Adam Oei
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore.
| | - Dongdong Li
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore
| | - Chi Meng Chu
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore; Policy Research Office, Ministry of Social and Family Development, 512 Thomson Road, MSF Building, #07-00, 298136, Singapore
| | - Irene Ng
- Department of Social Work & Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3, Level 4, 3 Arts Link, 117570, Singapore
| | - Eric Hoo
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, #01-02, 279621, Singapore
| | - Kala Ruby
- Probation and Community Rehabilitation Services, Ministry of Social and Family Development, 1 Kay Siang Road, #01-10, 248922, Singapore
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17
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Zhou X, Shein BW, Khalil A, Duncan RJ. Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic. FAMILY PROCESS 2023; 62:352-367. [PMID: 35165887 PMCID: PMC9111685 DOI: 10.1111/famp.12761] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 12/20/2021] [Accepted: 01/12/2022] [Indexed: 05/26/2023]
Abstract
Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (MAge = 5.04, SDAge = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.
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Affiliation(s)
- Xiang Zhou
- Counseling PsychologyDepartment of Educational StudiesCollege of EducationPurdue UniversityWest LafayetteIndianaUSA
| | - Brenda W. Shein
- Counseling PsychologyDepartment of Educational StudiesCollege of EducationPurdue UniversityWest LafayetteIndianaUSA
| | - Amani Khalil
- Counseling PsychologyDepartment of Educational StudiesCollege of EducationPurdue UniversityWest LafayetteIndianaUSA
| | - Robert J. Duncan
- Human Development and Family StudiesCollege of Health and Human SciencesPurdue UniversityWest LafayetteIndianaUSA
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18
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Zhu Y, Zhang G, Anme T. Adverse Childhood Experiences, Resilience, and Emotional Problems in Young Chinese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3028. [PMID: 36833720 PMCID: PMC9963758 DOI: 10.3390/ijerph20043028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Resilience plays an important role in the relationship between adverse childhood experiences (ACEs) and children's health. Young children are often neglected in ACEs research and suffer from the negative consequences of ACEs. However, few studies have focused on the relationship between ACEs and emotional problems in young Chinese children and the moderating and mediating effect of resilience on this relationship. This study included young children at the beginning of their kindergarten year (n = 874, 42.80 ± 4.09 months) from Wuhu City, China, to examine the mediation and moderation effects of resilience on early-life ACEs and emotional problems. Our results show a positive direct effect of ACEs on emotional problems. Furthermore, a positive indirect effect of ACEs and emotional problems on resilience was found. A moderating effect of resilience was not observed in this study. Our findings (a) highlight the significance of paying more attention to early ACEs and revealing a better understanding of the effect of resilience on ACEs at an early age and (b) indicate that age-specific interventions should be provided to enhance young children's resilience when exposed to adversity.
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Affiliation(s)
- Yantong Zhu
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 3058577, Japan
| | - Gengli Zhang
- Faculty of Educational Science, Anhui Normal University, Wuhu 241000, China
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba 3058577, Japan
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19
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Tsunga L, Lake M, Halligan S, Malcolm-Smith S, Hoffman N, Heron J, Zar H, Fraser A, Donald K, Stein D. Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS). Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18598.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Research has highlighted high rates of exposure to violence among South African youth. However, work to date has been largely cross-sectional, focused on violence exposure during the adolescence period, and has been limited to specific types of violence exposure. We examined violence exposure in South African preschool children between 3 and 6 years of age, capturing both direct and indirect forms of violence, and tested for potential sex differences across the several types of exposures. Methods: Lifetime direct and indirect exposure to domestic and community violence was measured by parental report when children were 3.5 years (N = 530), 4.5 years (N = 749) and 6 years of age (N= 417) in a South African birth cohort located in a peri-urban community. Results: There are three main findings. First, a large proportion of children (72%-75%) were reported as having been exposed to some form of direct or indirect violent experience in their homes or communities from a young age. Second, there was significant polyvictimization, with 49% of the children being exposed to more than one type of violence by age 6. Third, by 4.5 years of age, there was evidence that boys were more likely than girls to be exposed to domestic victimisation (28% vs. 17%) and polyvictimization (38% vs. 28%). Conclusions: These findings highlight the high levels of violence exposure in young South African children, particularly among boys, and the need for prevention at both the community and individual levels.
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20
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Feng JY, Hwa HL, Shen ACT, Hsieh YP, Wei HS, Huang CY. Patterns and trajectories of children's maltreatment experiences in Taiwan: Latent transition analysis of a nationally representative longitudinal study. CHILD ABUSE & NEGLECT 2023; 135:105951. [PMID: 36395698 DOI: 10.1016/j.chiabu.2022.105951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about the patterns of child maltreatment change over time and vary according to gender and child protective services (CPS) experience in Taiwan. OBJECTIVE To examine the latent status and the trajectories of child maltreatment and to identify effects that gender and CPS have on these statuses and trajectories in Taiwan. PARTICIPANTS AND SETTING A national proportionately stratified sample of 6233 4th-grade students were recruited from 314 elementary schools in Taiwan, and followed up at 6th and 8th graders. A total of 1908 students completed valid data at all three time points was analyzed. METHODS Latent class analysis and latent transition analysis were used to identify the number of latent variables and the patterns of child maltreatment. Multiple-group model was used to test with gender difference. RESULTS Four latent maltreatment statuses were identified: high all maltreatment, high psychological maltreatment, high neglect, and no/low maltreatment. A reduction in maltreatment severity occurred over time was found. The percentage of students in the "high all maltreatment" and "high neglect" groups decreased whereas those in the "high psychological maltreatment" and "no/low maltreatment" groups increased. Differences in the transition probabilities of latent maltreatment status by gender was revealed. The percentage of CPS recipients in the "high all maltreatment" decreased over time. CONCLUSIONS This study highlighted the dynamic nature of child maltreatment and described the timing, continuity, and change that characterizes children's exposure to maltreatment in Taiwan. Policies and interventions geared toward early detection, mitigation, and prevention of child maltreatment are needed.
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Affiliation(s)
- Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 70101, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Rd., Tainan 70403, Taiwan.
| | - Hsiao-Lin Hwa
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, 1, Sec. 1, Jen Ai Rd., Taipei 10051, Taiwan; The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - April Chiung-Tao Shen
- The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan; Department of Social Work, National Taiwan University, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, 225 Centennial Drive, Stop 7135, Grand Forks, ND 58202, USA.
| | - Hsi-Sheng Wei
- Department of Social Work, College of Social Sciences, National Taipei University, 151, University Rd., San Shia District, New Taipei City 23741, Taiwan.
| | - Ching-Yu Huang
- School of Psychology, Keele University, Staffordshire ST5 5BG, UK.
