Violence Exposure and the Development of School-Related Functioning: Mental Health, Neurocognition, and Learning

Episodic foresight, episodic memory, and executive functions in children engaged with Child Protective Services: The role of cumulative risk

Previous studies have determined that exposure to risk and adversities may impair children's cognitive abilities. In particular, children engaged with Child Protective Services (CPS) seem to be at greater risk for enhanced detrimental effects resulting from the cumulative risk factors to which they are exposed. However, little is known about children's future thinking when they face adverse circumstances, and it is not clear how the associations among episodic foresight abilities, episodic memory, and executive functions work with children under such circumstances. The current study describes the episodic foresight abilities of CPS-involved school-aged children, its association with other cognitive abilities, and how this association is affected by the exposure to cumulative risk and adversity factors. Episodic foresight, episodic memory, executive functions, and a composite of cumulative risk factors were analyzed in a sample of 95 school-aged children engaged with CPS in Portugal. Results suggest the detrimental effect of cumulative risk on the episodic foresight abilities of CPS-involved children. Episodic memory and cognitive flexibility were significant predictors of episodic foresight abilities, and cumulative risk exposure moderated the relation between episodic memory and episodic foresight. The current study provides a better understanding of the influences of multiple adversities on CPS-involved children's episodic foresight abilities and related cognitive outcomes.

Long-Term Growth and Neurodevelopmental Outcomes of Neonates Infected with SARS-CoV-2 during the COVID-19 Pandemic at 18-24 Months Corrected Age: A Prospective Observational Study

INTRODUCTION

During the early coronavirus disease (COVID-19) pandemic in 2020, researchers cautioned about the potential neuroinvasive capability of the virus and long-term neurological consequences. Although a few preliminary studies have found delayed communication, fine motor, and problem-solving skills in infants after COVID-19 infection, there continues to be a paucity of data on long-term development of neonates diagnosed with COVID-19.

METHODS

We conducted a prospective study of 20 neonates who acquired severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the first wave of the pandemic (April-July 2020). At 18-24 months corrected age, we assessed neurodevelopment by Bayley Scales of Infant and Toddler Development, the third edition (BSID-III), along with growth, hearing, and vision evaluation.

RESULTS

The mean corrected age at assessment was 21 months 11 days ± 1 month 28 days. We found developmental delay in nearly half of the children with scores below one standard deviation in either of the BSID-III domains. Mild delay in either motor, cognitive, or language domains was found in 9 (45%) children and moderate delay in 2 (10%). Expressive language, fine motor, and receptive language were predominantly affected. None of the children had hearing impairment, blindness, or significant growth faltering including clinically severe microcephaly. The mean composite cognitive, language, and motor scores were significantly lower in those with neurodevelopmental delay (p value - 0.02, 0.000, and 0.03, respectively) without any differences in their disease characteristics.

CONCLUSION

Neonates infected with SARS-CoV-2 have an increased risk of developmental delays in expressive language, fine motor, and receptive language skills at 18-24 months of age. The severity of delays is predominantly mild.

Violence and suicide risk behavior in a nationally representative sample of youth aged 12-17: What does it mean to be at-risk?

Suicide attempts and school violence, including gun violence, are now leading causes of death in youth 12-17. This study applied a latent class analytic approach to investigate how heterogenous subgroups of youth differed regarding patterns of violence engagement and suicide risk behavior and how geographic, demographic, and socioeconomic predictors related to subgroup membership. Data were drawn from the youth subsample of the 2021 National Survey on Drug Use and Health (N = 10,743). A suicide risk subgroup had low probabilities of violence engagement but high probabilities of suicide ideation and plan. A violence + suicide risk subgroup had high probabilities of violence engagement, suicide ideation, and suicide plan. A violence risk subgroup had high probabilities of violence engagement and carrying a handgun, but low probabilities of suicide ideation or plan. The largest subgroup had low probabilities across all class indicators. Demographic, geographic, and socioeconomic variables uniquely predicted subgroup membership.

Intimate Partner Violence and Child and Adolescent Cognitive Development: A Systematic Review

Intimate partner violence (IPV) is a public health and human rights issue, with millions of children affected worldwide. While several reviews have explored the emotional-behavioural functioning of children exposed to IPV, this review aimed to examine the relationship between children's exposure to IPV and their cognitive development, and to identify associated factors such as aspects of parenting. The databases MEDLINE, PsycInfo, EMBASE, Family and Society Studies Worldwide, CINAHL, and ERIC were searched using key words related to IPV, such as domestic, family, partner, interparental, spousal, marital, violence, abuse, aggression, assault, combined with key words related to cognitive functioning, such as neuropsychological, executive, intelligence, learning, memory, and key words related to children and adolescents. A total of 38 studies met the criteria for review which included reporting an estimate of the relationship between IPV and cognition using direct assessments of cognitive functioning. Approximately 70% of studies found a relationship between IPV and poorer cognitive functioning, with general IQ the most frequently assessed domain of functioning, followed by verbal abilities and academic skills. Most studies assessed skills during early childhood, with fewer studies assessing children during middle childhood and adolescence. Results were consistent across cognitive domains and developmental stages. In terms of factors associated with IPV and cognition, a range of demographic, individual, and family factors were included, with several studies exploring mediating and moderating mechanisms. The findings suggest that IPV in childhood is associated with poorer cognitive skills across a range of domains. Implications for policy, practice and research are discussed.