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21
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Wiemann AK, Werner A, Konrad K, Niestroj SC, Steden S, Lohaus A. Lifetime poly-victimization and later bullying victimization: Associations with internalizing problems and out-of-home care. CHILD ABUSE & NEGLECT 2023; 135:105970. [PMID: 36434979 DOI: 10.1016/j.chiabu.2022.105970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Many youth in out-of-home care (OOHC) have experienced victimization in their lifetime making them vulnerable to mental health problems and further victimization. However, little is known about mechanisms behind this continuing victimization, e.g. in the form of bullying victimization, and about possible mediating and moderating factors. OBJECTIVE This study examined the association between lifetime poly-victimization and later bullying victimization, as well as mediation by internalizing problems, and moderation by OOHC. PARTICIPANTS AND SETTING In total n = 226 youth (n = 117 OOHC, n = 109 biological families) participated, with one of their social/biological caregivers when possible, resulting in subsamples of n = 159 participants (11-21 years) for self-report, and n = 210 participants (8-21 years) for caregiver report. METHODS An online survey assessed self-report of bullying victimization in the past six months, as well as self-report and caregiver report of lifetime poly-victimization and internalizing problems. RESULTS Based on both self-report and caregiver report, youth in OOHC showed higher levels of poly-victimization and internalizing problems than youth in biological families. In self-report, a conditional direct effect of lifetime poly-victimization on bullying victimization was found for youth in OOHC, c' = 0.18, SE = 0.07, p = .007, while the association was mediated by internalizing problems for youth in biological families, ab = 0.13, 95 % CI [0.020; 10.805]. In the caregiver report, there was neither a direct nor a mediated effect of lifetime poly-victimization on bullying victimization. CONCLUSIONS The results stress the importance of considering the high impact of poly-victimization in predicting bullying victimization, particularly for youth in OOHC. For youth in biological families, a mediating effect of internalizing problems was found.
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Affiliation(s)
| | - Anika Werner
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany; JARA-Brain Institute II, MolecularNeuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Sophie Charlotte Niestroj
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Sarah Steden
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Arnold Lohaus
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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22
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Soriano-Díaz C, Moreno-Manso JM, García-Baamonde ME, Guerrero-Molina M, Cantillo-Cordero P. Behavioral and Emotional Difficulties and Personal Wellbeing of Adolescents in Residential Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:256. [PMID: 36612578 PMCID: PMC9819573 DOI: 10.3390/ijerph20010256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/26/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
This work studies the emotional and behavioural difficulties and the personal wellbeing of adolescents under protective measures. The sample is made up of 151 adolescents in residential care between 11 and 17 years of age. The instruments used were the Strengths and Difficulties Questionnaire (SDQ) and the Personal Wellbeing Index (PWI). The results indicate that a high percentage of adolescents have emotional and behavioural difficulties. We found a greater presence of behavioural rather than emotional problems in the adolescents. Similarly, we also found that females showed more emotional difficulties than the males. As for personal wellbeing, the results indicate that the adolescents are dissatisfied in several areas of their life, they feel insecure and have a pessimistic view of their future and of their achievements. Furthermore, those adolescents who were admitted to residential care due to something other than child abuse have a greater prosocial behaviour. It can be concluded that the more difficulties the adolescents experience (emotional, behavioural and with their peers), the lower the perception of their personal wellbeing will be. This study allows us to design interventions aimed at promoting psychological wellbeing among these adolescents.
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23
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Stewart SL, Semovski V, Lapshina N. Adolescent Inpatient Mental Health Admissions: An Exploration of Interpersonal Polyvictimization, Family Dysfunction, Self-Harm and Suicidal Behaviours. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01450-4. [PMID: 36315373 DOI: 10.1007/s10578-022-01450-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
The mental health system is impacted by extreme delays in the provision of care, even in the face of suicidal behaviour. The failure to address mental health issues in a timely fashion result in a dependence on acute mental health services. Improvement to the mental health care system is impacted by the paucity of information surrounding client profiles admitted to inpatient settings. Using archival data from 10,865 adolescents 12-18 years of age (Mage = 14.87, SDage = 1.77), this study aimed to examine the characteristics of adolescents admitted to psychiatric inpatient services in Ontario, Canada. Multivariate binary logistic regression revealed that adolescents reporting interpersonal polyvictimization, greater family dysfunction and higher risk of suicide and self-harm had a greater likelihood of an inpatient mental health admission. The interRAI Child and Youth Mental Health assessment can be used for care planning and early intervention to support adolescents and their families before suicide risk is imminent.
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Affiliation(s)
- Shannon L Stewart
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
| | - Valbona Semovski
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada.
| | - Natalia Lapshina
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
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24
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Landry J, Asokumar A, Crump C, Anisman H, Matheson K. Early life adverse experiences and loneliness among young adults: The mediating role of social processes. Front Psychol 2022; 13:968383. [PMID: 36204733 PMCID: PMC9530052 DOI: 10.3389/fpsyg.2022.968383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Loneliness has been described as endemic among young people. Such feelings of social isolation 'even in a crowd' are likely linked to adverse early life experiences that serve to diminish perceptions of social support and intensify negative social interactions. It was suggested in the present series of survey studies that childhood abuse, which compromises a child's sense of safety in relationships, may affect social processes that contribute to loneliness in young adulthood. Study 1 assessed different adverse childhood and adult experiences in relation to loneliness among young adults (N = 171). Linear regression analyses indicated that childhood abuse was uniquely associated with greater loneliness, and this relationship was partially mediated by the perceived availability of social support. Study 2 (N = 289) assessed different forms of childhood abuse and demonstrated that early life emotional abuse was a unique predictor of loneliness, and this relationship was fully mediated by lower perceived support or value in social connections (social connectedness) and more frequent unsupportive interactions with friends. Study 3 evaluated the implications of the age of occurrence of abuse (N = 566). Both emotional and sexual abuse predicted young adult loneliness regardless of age; abuse that was recalled to have occurred at very early ages (0-5 years) was not predictive of loneliness over and above consideration of events that happened in older childhood. These relationships were at least partially mediated by perceived social support, social connectedness, and in the case of emotional abuse, unsupportive interactions with friends. Our results add to mounting evidence pointing to the prevalence of loneliness among young adults and the links to adverse early life experiences that may serve to shape appraisals of safety, value, and personal worth in social relationships.
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Affiliation(s)
- Jyllenna Landry
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Ajani Asokumar
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Carly Crump
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Hymie Anisman
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Kimberly Matheson
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
- The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
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Grummitt LR, Keyes KM, Rajan S, Kelly EV, Barrett EL, Newton NC. Clusters of Adversity Types Among U.S. Youth: Associations With Mental Health. Am J Prev Med 2022; 63:331-340. [PMID: 35523697 DOI: 10.1016/j.amepre.2022.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Childhood adversities are risk factors for subsequent mental health problems. Research commonly focuses on adverse childhood experiences, despite evidence that other exposures, such as neighborhood violence or peer victimization, co-occur with adverse childhood experiences and are associated with similar mental health outcomes. This study explored the clustering of these exposures and examined the associations with mental health. METHODS Data were a nationally representative sample of U.S. children aged 10-17 years (N=1,959), collected in 2013-2014. Latent class analysis was conducted on 22 types of childhood adversity. Regression models examined associations with mental health and substance use. These secondary analyses were conducted in 2021. RESULTS A total of 5 classes were identified: Low all (59% of the sample), Abuse (29%), High multiple adversities (5%), Peer adversity (4%), and Neighborhood violence (4%). All classes had poorer mental health and a higher prevalence of substance use than Low all, with particularly harmful levels in High multiple adversities. Neighborhood violence was not significantly different from High multiple adversities on mental health symptoms and showed a greater proportion of past-year substance use than all other classes except High multiple adversities. Peer adversity and Abuse classes did not differ significantly in any outcomes. CONCLUSIONS Findings highlight the particularly deleterious impact of neighborhood violence and highly co-occurring adversity types on mental health and substance use. It is important to extend our conceptualization of adverse childhood experiences to include peer adversity and neighborhood violence and shift from a siloed approach to examining all these exposures.
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Affiliation(s)
- Lucinda R Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sonali Rajan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Teachers College, A Graduate School of Education & Psychology, Columbia University, New York, New York
| | - Erin V Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Cibralic S, Alam M, Mendoza Diaz A, Woolfenden S, Katz I, Tzioumi D, Murphy E, Deering A, McNamara L, Raman S, Eapen V. Utility of screening for adverse childhood experiences (ACE) in children and young people attending clinical and healthcare settings: a systematic review. BMJ Open 2022; 12:e060395. [PMID: 36008078 PMCID: PMC9422820 DOI: 10.1136/bmjopen-2021-060395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine and synthesise the literature on adverse childhood experience (ACE) screening in clinical and healthcare settings servicing children (0-11) and young people (12-25). DESIGN A systematic review of literature was undertaken. DATA SOURCE PsycInfo, Web of Science, Embase, PubMed and CINAHL were searched through June 2021. Additional searches were also undertaken. ELIGIBILITY CRITERIA English language studies were included if they reported results of an ACE tool being used in a clinical or healthcare setting, participants were aged between 0 and 25 years and the ACE tool was completed by children/young people or by parents/caregivers/clinicians on behalf of the child/young person. Studies assessing clinicians' views on ACE screening in children/young people attending health settings were also included. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed for risk of bias using the Mixed Methods Appraisal Tool. Results were synthesised qualitatively. RESULTS Initial searches identified 5231 articles, of which 36 were included in the final review. Findings showed that the most commonly used tool for assessing ACE was the ACE questionnaire; administering ACE tools was found to be feasible and acceptable; there were limited studies looking at the utility, feasibility and acceptability of assessing for ACE in First Nations people; and while four studies provided information on actions taken following ACE screening, no follow-up data were collected to determine whether participants accessed services and/or the impact of accessing services. CONCLUSION As the evidence stands, widespread ACE screening is not recommended for routine clinical use. More research is needed on how and what specific ACE to screen for and the impact of screening on well-being. PROSPERO REGISTRATION NUMBER University of York Centre for Reviews and Dissemination (CRD42021260420).
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Affiliation(s)
- Sara Cibralic
- Ingham Institute, Liverpool, New South Wales, Australia
| | - Mafruha Alam
- Ingham Institute, Liverpool, New South Wales, Australia
| | - Antonio Mendoza Diaz
- Department of Psychiatry, University of South Wales, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- Sydney Local Health District, Camperdown, New South Wales, Australia
- Department of Paediatrics, University of New South Wales, Sydney, New South Wales, Australia
| | - Ilan Katz
- Department of Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Dimitra Tzioumi
- University of New South Wales, Sydney, New South Wales, Australia
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - Elisabeth Murphy
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - April Deering
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - Lorna McNamara
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
| | - Shanti Raman
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Valsamma Eapen
- Department of Psychiatry, University of South Wales, Sydney, New South Wales, Australia
- ICAMHS, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
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Tidmarsh LV, Harrison R, Ravindran D, Matthews SL, Finlay KA. The Influence of Adverse Childhood Experiences in Pain Management: Mechanisms, Processes, and Trauma-Informed Care. FRONTIERS IN PAIN RESEARCH 2022; 3:923866. [PMID: 35756908 PMCID: PMC9226323 DOI: 10.3389/fpain.2022.923866] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/20/2022] [Indexed: 12/30/2022] Open
Abstract
Adverse childhood experiences (ACEs) increase the likelihood of reduced physical and psychological health in adulthood. Though understanding and psychological management of traumatic experiences is growing, the empirical exploration of ACEs and physical clinical outcomes remains under-represented and under-explored. This topical review aimed to highlight the role of ACEs in the experience of chronic pain, pain management services and clinical decision making by: (1) providing an overview of the relationship between ACEs and chronic pain; (2) identifying biopsychosocial mechanisms through which ACEs may increase risk of persistent pain; (3) highlighting the impact of ACEs on patient adherence and completion of pain management treatment; and (4) providing practical clinical implications for pain management. Review findings demonstrated that in chronic pain, ACEs are associated with increased pain complications, pain catastrophizing and depression and the combination of these factors further heightens the risk of early treatment attrition. The pervasive detrimental impacts of the COVID-19 pandemic on ACEs and their cyclical effects on pain are discussed in the context of psychological decline during long treatment waitlists. The review highlights how people with pain can be further supported in pain services by maintaining trauma-informed practices and acknowledging the impact of ACEs on chronic pain and detrimental health outcomes. Clinicians who are ACE-informed have the potential to minimize the negative influence of ACEs on treatment outcomes, ultimately optimizing the impact of pain management services.