Early life stress, depression and epigenetics

Different factors are essential in increasing the vulnerability to psychiatric disorders, such as genetics. Among these factors, early life stress (ELS), including sexual, physical, emotional abuse, and emotional and physical neglect, enhances the odds of having menial conditions throughout life. Exhaustive research has shown that ELS leads to physiological changes, such as alteration in the HPA axis. During the most critical development period (childhood and adolescence), these changes increase the risk of having child-onset psychiatric disorders. Furthermore, research has suggested a relationship between early life stress and depression, particularly more prolonged episodes of depression with treatment-resistant outcomes. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders is polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. However, whether there are independent effects among subtypes of ELS remains unclear. This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology. Furthermore, they could lead to identifying new targets for clinical intervention.

Treatment Engagement Among Children Exposed to Violence: A Systems Perspective

Childhood exposure to violence is a major public health issue. Effective treatment can reduce the impact of violence exposure on child outcomes. However, disparities in treatment engagement can interfere with effective treatment. This study reviews data collected from 2,546 children referred to community-based mental health services from 2001 to 2015 after exposure to violence. Children were categorized into three groups: those who attended intake but never started treatment, referred to as the Nonengager group; those who started but discontinued treatment prior to meeting treatment goals, referred to as the Attriter group; and those who completed treatment as rated by the treating therapist, referred to as the Completer group. The three groups were analyzed for differences in behavioral and emotional problems, racial identity, child social support, household income, number of people living in the home, parent stress, parent social support, community violence exposure, and neighborhood-level child opportunity. Analyses demonstrated that the Completer group were more likely to: live in neighborhoods with higher levels of childhood opportunity, identify as White, have an annual household income of $40,000 or greater, have significantly fewer people living in the home, report lower levels of parental stress, report higher levels of parental social support, report higher levels of child social support, and have significantly lower scores of emotional and behavioral problems after treatment. Overall, our study supports the importance of considering multiple ecological levels when targeting treatment engagement for children after exposure to violence. Results indicate that children from more advantaged environments are more likely to complete treatment, which leads to better outcomes. This can exacerbate existing disparities. Findings highlight the need for systems change and advocacy for children in less advantaged environments and meeting families in their specific context, to combat treatment disparities.

Australian Educators' Perceptions and Attitudes Towards a Trauma-Responsive School-Wide Approach

Staff perceptions and attitudes regarding the introduction of the Reframing Learning and Teaching Environments (ReLATE) trauma-responsive school-wide approach were investigated in three Catholic primary schools in Victoria, Australia. School leaders, teachers, and support staff were interviewed regarding their experiences of the approach either individually or in focus groups. Educator attitudes towards trauma-responsive education was evaluated using the ARTIC-ED Scale, prior to and after participating in the six-month intervention. Qualitative data were interpreted using ecological analysis of the themes arising guided by the trauma informed principles and frameworks of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Trauma Learning Policy Initiative (TLPI). Findings indicated significant shifts towards trauma-responsive practice following the introduction of ReLATE. Strong themes emerged relating to the influence of improved trauma knowledge on perceptions of student behavior, consequent reported adaptations to behavior management practices, strengthened sense of trust and respect in the school climate, the centrality of leadership to effect change, and importance of school-fit to program uptake. Strengths and limitations of ReLATE are considered, along with implications for teacher professional learning, the role of leadership in effecting change and significance of perceived school-fit and collaboration.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-021-00394-6.

The Relationship Between Children's Exposure to Intimate Partner Violence and an Emotional-Behavioral Disability: A Scoping Review

Children's exposure to intimate partner violence (IPV) is an adverse childhood experience that often results in academic, behavior, and mental health difficulties. This study reviewed the empirical studies examining the relationship between children's exposure to IPV and an emotional-behavioral disability (EBD). Studies were included in the review if they examined the relationship between exposure to IPV and EBD among children under 18. This research identified three empirical studies that analyzed the relationship between exposure to IPV and EBD. The review demonstrated that few studies had been conducted that explored the relationship between children's exposure to IPV and EBD and that most of the extant studies are dated. Findings from this review showed that children exposed to IPV were more likely to have EBD compared to other disabilities such as a learning disability, hearing disability, speech and language disability, and an intellectual disability. Higher frequency of violence exposure was associated with EBD. Practice implications include assessing children's functioning at school and discussing with families or caregivers the option of requesting an evaluation for EBD for children with severe emotional or behavioral difficulties. Special education evaluators assessing children for EBD should consider screening for children's exposure to IPV and providing resources for IPV. Future research should conceptualize the full range of IPV experiences and collect exposure data from children directly using a validated measure.