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Affiliation(s)
- Lydia V. Tidmarsh
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- *Correspondence: Lydia V. Tidmarsh
| | - Richard Harrison
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Samantha L. Matthews
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Katherine A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Rudmer de Vries T, Arends I, Hulvej Rod N, Oldehinkel AJ, Bültmann U. Proposing network analysis for early life adversity: An application on life event data. Soc Sci Med 2022; 296:114784. [DOI: 10.1016/j.socscimed.2022.114784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/16/2022] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
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Becker-Haimes EM, Wislocki K, DiDonato S, Jensen-Doss A. Predictors of Clinician-Reported Self-Efficacy in Treating Trauma-Exposed Youth. J Trauma Stress 2022; 35:109-119. [PMID: 34048094 PMCID: PMC10676627 DOI: 10.1002/jts.22688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/09/2022]
Abstract
Clinicians' self-efficacy with regard to delivering evidence-based interventions (EBIs) to youth is an important target for both improving EBI use in the community and mitigating the risk of clinician burnout and turnover. Examining predictors of clinician self-efficacy to treat trauma-exposed youth is, therefore, an important step for informing the design of implementation strategies to enhance the mental health workforce's capacity to deliver EBIs in this population. We examined predictors of clinician self-efficacy in working with trauma-exposed youth in a sample of practicing mental health clinicians (N = 258, M age = 34.4 years, 85.0% female). Clinicians were recruited and surveyed as part of a larger study examining how clients' exposure to potentially traumatic events influences clinician decision-making. Results of regression models indicated that training in any trauma treatment model, being trained via a variety of formats (e.g., in-person training, online, supervision), and training in a variety of treatment models were all associated with higher perceived self-efficacy regarding effectively treating trauma-exposed youth. Of the treatment models and training formats examined, receiving in-person training, R2 = .10, and training in trauma-focused cognitive behavioral therapy, R2 = .10, were the strongest predictors of higher self-efficacy ratings. Clinician discipline, R2 = .04, and clinical practice factors, R2 = .20, were also related to self-efficacy. Collectively, the R2 indicated a large effect, with the predictors explaining 25.4% of the variance in self-efficacy ratings. Implications for designing implementation strategies targeting clinician self-efficacy and future research are discussed.
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Affiliation(s)
- Emily M. Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
- Hall Mercer Community Mental Health, University of Pennsylvania Health System
| | - Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
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Grasso DJ. A Trauma-Informed Approach to Assessment, Case Conceptualization, and Treatment Planning for Youth Exposed to Intimate Partner Violence. JOURNAL OF HEALTH SERVICE PSYCHOLOGY 2022; 48:3-11. [PMID: 35106481 PMCID: PMC8794594 DOI: 10.1007/s42843-021-00053-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Children’s exposure to intimate partner violence (IPV) is a prevalent public health problem that can result in serious mental health impairments, including traumatic stress. These can emerge early and persist across development. IPV early in life has also been described as a “gateway exposure” to other forms of adversity and trauma. Children and families impacted by IPV have complex needs that complicate assessment and intervention. This paper highlights these issues and reviews best practices in assessment, case conceptualization, and treatment planning as they pertain to the treatment of IPV-exposed children. A case vignette illustrates the complex nature of IPV and application of best practices by telling the story of Isaiah, a 13-year-old boy with an extensive history of IPV exposure and co-occurring adversity and trauma.
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Lee RY, Oxford ML, Sonney J, Enquobahrie DA, Cato KD. The mediating role of anxiety/depression symptoms between adverse childhood experiences (ACEs) and somatic symptoms in adolescents. J Adolesc 2022; 94:133-147. [PMID: 35353421 PMCID: PMC9511877 DOI: 10.1002/jad.12012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study examines the relationships among recent adverse childhood experiences (ACEs), somatic symptoms, and anxiety/depression symptoms during adolescence and whether anxiety/depression symptoms mediate the relationship between ACEs and somatic symptoms. METHODS Longitudinal prospective data from the Longitudinal Studies of Child Abuse and Neglect study of 1354 children and their primary caregivers in the United States was used in this study. A longitudinal cross-lagged path analysis among recent ACEs, anxiety/depression symptoms, and somatic symptoms at three points during adolescence (ages 12, 14, and 16 years) was conducted. RESULTS The sample was 51% female and 53% African American. The results indicated significant concurrent associations between recent ACEs and increased anxiety/depression symptoms at ages 12, 14, and 16 (β = .27, p < .001; β = .15, p < .001; β = .07, p < .05) and between anxiety/depression symptoms and increased somatic symptoms at ages 12, 14, and 16 years (β = .44, p < .001; β = .39, p < .001; β = .49, p < .001). Moreover, anxiety/depression symptoms significantly mediated the relationship between recent ACEs and concurrent somatic symptoms at ages 12, 14, and 16 years (β = .12, p < .001; β = .06, p < .001; β = .04, p < .05). However, there was no significant relationship between recent ACEs and somatic symptoms. CONCLUSION The findings suggest that anxiety/depression symptoms mediate the concurrent relationships between recent ACEs and somatic symptoms at ages 12, 14, and 16. Clinicians should consider assessing anxiety/depression symptoms and possible concurrent exposure to ACEs when caring for adolescents who present with somatic symptoms.
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Affiliation(s)
- Rachel Y. Lee
- School of Nursing, Columbia University, New York City, New York, USA
| | - Monica L. Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Jennifer Sonney
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | | | - Kenrick D. Cato
- School of Nursing, Columbia University, New York City, New York, USA
- Department of Emergency Medicine, Columbia University College of Physicians & Surgeons, New York City, New York, USA
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Canale CA, Hayes AM, Yasinski C, Grasso DJ, Webb C, Deblinger E. Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Behav Ther 2022; 53:64-79. [PMID: 35027159 PMCID: PMC8765780 DOI: 10.1016/j.beth.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 01/03/2023]
Abstract
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective treatment for children impacted by trauma, and non-offending caregivers play an important role in this treatment. This study aims to identify correlates of four caregiver variables that have been identified as predictors of child outcomes in TF-CBT: support, cognitive-emotional processing, avoidance, and blame/criticism. Audio recorded sessions were coded from a community effectiveness trial of TF-CBT that included 71 child-caregiver dyads participating in the trauma narration and processing phase of treatment. Regression analyses were conducted to examine caregiver trauma history and child baseline symptoms (internalizing, externalizing, and posttraumatic stress disorder [PTSD] symptoms) as predictors of caregiver behavior during the trauma processing sessions. Caregivers who reported exposure to more trauma types exhibited more in-session avoidance and also processing during the trauma processing phase of treatment. Child symptoms at baseline did not predict caregiver in-session behaviors. Bivariate correlations were used to investigate concurrent associations between mean levels of in-session caregiver behaviors and in-session child distress (negative emotion, hopelessness, negative behaviors). More caregiver blame/criticism was associated with more in-session child distress on all three measures. Caregiver avoidance was associated with more child negative emotion and hopelessness. Findings may help identify therapeutic targets when working with caregivers to promote change and enhance TF-CBT outcomes.
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Affiliation(s)
| | - Adele M. Hayes
- University of Delaware, Department of Psychological and Brain Sciences
| | | | - Damion J. Grasso
- University of Connecticut School of Medicine, Department of Psychiatry
| | - Charles Webb
- State of Delaware Division of Prevention and Behavioral Health Services
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Brown SM, Rhoades GK, Marti CN, Lewis T. The Co-Occurrence of Child Maltreatment and Intimate Partner Violence in Families: Effects on Children's Externalizing Behavior Problems. CHILD MALTREATMENT 2021; 26:363-375. [PMID: 33438463 PMCID: PMC8275675 DOI: 10.1177/1077559520985934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Children exposed to maltreatment are at risk of experiencing intimate partner violence (IPV) and behavioral problems. This study examined different forms of family violence that co-occur and their relationship to children's externalizing behaviors across developmental stages (early childhood, middle childhood, adolescence). Longitudinal data (N = 1,987) at baseline and 18 months and 36 months post-baseline from the NSCAW II were used. Mixture modeling was employed in which latent class models estimated subgroups of children who experienced co-occurring forms of family violence; regression models estimated which subgroups of children were at risk of externalizing behaviors. Three latent classes were identified across developmental stages: high family violence, low family violence, and child physical abuse and psychological aggression. For children in early childhood, a fourth class was identified: partner and child physical abuse and child psychological aggression. Results from regression models revealed differences in externalizing scores by class membership across developmental age groups and over time. That distinct classes of child maltreatment and IPV co-occur and differentially impact children's behavior suggests a need for strong prevention and intervention responses to address children's dual maltreatment and IPV exposure.
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Affiliation(s)
- Samantha M. Brown
- School of Social Work, Colorado State University, Fort Collins, CO, USA
| | | | | | - Terri Lewis
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Haahr-Pedersen I, Hyland P, Hansen M, Perera C, Spitz P, Bramsen RH, Vallières F. Patterns of childhood adversity and their associations with internalizing and externalizing problems among at-risk boys and girls. CHILD ABUSE & NEGLECT 2021; 121:105272. [PMID: 34438263 DOI: 10.1016/j.chiabu.2021.105272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Different types of childhood adversity often cluster and overlap, underlining the importance of studying likely patterns of adversity co-occurrences and their impact on child functioning. Further sex-specific investigations of adversity co-occurrences and their associations with child mental health are warranted. OBJECTIVE To investigate if different sex-specific patterns of childhood adversity exist among at risk-children living in Denmark and to explore if divergent constellations of adversity are differentially associated with externalizing and internalizing problems. PARTICIPANTS AND SETTING Participants (N = 2198) were a sample of children ages 1-17 who have been in contact with the Danish child protection system due to suspected child abuse. The study included existing data collected as a part of child case procedures. METHOD Latent class analysis was used to identify patterns of adversity co-occurrences among girls and boys, respectively. Inter-class differences on age and child mental health were assessed using ANOVAs. RESULTS Greater variation and complexity in adversity exposure was found among girls (5 classes) compared to boys (3 classes). The female classes differed on age (p < .001, η2 = 0.06), internalizing (p < .001, η2 = 0.05), and externalizing problems (p = .002, η2 = 0.02). The male classes differed on internalizing (p < .001, η2 = 0.02) and externalizing problems (p < .001, η2 = 0.04). Overall, classes characterized by multiple adversities displayed higher scores of mental health problems compared to less exposed classes. CONCLUSIONS Exposure to multiple adversities is common among at-risk children. Information on different sex-specific patterns of adversity co-occurrences can guide intervention planning for affected children.
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Affiliation(s)
- Ida Haahr-Pedersen
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland; ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark; The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | - Philip Hyland
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland; Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Maj Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Camila Perera
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland
| | - Pernille Spitz
- The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | | | - Frédérique Vallières
- Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, Ireland.
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Renner LM. The Co-Occurrence of Child Maltreatment and Intimate Partner Violence: A Commentary on the Special Issue. CHILD MALTREATMENT 2021; 26:464-469. [PMID: 34463156 DOI: 10.1177/10775595211034430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Grasso DJ, Stover CS, Whitaker DJ. Introduction to the Special Issue on the Intersection of Intimate Partner Violence and Child Maltreatment. CHILD MALTREATMENT 2021; 26:351-355. [PMID: 34338044 DOI: 10.1177/10775595211036411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Damion J Grasso
- 242847University of Connecticut School of Medicine, Farmington, CT, USA
| | - Carla S Stover
- Child Study Center, 5755Yale University School of Medicine, New Haven, CT, USA
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Caputi M, Forresi B, Giani L, Michelini G, Scaini S. Italian Children's Well-Being after Lockdown: Predictors of Psychopathological Symptoms in Times of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111429. [PMID: 34769947 PMCID: PMC8583178 DOI: 10.3390/ijerph182111429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 02/02/2023]
Abstract
The first Italian lockdown imposed to fight the spread of COVID-19 caused important disruptions in families’ everyday lives. The main aim of this research was to investigate the predictors of psychopathology in children aged 5–10 years, immediately after the national 2-month lockdown. A total of 158 Italian parents (148 mothers, 10 fathers, mean age = 41 years) were recruited and asked to complete an online research concerning their 158 children (76 boys, mean age = 7.4 years). Parents completed questionnaires on parent–child conflict, resilience, temperament, behavior, and previous adverse childhood experiences. Hierarchical regressions showed that children’s psychopathology was predicted by low child resilience, high novelty seeking and harm avoidance, adverse experiences, and high flooding levels. Moreover, girls exposed to adverse experiences appeared more vulnerable to psychopathology. The recruitment of a convenience sample, the small sample size, and the cross-sectional design of our study limit the generalizability and interpretation of the present findings. Nonetheless, this research extends our knowledge of children’s functioning in such an exceptional period. Shedding light on predictors of children’s psychopathology following prolonged quarantine can indeed guide effective psychological interventions now and in future similar situations.
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Affiliation(s)
- Marcella Caputi
- Department of Life Sciences, University of Trieste, Via E. Weiss 21, 34128 Trieste, Italy
- Correspondence:
| | - Barbara Forresi
- Child and Youth Lab, Sigmund Freud University of Milan, Via Ripa di Porta Ticinese 77, 20143 Milan, Italy; (B.F.); (L.G.); (G.M.); (S.S.)
| | - Ludovica Giani
- Child and Youth Lab, Sigmund Freud University of Milan, Via Ripa di Porta Ticinese 77, 20143 Milan, Italy; (B.F.); (L.G.); (G.M.); (S.S.)
| | - Giovanni Michelini
- Child and Youth Lab, Sigmund Freud University of Milan, Via Ripa di Porta Ticinese 77, 20143 Milan, Italy; (B.F.); (L.G.); (G.M.); (S.S.)
| | - Simona Scaini
- Child and Youth Lab, Sigmund Freud University of Milan, Via Ripa di Porta Ticinese 77, 20143 Milan, Italy; (B.F.); (L.G.); (G.M.); (S.S.)