Childhood Violence Exposure, Inflammation, and Cardiometabolic Health

Exposure to interpersonal violence during childhood, a severe and often traumatic form of social stress, is an enduring problem that an emerging body of work suggests may be relevant to cardiometabolic health and the progression of cardiovascular disease (CVD) across the life course. Less is known about this association causally, and consequently, the biological mechanisms that may confer risk for, and resilience to, poor health outcomes in the aftermath of violence are not well understood. Drawing on recent theoretical insights and empirical research in both humans and non-human animal models, the current paper articulates a hypothesis for one way that childhood violence could get "under the skin" to influence CVD. Based on this emerging literature, one plausible way that childhood violence exposure could increase susceptibility to CVD in later life is by sensitizing stress-response neurobiology and immune processes that regulate and promote inflammation, which is a key pathogenic mechanism in CVD. This is inherently a developmental process that begins in early life and that unfolds across the life course, although less is known about the specific mechanisms through which this occurs. The goal of this paper is to articulate some of these plausible mechanisms and to suggest areas for future research that aims to reduce the burden of disease among individuals who are exposed to violence.

Exposure to IPV among Children in the Child Welfare System and an Emotional-Behavioral Disability: the Role of Maternal Depression and Social Support

This study examines the relationship between children's exposure to IPV and EBD among children involved in the child welfare system for suspected maltreatment (both substantiated and unsubstantiated). It specifically examines how children's trauma symptoms, maternal depression, and maternal social support may impact the relationship between exposure to IPV and EBD. This study uses structural equation modeling with data from the second National Survey of Child and Adolescent Wellbeing to examine the relationship between exposure to IPV and EBD among 989 children (ages 8-17) involved in the child welfare system. Moderated mediation was employed to examine whether children's trauma symptoms mediate the relationship between IPV exposure and EBD and whether differences in maternal depression and social support impact such mediation effect. Child trauma symptoms and maternal social support were significantly related to EBD. The current study highlights the relationship between children's trauma symptoms and EBD among children in the child welfare system. The study also provides preliminary evidence for maternal social support as a protective factor for children developing EBD. Implications of this research include providing interventions as well as increasing maternal social support to potentially reduce the likelihood of children developing EBD.

Unity or diversity of executive functioning in children and adolescents with post-traumatic stress symptoms? A systematic review and meta-analysis

For some children, psychological reactions to a traumatic event develop into severe or persistent post-traumatic stress symptoms (PTSS) or the clinical condition of post-traumatic stress disorder (PTSD). Cognitive problems in children with PTSS have been reported, but it is not clear which specific functions are affected. Executive functions is a domain of particular interest, given its importance for academic performance and social and emotional functioning. A systematic literature search was performed, and 12 studies with 55 comparisons of executive functions in children with PTSS and healthy controls were eligible for meta-analysis. A subset of the studies also included a comparison group of children with traumatic experienced but without PTSS. Overall, across all tasks and measures, children with PTSS showed lower executive functioning than healthy controls (SMD = -0.57). The effect sizes between the subdomains complex tasks, verbal fluency, inhibition, shifting and working memory were not significantly different from each other, but was largest for verbal fluency (SMD = -1.45). Analyses comparing children with traumatic experiences with and without PTSS similarly showed overall lower executive functioning in the PTSS group (SMD = -0.34) and no significant differences in effect sizes between subdomains. The results have implications for assessment and clinical work with youth exposed to traumatic events. We should be aware of the poor executive functioning that may be an issue for some children with a history of trauma and subsequent development of PTSS, and the impact this could have on everyday functioning.

Vulnerabilities and academic outcomes among students in Puerto Rico

Violence and health inequalities impact the academic outcomes of students, especially among minority groups. This study examines the differences in grade retention and dropout intentions with respect to exposure to violence and to mental health (anxiety, depression, and trauma) among youth living in Puerto Rico. Data from 566 students of fifth to twelfth grade in Puerto Rico were collected as part of a school-based service program. A two-way ANOVA showed no significant differences in exposure to violence and mental health among students with and without a history of grade retention. However, students who reported dropout intentions showed higher exposure to violence and mental health issues. These results highlight the value of assessing mental health and contextual indicators in designing interventions to prevent adverse academic outcomes in vulnerable populations.

Community Violence Exposure and School Functioning in Youth: Cross-Country and Gender Perspectives

Background: Many children and adolescents experience violent events which can be associated with negative consequences for their development, mental health, school, and social functioning. However, findings between settings and on the role of gender have been inconsistent. This study aimed to investigate cross-country and gender differences in the relationship between community violence exposure (CVE) and school functioning in a sample of youths from three countries. Methods: A self-report survey was conducted among school students (12-17 years old) in Belgium (Antwerp, N = 4,743), Russia (Arkhangelsk, N = 2,823), and the US (New Haven, N = 4,101). Students were recruited from within classes that were randomly selected from within schools that had themselves been randomly selected (excepting New Haven, where all students were included). CVE was assessed with the Screening Survey of Exposure to Community Violence. School functioning was assessed with four measures: the Perceived Teacher Support scale, Negative Classroom Environment scale, and Academic Motivation and Perception of Safety at School scales. Multivariate Analyses of Covariance were performed to assess differences in the levels of school-related problem behaviors in boys and girls, who reported different degrees of CVE. Results: Participants in all three countries reported a relatively high prevalence of violence exposure (36.2% in Belgium, 39.3% in Russia and 45.2% in the US who witnessed violence), with a higher proportion of girls than boys witnessing violent events (varied from 37.4 to 51.6% between the countries), whereas boys reported more episodes of victimization by violence than girls (varied from 32.3 to 49.9% between the countries). Youths who experienced increased CVE (from no exposure to witnessing to victimization) reported an increase in all school functioning problems in all of the countries and this association was not gender-specific. Conclusions: Our findings suggest that regardless of differences in the level of CVE by country and gender, violence exposure is negatively associated with school functioning across countries. Nonetheless, even though reactions to community violence among adolescents may be expressed in a similar fashion, cross-country differences in social support systems should also be taken into account in order to provide culturally sensitive treatment modalities.

The Prevalence and Nature of Violence Against Women Experiencing Homelessness: A Quantitative Study

Individuals experiencing homelessness-an extreme form of social exclusion-have considerably higher risk of being victims of violence than the general population. We analyze the episodes of violence suffered by 504 individuals experiencing homelessness in Spain, as well as the differences between men and women. The results indicate high levels of violence and suggest that gender (specifically, being a woman) is the primary factor driving exposure to violence among this group. Highlighting the reality of women experiencing homelessness can help social, mental health, and addiction services adjust responses to better address the needs of this group and offer comprehensive care.

White Matter Microstructure in the Young Adult Brain Varies with Neighborhood Disadvantage in Adolescence

Neighborhood disadvantage and community violence are common in poor, urban communities and are risk factors for emotional dysfunction. Emotional processes are supported by neural circuitry that includes the prefrontal cortex (PFC), hippocampus, amygdala, and hypothalamus. These brain regions are connected by white matter pathways that include the cingulum bundle, uncinate fasciculus, stria terminalis, and fornix. Emotional function varies with the microstructure of these white matter pathways. However, it is not clear whether the microstructure of these pathways varies with risk factors for emotional dysfunction (e.g., neighborhood disadvantage and violence exposure). Therefore, determining the relationships between neighborhood disadvantage, violence exposure, and white matter microstructure may offer insight into the neural mechanisms by which adverse life experiences alter developing neural systems. The current study investigated the association that exposure to neighborhood disadvantage and violence have with the quantitative anisotropy (QA), a measure of the amount of directional water diffusion, of the cingulum bundle, uncinate fasciculus, stria terminalis, and fornix. Neighborhood disadvantage (M_age = 11.20) and violence exposure (M_W1age = 11.20; M_W2age = 13.05; M_W3age = 16.20; M_W4age = 19.25) were assessed during adolescence and participants returned for magnetic resonance imaging as young adults (N = 303; M_age = 20.25, SD = 1.55), during which diffusion weighted brain images were collected. The QA of the cingulum bundle, uncinate fasciculus, and stria terminalis/fornix varied negatively with neighborhood disadvantage such that the QA of these white matter tracts decreased as neighborhood disadvantage increased. Violence exposure was not related to QA in any tract (i.e., cingulum bundle, uncinate fasciculus, and stria terminalis/fornix) after correction for multiple comparisons. These results suggest that an adolescent's neighborhood may play an important role in the microstructure (i.e., QA) of white matter pathways that connect brain regions that support emotional function.

Vital Signs: Prevalence of Multiple Forms of Violence and Increased Health Risk Behaviors and Conditions Among Youths - United States, 2019

INTRODUCTION

Experiencing violence, especially multiple types of violence, can have a negative impact on youths' development. These experiences increase the risk for future violence and other health problems associated with the leading causes of morbidity and mortality among adolescents and adults.

METHODS

Data from the 2019 national Youth Risk Behavior Survey were used to determine the prevalence of high school students' self-reported experiences with physical fighting, being threatened with a weapon, physical dating violence, sexual violence, and bullying. Logistic regression models adjusting for sex, grade, and race/ethnicity were used to test the strength of associations between experiencing multiple forms of violence and 16 self-reported health risk behaviors and conditions.