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Schwartz B, Kaminer D, Hardy A, Nöthling J, Seedat S. Gender Differences in the Violence Exposure Types That Predict PTSD and Depression in Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8358-8381. [PMID: 31130044 DOI: 10.1177/0886260519849691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Both specific forms of violence and polyvictimization have been associated with an increased risk for negative mental health outcomes in youth. Despite evidence of gender differences in trauma experience and impact, gender patterns in the comparative contribution of specific violence exposures versus polyvictimization to mental health outcomes have seldom been explored. The few existing studies have all been conducted in high-income countries, while there is a dearth of research from lower and middle-income countries. This study examined the contribution of witnessed and direct community violence, domestic violence, sexual abuse, and different levels of polyvictimization to the severity of posttraumatic stress disorder (PTSD) and depression in a clinic sample of children and adolescents (n = 310) in South Africa. Although polyvictimization rates were high across both genders, polyvictimization posed differential risks for boys and girls. For girls, higher levels of polyvictimization, but not individual violence types, predicted both PTSD and depression severity. For boys, polyvictimization did not predict PTSD or depression severity. Higher levels of victimization in the community predicted PTSD severity among boys, while no forms of violence predicted depression. The findings confirm the value of examining gender patterns in the risk for posttraumatic sequelae posed by exposure to specific and cumulative forms of violence. Implications for interventions with youth in high-violence contexts such as South Africa are considered.
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Grasso DJ, DiVietro S, Beebe R, Clough M, Lapidus G. Quantifying Severity of Maltreatment, Adversity, and Trauma From Child Protective Services Case Record Files. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8142-8163. [PMID: 31092088 DOI: 10.1177/0886260519847774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Children referred to child protective services (CPS) for allegations of abuse or neglect often have diverse experiences of maltreatment, adversity, and trauma. Severity of these experiences is associated with greater mental health impairment and increased risk of revictimization and other adversities. Although aspects of these experiences are often captured during CPS investigations and stored in case records as narrative documents, much of this information is underutilized in estimating risk and service planning. The current study extracted case record information from a randomly selected sample of 100 families, with 150 children referred to CPS during a 12-month period. The Yale-Vermont Adversity in Childhood Scale (Y-VACS) was applied to extracted information for quantifying severity of various forms of childhood maltreatment, adversity, and trauma. Study aims were to examine (a) the scope and severity of maltreatment, adversity, and trauma types and their associations; (b) linkages between severity and CPS allegation types and outcomes; and (c) the utility of severity in predicting new allegations of abuse or neglect within 12 months of referral. Results indicated feasibility in quantifying severity of maltreatment and other adversities from case record information and revealed associations between adversity severity and CPS allegation types and outcomes. Severity of psychological intimate partner violence and neglect were predictive of new allegations of abuse or neglect within 12 months of referral. Findings support moving beyond an incident-based CPS strategy to one that better incorporates case record information to assess risk.
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Affiliation(s)
- Damion J Grasso
- University of Connecticut School of Medicine, Farmington, CT, USA
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Susan DiVietro
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Rebecca Beebe
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Meghan Clough
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Garry Lapidus
- Connecticut Children's Medical Center, Hartford, CT, USA
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Determinants of Implementing Evidence-Based Trauma-Focused Interventions for Children and Youth: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 47:705-719. [PMID: 31813066 DOI: 10.1007/s10488-019-01003-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A systematic review was conducted to identify determinants (barriers and facilitators) of implementing evidence-based psychosocial interventions for children and youth who experience emotional or behavioral difficulties due to trauma exposure. Determinants were coded, abstracted, and synthesized using the Exploration, Preparation, Implementation, and Sustainment framework. Twenty-three articles were included, all of which examined implementation of Trauma-Focused Cognitive Behavioral Therapy or Cognitive-Behavioral Intervention for Trauma in Schools. This review identified multilevel and multiphase determinants that can be addressed by implementation strategies to improve implementation and clinical outcomes, and suggests how future studies might address gaps in the evidence base.
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Grasso DJ, Briggs-Gowan MJ, Carter AS, Goldstein BL, Ford JD. Profiling COVID-related experiences in the United States with the Epidemic-Pandemic Impacts Inventory: Linkages to psychosocial functioning. Brain Behav 2021; 11:e02197. [PMID: 34216110 PMCID: PMC8413802 DOI: 10.1002/brb3.2197] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/09/2021] [Accepted: 05/06/2021] [Indexed: 01/31/2023] Open
Abstract
The COVID-19 pandemic has had a profound impact on the lives of individuals, families, and communities around the world with constraints on multiple aspects of daily life. The purpose of the present study was to identify specific profiles of pandemic-related experiences and their relation to psychosocial functioning using the 92-item Epidemic-Pandemic Impacts Inventory (EPII). Data were collected as part of a cross-sectional, online survey of adults (18+) residing in the Northeast region of the United States (N = 652) and recruited via online advertisements. Person-centered latent class analysis (LCA) was applied to 38 pandemic-related experiences that showed a significant bivariate correlation with perceived stress. Measures of psychosocial risk were also obtained. Results revealed five unique profiles of respondents based on patterns of pandemic-related experiences. Three profiles representing about 64% of the sample were characterized by moderate to high exposure to adverse experiences during the pandemic and were more likely to screen positive for depression, anxiety, and posttraumatic stress. These profiles were differentiated by sociodemographic differences, including age, caregiving, and employment status. Two profiles differentiated by age and caregiver status represented about 36% of the sample and were characterized by relatively low exposure to adverse experiences and lower risk for psychosocial impairment. Findings support the EPII as an instrument for measuring tangible and meaningful experiences in the context of an unprecedented pandemic disaster. This research may serve to identify high-risk subpopulations toward developing public health strategies for supporting families and communities in the context of public health emergencies such as the COVID-19 pandemic.
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Affiliation(s)
- Damion J Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Brandon L Goldstein
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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Moreno-Manso JM, García-Baamonde ME, Guerrero-Barona E, Godoy-Merino MJ, Guerrero-Molina M, Barbosa-Torres C. Externalizing and internalizing symptoms and coping strategies in young victims of abuse. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01996-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractThis research analyses the internalizing and externalizing symptoms and the coping strategies of young victims of abuse. These young people are in residential care under protective measures due to abuse. The participants were 61 youths (32 male and 29 female) between 12 and 17 years of age. Different works of research stress the need for an early identification of the psychopathological symptomatology that these adolescents may present in order to provide an adequate psycho-educational intervention. The relationship between the adolescents’ psychopathological symptomatology and the coping strategies and styles they use to resolve problems is studied. It is also analyzed whether internalizing and externalizing problems predict the style and coping strategies of adolescents. Two tests were used: 1. Child and Adolescent Evaluation System (SENA); 2. Adolescent Coping Scales (ACS). The results indicate that young victims of abuse have internalizing and externalizing symptoms. These adolescents are characterized by an unproductive coping style, as well as by the use of coping strategies that are not very functional and ineffective for resolving conflicts. The psychopathological symptomatology is related to and predicts an unproductive coping style, badly adapted to solving daily problems (worrying, blaming oneself, not coping, ignoring the problem, or keeping it to oneself). This research has allowed us to identify the presence of several areas of vulnerability in these young persons which could be playing an important role in their psychosocial maladjustment. The research suggests the design of intervention strategies, for both groups and individuals, aimed at mitigating and modifying the sources of the problems in victims of child abuse.