RESULTS

Approximately one half of students (44.3%) experienced at least one type of violence; more than one in seven (15.6%) experienced two or more types during the preceding 12 months. Experiencing multiple types of violence was significantly more prevalent among females than among males and among students identifying as gay, lesbian, or bisexual or not sure of their sexual identity than among heterosexual students. Experiencing violence was significantly associated with higher prevalence of all examined health risks and conditions. Relative to youths with no violence experiences, adjusted health risk and condition prevalence estimates were up to seven times higher among those experiencing two types of violence and up to 21 times higher among those experiencing three or more types of violence.

CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE

Many youths experience multiple types of violence, with potentially lifelong health impacts. Violence is preventable using proven approaches that address individual, family, and environmental risks. Prioritizing violence prevention is strategic to promoting adolescent and adult health.

Artificial Intelligence, Big Data, and mHealth: The Frontiers of the Prevention of Violence Against Children

Violence against children is a global public health threat of considerable concern. At least half of all children worldwide experience violence every year; globally, the total number of children between the ages of 2 and 17 years who have experienced violence in any given year is one billion. Based on a review of the literature, we argue that there is substantial potential for AI (and associated machine learning and big data), and mHealth approaches to be utilized to prevent and address violence at a large scale. This potential is particularly marked in low- and middle-income countries (LMIC), although whether it could translate into effective solutions at scale remains unclear. We discuss possible entry points for Artificial Intelligence (AI), big data, and mHealth approaches to violence prevention, linking these to the World Health Organization's seven INSPIRE strategies. However, such work should be approached with caution. We highlight clear directions for future work in technology-based and technology-enabled violence prevention. We argue that there is a need for good agent-based models at the level of entire cities where and when violence can occur, where local response systems are. Yet, there is a need to develop common, reliable, and valid population- and individual/family-level data on predictors of violence. These indicators could be integrated into routine health or other information systems and become the basis of Al algorithms for violence prevention and response systems. Further, data on individual help-seeking behavior, risk factors for child maltreatment, and other information which could help us to identify the parameters required to understand what happens to cause, and in response to violence, are needed. To respond to ethical issues engendered by these kinds of interventions, there must be concerted, meaningful efforts to develop participatory and user-led work in the AI space, to ensure that the privacy and profiling concerns outlined above are addressed explicitly going forward. Finally, we make the case that developing AI and other technological infrastructure will require substantial investment, particularly in LMIC.

Effects of Intimate Partner Violence and Home Environment on Child Language Development in the First 3 Years of Life

OBJECTIVE

Intimate partner violence (IPV) can adversely affect children's cognitive development, but links between IPV exposure and language development in the earliest years of life remain unknown. The present study examined the effects of IPV and the quality of the home environment on children's language development at age 3 years.

METHODS

In a prospective, 5-panel, longitudinal study of 79 mother-child dyads assessed prenatally to age 3 years, we examined standardized measures of receptive and expressive language development at age 3 years. Predictors and covariates included measures of IPV, characteristics of the home environment, maternal education, and maternal depression.

RESULTS

Regression analyses indicated a significant main effect of the home environment and maternal education on receptive language, with more supportive homes and more educated mothers at age 1 year linked to better child receptive language at age 3 years. Higher maternal education also significantly predicted better child expressive language at age 3 years. Early exposure to IPV had a direct adverse effect on children's expressive language development; however, interaction analyses indicated that this association was moderated by the quality of the home environment. Specifically, IPV adversely affected expressive language even when home quality was high, indicating that a supportive and stimulating home environment did not buffer effects of IPV on expressive language development.

CONCLUSIONS

Intimate partner violence may adversely affect expressive language, even in positive home environments. Early language skill is an important predictor of later academic readiness and psychological development; therefore, children from at-risk home environments should be screened and monitored early for intervention.

Cumulative risk, teacher-child closeness, executive function and early academic skills in kindergarten children

We tested the role of teacher-child closeness in moderating the associations between early childhood adversity, measured as a cumulative risk index, and child outcomes during the kindergarten year. Using the ECLSK:11, a national dataset of kindergarteners in the 2010-11 academic year, we examined three dimensions of executive function (cognitive flexibility, inhibitory control, working memory), as well as early reading and math scores, as key skills that facilitate the transition to school. Cumulative risk was negatively associated with all outcomes, and teacher-child closeness was positively associated with all outcomes. Teacher-child closeness moderated the relation between cumulative risk and working memory and cumulative risk and reading scores in a protective manner, but not cognitive flexibility, inhibitory control, or math scores. Implications for research in early childhood adversity and education are discussed.

Violent Behaviors, Weapon Carrying, and Firearm Homicide Trends in African American Adolescents, 2001-2015

African American youths have the highest risk for firearm and other weapon related homicides. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of African American adolescents. Our analyses found statistically significant reductions in physical fighting and weapon carrying among African American male adolescents from 2007 to 2015. Planning suicide increased in both male and female African American adolescents since 2007. In addition, the number of firearm homicides increased in African American males. African American females and males had groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A's or B's in school were significantly less likely to carry weapons in and out of school. Our findings indicate that firearm homicides have increased in African American adolescents, but weapon carrying in school going adolescents has significantly declined. School engagement and satisfactory school performance seems to have a significant protective effect on firearm homicides and violent behavior risks in African American adolescents.