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Ford JD, Courtois CA. Complex PTSD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:16. [PMID: 33958001 PMCID: PMC8103648 DOI: 10.1186/s40479-021-00155-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This article builds on a previous review (Ford and Courtois, Borderline Personal Disord Emot Dysregul 1:9, 2014) which concluded that complex posttraumatic stress disorder (cPTSD) could not be conceptualized as a sub-type of either PTSD or BPD. Recent research is reviewed that extends and clarifies the still nascent understanding of the relationship between cPTSD and BPD. MAIN BODY The circumscribed formulation of adult cPTSD that has been developed, validated, and included in the 11th Edition of the International Classification of Diseases has spurred research aimed at differentiating cPTSD and BPD both descriptively and empirically. A newly validated Developmental Trauma Disorder (DTD) syndrome for children and adolescents provides a basis for systematic research on the developmental course and origins of adult cPTSD and BPD. This review summarizes recent empirical findings regarding BPD, PTSD, and cPTSD in terms of: (1) prevalence and comorbidity; (2) clinical phenomenology; (3) traumatic antecedents; (4) psychobiology; (5) emotion dysregulation; (6) dissociation; and (7) empirically supported approaches to clinical assessment and psychotherapeutic treatment. CONCLUSION The evidence suggests that PTSD, cPTSD, and BPD are potentially comorbid but distinct syndromes. A hypothesis is advanced to stimulate scientific research and clinical innovation defining and differentiating the disorders, positing that they may represent a continuum paralleling the classic conceptualization of the stress response, with dissociation potentially involved in each disorder.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA.
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Karsberg S, Hesse M, Pedersen MM, Charak R, Pedersen MU. The impact of poly-traumatization on treatment outcomes in young people with substance use disorders. BMC Psychiatry 2021; 21:140. [PMID: 33685430 PMCID: PMC7941934 DOI: 10.1186/s12888-021-03129-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. METHODS Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. RESULTS Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. CONCLUSION Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. TRIAL REGISTRATION ISRCTN88025085 , date of registration: 29.08.2016, retrospectively registered.
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Affiliation(s)
- Sidsel Karsberg
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus, Denmark.
| | - Michael Mulbjerg Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Ruby Charak
- grid.449717.80000 0004 5374 269XDepartment of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr, Edinburg, TX USA
| | - Mads Uffe Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
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Modrowski CA, Munion AK, Kerig PK, Kilshaw RE. A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021; 43:119-130. [PMID: 34149159 PMCID: PMC8210953 DOI: 10.1007/s10862-020-09854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.
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Affiliation(s)
- Crosby A. Modrowski
- Alpert Medical School of Brown University/Bradley Hasbro Children’s Research Center
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Butler N, Quigg Z, Bellis MA. Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood. BMC Med 2020; 18:325. [PMID: 33190642 PMCID: PMC7667802 DOI: 10.1186/s12916-020-01788-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/17/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood. METHODS Data from a nationally representative survey of household residents (adults aged 16 to 59 years; n = 21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes. RESULTS Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16 years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA. CONCLUSIONS Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.
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Affiliation(s)
- Nadia Butler
- Public Health Institute, Liverpool John Moores University, 3rd Floor Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK.
| | - Zara Quigg
- Public Health Institute, Liverpool John Moores University, 3rd Floor Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK
| | - Mark A Bellis
- College of Health and Behavioural Sciences, Bangor University, Bangor, UK
- Policy and International Health Directorate, Public Health Wales, Clwydian House, Wrexham, UK
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Liang Y, Zhou Y, Ruzek JI, Liu Z. Patterns of childhood trauma and psychopathology among Chinese rural-to-urban migrant children. CHILD ABUSE & NEGLECT 2020; 108:104691. [PMID: 32854057 DOI: 10.1016/j.chiabu.2020.104691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to childhood trauma can cause psychopathology and negative psychosocial outcomes across the lifespan. Rural-to-urban migrant children are commonly exposed to traumatic experiences (TEs). However, no study has comprehensively examined patterns of childhood trauma in Chinese culture. The current study aimed to examine patterns of childhood trauma exposure among Chinese rural-to-urban migrant children. METHODS A large-scale (N = 15,890) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Childhood TEs, including accidents and injuries, interpersonal violence, and vicarious trauma, as well as demographics and internalizing and externalizing behaviors, were measured. RESULTS Four patterns of childhood trauma were found: low trauma exposure (60.4%), vicarious trauma exposure (23.9%), domestic violence exposure (10.5%), and multiple trauma exposure (5.3%). Age, gender, parents' marital status, father's education level, family support and peer support differentiated the four TE patterns. Both internalizing and externalizing behaviors were more severe in patterns with more types of TEs. CONCLUSIONS Our findings provide a better understanding of childhood trauma in Chinese culture and the relationship between TEs and mental health. Clinicians and policy makers should tailor prevention and treatment programs according to different patterns of victimization.
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Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Josef I Ruzek
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, 19A Yuquan Road, Shijingshan District, Beijing 100049, China.
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Haahr-Pedersen I, Ershadi AE, Hyland P, Hansen M, Perera C, Sheaf G, Bramsen RH, Spitz P, Vallières F. Polyvictimization and psychopathology among children and adolescents: A systematic review of studies using the Juvenile Victimization Questionnaire. CHILD ABUSE & NEGLECT 2020; 107:104589. [PMID: 32562962 DOI: 10.1016/j.chiabu.2020.104589] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Exposure to child abuse can lead to lasting mental health problems. Extant research has found that different types of child abuse tend to co-occur and overlap, which merits the investigation of the effects of exposure to multiple types of childhood mistreatment. OBJECTIVE The aim of this study was to systematically review the evidence on the associations between multiple different types of interpersonal victimization or polyvictimization, and indicators of psychopathology among children ages 0-17. METHODS The review included studies across all economic strata and research on nationally representative, community, and at-risk samples, using the same standardized assessment tool (i.e. the Juvenile Victimization Questionnaire or JVQ). The review was conducted using peer-reviewed evidence published up until August 2019 from Scopus, EMBASE, PsycINFO, Medline, CINAHL, and ERIC. Out of 4998 relevant references screened, 255 met the inclusion criteria, 22 of which aimed to address childhood polyvictimization and psychopathology. RESULTS A total of 21 of the 22 included studies identified a significant positive association between polyvictimization and various indicators of psychopathology comprising both externalizing (e.g. anger), internalizing problems (e.g. depression) and total psychological distress. A range of studies demonstrated that polyvictimization was a stronger risk factor for psychopathology than individual (sub)types of victimization. Based on the study findings, we provide a set of recommendations for future research on polyvictimization and psychopathology. CONCLUSION The present systematic review was the first to review the evidence on the associations between polyvictimization (as measured by the JVQ) and child and adolescent psychopathology in the global research literature. As a novel approach, the present review included both normative and high-risk samples. The results showed that polyvictimization is a substantial risk factor for mental health problems spanning both inner-directed and outer-directed mental health difficulties. However, the inconsistency in methods of defining and measuring polyvictimization severely undermines the scientific impact of this body of work. Additional well-designed, longitudinal studies that take account of the context-specific nature of polyvictimization are required to better establish the causal relationships between childhood polyvictimization and psychopathology so as to improve prevention and intervention efforts.
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Affiliation(s)
- Ida Haahr-Pedersen
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland; The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | - Afrodite Emma Ershadi
- Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, United Kingdom.
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Camila Perera
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Greg Sheaf
- The Library of Trinity College Dublin, Trinity College Dublin, Dublin, Ireland.
| | - Rikke Holm Bramsen
- The Danish Children Centre for the Central Denmark Region, Aarhus, Denmark.
| | - Pernille Spitz
- The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
| | - Frédérique Vallières
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland.
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Craig SL, Austin A, Levenson J, Leung VWY, Eaton AD, D'Souza SA. Frequencies and patterns of adverse childhood events in LGBTQ+ youth. CHILD ABUSE & NEGLECT 2020; 107:104623. [PMID: 32682145 DOI: 10.1016/j.chiabu.2020.104623] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/14/2020] [Accepted: 07/03/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Trauma, specifically adverse childhood experiences (ACEs), predicts significant health and mental health disparities, yet there is a paucity of research with LGBTQ + youth. OBJECTIVE This study explored ACE prevalence in a large sample of LGBTQ+ youth; examined ACE patterns within and across subgroups; and compared results with the general population. PARTICIPANTS AND SETTING Participant (n = 3,508) ages ranged between 14-18 (x̄ = 16.02) and represented a range of sexual orientations: pansexual (33.9 %), bisexual (26.6 %), and queer (16.2 %), and gender identities: female (39.9 %), non-conforming (38 %), male (14.9 %), and transgender (16.6 %). METHODS An online cross-sectional survey was conducted with LGBTQ+ youth ages 14-18 that self-identified as LGBTQ+ and resided in the US or Canada. Descriptive statistics generated the prevalence of ACEs, and ANOVAs and post-hoc tests were run for comparisons. RESULTS Participants reported multiple ACEs (M = 3.14, SD = 2.44) with emotional neglect (58 %), emotional abuse (56 %), and living with a family member with mental illness (51 %) as the most prevalent. Notably, 43 % of participants experienced 4+ ACEs, considered to be a high level of trauma exposure. Compared to national samples, LGBTQ + youth demonstrated unique patterns of ACEs and were higher in 9 of 10 categories. Significantly high (all p < .001) ACEs were found in pansexual (t = 7.67), transgender and gender non-conforming (t = 5.19), American-Indian (t = 6.42), Latinx (t = 2.83) and rural youth (F = 12.12) while those with highly educated parents (F = 83.30, p < .001), lived with a parent (t = 6.02), and in Canada (t = 6.14) reported fewer ACEs. CONCLUSION LGBTQ+ youth experience significant childhood trauma with potential impact on their mental health. This study identifies implications for trauma-informed practice and research.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Ashley Austin
- Ellen Whiteside McDonnell Faculty of Social Work, Barry University, 11300 NE 2nd Ave., Miami Shores, FL, 33161-6695, USA.
| | - Jill Levenson
- Ellen Whiteside McDonnell Faculty of Social Work, Barry University, 11300 NE 2nd Ave., Miami Shores, FL, 33161-6695, USA.
| | - Vivian W Y Leung
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Andrew D Eaton
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Sandra A D'Souza
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
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Loomis AM, Feely M, Kennedy S. Measuring self-reported polyvictimization in foster youth research: A systematic review. CHILD ABUSE & NEGLECT 2020; 107:104588. [PMID: 32535337 DOI: 10.1016/j.chiabu.2020.104588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Youth who are or have been in foster care (foster youth) are at higher risk for adverse outcomes in early adulthood. As the importance and complexity of victimization experiences, including types, timing, and perpetrators, is better understood it is unclear whether or to what extent the research on foster youth assesses polyvictimization. Because many types of victimization, such as community violence, are under-reported or absent in the administrative data typically used for research with foster care populations, self-reports of victimization experiences are necessary to comprehensively assess polyvictimization. Polyvictimization places youth at increased risk for adverse outcomes, and yet is not widely measured in the foster youth population. This is likely in part due to the wide-use of administrative reports to assess maltreatment among research on foster youth which does not capture a full range of victimization experiences. OBJECTIVE The aim of the present study was to systematically review and evaluate the measurement of self-reported polyvictimization with foster youth samples. METHODS A search in Academic Search Premier, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, Social Work Abstracts, SociINDEX, and Scopus was conducted. Articles included peer-reviewed, quantitative research studies that measured self-reported victimization (including violence exposure and/or maltreatment) with foster youth samples between 1997-2017. In total, 1887 studies were identified and reviewed by two raters and of those 18 met the study criteria. RESULTS Almost all of the included studies (n = 16) measured multiple types of victimization through self-report. The most common types of victimization measured were sexual abuse (n = 15), physical abuse (n = 14), and physical neglect (n = 11). Half of studies (n = 9) measured at least one non-maltreatment victimization experience, such as community violence exposure and/or dating violence. However, included studies rarely measured other aspects of victimization, such as timing of exposure (e.g., pre or during foster care), which research has identified as relevant to outcomes. CONCLUSIONS This is the first systematic review to assess the measurement of self-reported polyvictimization in research with current or former foster youth. Given the limited comprehensive assessment of victimization, these findings support strong recommendations for developing or adapting polyvictimization measures specifically for foster youth so that the measures include child welfare-specific factors such as the timing and perpetration of victimization experiences.
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Affiliation(s)
- Alysse M Loomis
- University of Utah College of Social Work, 395 South 1500 East #111, Salt Lake City, UT, 84112, United States.
| | - Megan Feely
- University of Connecticut School of Social Work, 38 Prospect Street, Hartford, CT, 06103, United States.
| | - Stephanie Kennedy
- Institute for Justice Research and Development, College of Social Work, The Florida State University, 2010 Levy Avenue, Suite 3400, Tallahassee, FL, 32310, United States.
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