Violence Exposure and Sexual Risk Behaviors for African American Adolescent Girls: The Protective Role of Natural Mentorship and Organizational Religious Involvement

African American adolescent girls are at increased risk of being exposed to community violence and being diagnosed with a sexually transmitted infection. Fewer studies, however, have examined the protective roles of natural mentorship and organizational religious involvement as potential moderators that could lessen the effects of violence exposure on health risk behavior. Data from 273 African American ninth grade girls were used to test hypothesized independent and moderated-moderation models. Results suggest that natural mentorship and religious involvement were protective for girls who reported at least one mentor and moderate to high levels of religious involvement. Our findings may be relevant for community stakeholders and organizations that directly interact with religious institutions and community programs that focus on outreach to African American adolescent girls.

"A child who is hidden has no rights": Responses to violence against children with disabilities

BACKGROUND

There is an urgent need to understand how best to prevent and respond to violence against children with disabilities as they are at a high risk for violence because they are marginalized, isolated, and targeted and have little power within their communities.

OBJECTIVE

Guided by social-ecological theory, this study explores responses to violence against children with disabilities, including preventative measures and treatment of victims in the West African countries of Guinea, Niger, Sierra Leone, and Togo.

PARTICIPANTS

Participants were recruited using purposive and snowball sampling from the following three groups: disability stakeholders including representatives from local, national, and international organizations and governments; community members including parents, teachers, and leaders; and children with disabilities.

METHODS

A qualitative study design guided data generation, that included document analysis, semi-structured interviews, and focus groups across the four countries. In total, 419 people participated. Of those participants, 191 took part in an interview and the rest participated in one of 55 focus groups.

FINDINGS

Responses to disability-based violence are driven at the mesosystem and exosystem levels. Prevailing views indicated that national level policies and laws are not always considered part of solutions, communities are leading responses to violence, and children with disabilities are hidden at home or in institutions for both their own and their family's safety. Conclusions The findings can inform development of prevention and intervention programs that will protect children with disabilities from violence in contexts with high levels of disability stigma, social conflict, violence, and poverty.

Violent Lives: Pathways Linking Exposure to Violence To Suicidal Behavior in a National Sample

This study explored the extent to which depression, somatic symptoms, and substance use mediated the effects of exposure to violence on suicidal ideation and attempted suicide, and whether these pathways varied across gender, age, and race/ethnicity. Path analysis was conducted on 12,272 adolescents (mean = 15.3 years) from the National Longitudinal Study of Adolescent to Adult Health. The impact of exposure to violence on suicidal ideation was fully mediated, and the impact of exposure to violence on attempted suicide was partially mediated by depression, somatic symptoms, and substance use. Mediating pathways were stronger for females and for younger adolescents. Understanding the impact of exposure to violence on adolescent suicidal behavior requires the consideration of direct, indirect, and conditional indirect effects.

Heterogeneity in the impact of type of schooling on adult health and lifestyle

Using data from a major educational reform in England and Wales, we examine heterogeneity in the long-term impacts of the exposure to different secondary schooling systems, characterized by selective early-tracking system versus non-selective comprehensive schooling, on health outcomes and smoking. We adopt a local instrumental variables approach to estimate person-centered treatment (PeT) effects, thereby recovering the full distribution of individual-level causal effects. We find that the transition from a selective early-tracking system to a non-selective one produced, on a fraction of individuals, significantly increased depression and cigarette smoking. These effects were persistent over time. Cognitive abilities did not moderate the effects, but students with lower non-cognitive skills were most likely to be negatively affected by this exposure.

Intrauterine exposure to tobacco and executive functioning in high school

BACKGROUND

Executive functioning (EF), an umbrella construct encompassing gradual maturation of cognitive organization/management processes, is important to success in multiple settings including high school. Intrauterine tobacco exposure (IUTE) correlates with negative cognitive/behavioral outcomes, but little is known about its association with adolescent EF and information from real-life contexts is sparse. We evaluated the impact of IUTE on teacher-reported observations of EF in urban high school students controlling for covariates including other intrauterine and adolescent substance exposures.

METHODS

A prospective low-income birth cohort (51% male; 89% African American/Caribbean) was followed through late adolescence (16-18 years old). At birth, intrauterine exposures to cocaine and other substances (52% cocaine, 52% tobacco, 26% marijuana, 26% alcohol) were identified by meconium and/or urine assays, and/or maternal self-report. High school teachers knowledgeable about the student and unaware of study aims were asked to complete the Behavior Rating Inventory of Executive Functioning-Teacher Form (BRIEF-TF) annually.

RESULTS

Teachers completed at least one BRIEF-TF for 131 adolescents. Multivariable analyses included controls for: demographics; intrauterine cocaine, marijuana, and alcohol exposures; early childhood exposures to lead; and violence exposure from school-age to adolescence. IUTE was associated with less optimal BRIEF-TF Behavioral Regulation scores (p <0.05). Other intrauterine substance exposures did not predict less optimal BRIEF-TF scores, nor did exposures to violence, lead, nor adolescents' own substance use.

CONCLUSIONS

IUTE is associated with offspring's less optimal EF. Prenatal counseling should emphasize abstinence from tobacco, as well as alcohol and illegal substances.

Examining the Contemporaneous, Short-Term, and Long-Term Effects of Secondary Exposure to Violence on Adolescent Substance Use

The relationship between secondary exposure to violence-defined as witnessing violence in the home, community, or school-and adolescent substance use is well-documented. Yet, multi-wave empirical studies examining this relationship are sparse. In addition, studies have only begun to examine whether this relationship varies by the situational components of the violent event. Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), this study examines the contemporaneous, short-term, and long-term effects of secondary exposure to violence on substance use, and whether witnessing violence in which a weapon is present has a different impact on adolescent substance use than does witnessing violence without a weapon. Hierarchical logistic regression models on a racially and ethnically diverse sample of 1670 youth (51.5% female) residing in 79 neighborhoods indicated that: (1) the effects of secondary exposure to violence on alcohol and marijuana use were enduring, albeit attenuated, over time; (2) the effect of secondary exposure to violence on illicit drug use was suppressed in the short-term but significant in the long-term; (3) witnessing violence without a weapon was salient for alcohol and marijuana use at all time points; and (4) witnessing violence with a weapon impacted illicit drug use in the long-term. The results suggest that addressing the consequences of secondary exposure to violence requires prolonged intervention efforts and that the study of secondary exposure to violence requires a more nuanced approach that accounts for situational aspects of the violent event.

Social Skills and School Readiness in Young Children Exposed to Violence

Witnessing violence is associated with negative outcomes for preschool-aged children, including lowered school readiness; however, not all children evidence negative outcome, indicating the presence of protective factors. This study examined social skills as a moderator of the relation between violence exposure and school readiness in preschoolaged children. Seventy-eight children completed a measure of school readiness, and their caregiver completed measures of social skills, witnessed violence exposure, and direct victimization. Results revealed that social skills moderated the witnessed violence- school readiness association, controlling for direct victimization and family income. When children evidenced more appropriate social skills, witnessed violence and school readiness were inversely related. However, for children whose caregivers endorsed less appropriate social skills, there was no association between witnessed violence and school readiness.

Current Psychopathological Symptoms in Children and Adolescents Who Suffered Different Forms of Maltreatment

The aim of the present study is to evaluate the current psychopathological problems of different forms associated with maltreatment on children's and adolescents' mental health. Ninety-five females and ninety males with a mean age of 8.8 years who have suffered in the last six months different forms of abuse (physical, sexual, and emotional) and neglect were included in the study. The current reaction to trauma as directly observed by clinical instruments was examined. Differences in gender, age at the time of medical examination, familial psychiatric disorders, neuropsychiatric status, and type of maltreatment were also taken into account. Results documented that 95.1% of abused children and adolescents developed a psychiatric disorder or a subclinical form of a Posttraumatic Stress Disorder (PTSD). Moreover, our data demonstrate a role for gender, age, and familial psychiatric comorbidity in the current psychopathological problems associated with maltreatment. Overall, our findings can help clinicians make a diagnosis and provide efficient treatment and prevention strategies for child maltreatment and abuse.

Behavior Problems Among Adolescents Exposed to Family and Community Violence in Chile

Research that simultaneously examines the relationship of multiple types of family and community violence with youth outcomes is limited in the previous research literature, particularly in Latin America. This study examined the relationship of youth exposure to family and community violence-parental use of corporal punishment, violence in the community, intimate partner physical aggression-with eight subscales of the Youth Self Report among a Chilean sample of 593 youth-mother pairs. Results from multilevel models indicated a positive association between youth exposure to violence in the family and community, and a wide range of behavior problem outcomes, in particular, aggression. With growing evidence concerning the detrimental effect of violence on youth's well-being, these findings highlight the need for a more comprehensive understanding of the various kinds of violence youth are exposed to within the family and community and the concomitant need to reduce multiple forms of violence.

The expression of personality among adolescents exposed to community interpersonal violence

The high level of crime in South Africa affects many adolescents. Experience of community interpersonal violence affects the social, emotional, and cognitive functioning of adolescents and could have an impact on their personality development. The aim of the study was to explore possible differences in the expression of personality between adolescents exposed to community interpersonal violence and those not exposed to such violence. The sample comprised 183 Grade 12 learners from a secondary school in a middle-class community in Gauteng. Participants were divided into two groups: adolescents who reported exposure to community interpersonal violence ( n = 93) and those who did not report exposure to such violence ( n = 90). Both groups completed the 16 Personality Factor and Posttraumatic Diagnostic Scales. Differences between the groups were explored using a one-way between-groups multivariate analysis of variance and t-tests for independent groups. Results indicated statistically significant differences between the two groups on Factor G (rule consciousness), Factor I (emotional sensitivity), and Factor Q4 (anxiety). Adolescents exposed to interpersonal violence reported higher levels of posttraumatic stress disorder symptoms than the control group. The group that experienced posttraumatic stress disorder symptoms differed more in terms of personality functioning (Factors I and Q4). Violence-exposed adolescents experienced more emotional volatility, difficulty to regulate emotions, anxiety, and sensitivity to environmental stressors than those not exposed to such violence. Although causality cannot be assumed, it is possible that exposure to community interpersonal violence, which could result in posttraumatic stress disorder symptoms, has implications for the personality development of adolescents. Interventions for adolescents exposed to interpersonal violence are recommended to prevent the development of posttraumatic stress disorder symptoms.

Risk Factors for and Behavioral Consequences of Direct Versus Indirect Exposure to Violence

Research suggests that direct exposure (personal victimization) and indirect exposure (witnessing or hearing about the victimization of a family member, friend, or neighbor) to violence are correlated. However, questions remain about the co-occurrence of these phenomena within individuals. We used data on 1915 youths (with an average age of 12 years at baseline) from the Project on Human Development in Chicago Neighborhoods to examine this issue. Results indicated that youths who tended to be personally victimized were also likely to witness violence; conversely, youths who disproportionately witnessed violence were relatively unlikely to experience personal victimization. In addition, direct and indirect exposures to violence were associated with subsequent adverse outcomes in similar ways. The key distinguishing factor was, rather, the cumulative level of violence (both direct and indirect) to which youths were exposed.

The association between youth violence exposure and attention-deficit/hyperactivity disorder (ADHD) symptoms in a sample of fifth-graders

The purpose of the current study was to examine the association between violence exposures (no exposure, witness or victim only, and both witness and victim) and attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as the potential moderating role of gender. Data from 4,745 5th graders and their primary caregivers were drawn from the Healthy Passages study of adolescent health. Parent respondents completed the DISC Predictive Scales for ADHD, and youth provided information about exposure to violence. Results indicated that youth who reported both witnessing and victimization had more parent-reported ADHD symptoms and were more likely to meet predictive criteria for ADHD. Among those with both exposures, girls exhibited a steeper increase in ADHD symptoms and higher probability of meeting predictive criteria than did boys. Findings indicate that being both victim-of and witness-to violence is significantly associated with ADHD symptoms particularly among girls.

Paternal Antisocial Behavior and Sons’ Cognitive Ability

Parents’ antisocial behavior is associated with developmental risks for their offspring, but its effects on their children’s cognitive ability are unknown. We used linked Swedish register data for a large sample of adolescent men ( N = 1,177,173) and their parents to estimate associations between fathers’ criminal-conviction status and sons’ cognitive ability assessed at compulsory military conscription. Mechanisms behind the association were tested in children-of-siblings models across three types of sibling fathers with increasing genetic relatedness (half-siblings, full siblings, and monozygotic twins) and in quantitative genetic models. Sons whose fathers had a criminal conviction had lower cognitive ability than sons whose fathers had no conviction (any crime: Cohen’s d = −0.28; violent crime: Cohen’s d = −0.49). As models adjusted for more genetic factors, the association was gradually reduced and eventually eliminated. Nuclear-family environmental factors did not contribute to the association. Our results suggest that the association between men’s antisocial behavior and their children’s cognitive ability is not causal but is due mostly to underlying genetic factors.

Interparental Aggression and Adolescent Adjustment: The Role of Emotional Insecurity and Adrenocortical Activity

Adolescents exposed to interparental aggression are at increased risk for developing adjustment problems. The present study explored intervening variables in these pathways in a community sample that included 266 adolescents between 12 and 16 years old (M = 13.82; 52.5% boys, 47.5% girls). A moderated mediation model examined the moderating role of adrenocortical reactivity on the meditational capacity of their emotional insecurity in this context. Information from multiple reporters and adolescents' adrenocortical response to conflict were obtained during laboratory sessions attended by mothers, fathers and their adolescent child. A direct relationship was found between marital aggression and adolescents' internalizing behavior problems. Adolescents' emotional insecurity mediated the relationship between marital aggression and adolescents' depression and anxiety. Adrenocortical reactivity moderated the pathway between emotional insecurity and adolescent adjustment. The implications for further understanding the psychological and physiological effects of adolescents' exposure to interparental aggression and violence are discussed.

Childhood trauma and the risk of violence in adulthood in a population with a psychotic illness

There are strong links between childhood trauma and the risk of violence (Ford et al., 2007). Despite evidence that people with psychotic disorders are at a higher risk of violence than the general population (Witt et al., 2013) there have been few studies that have examined the trauma-violence link in this population (Spidel et al., 2010). This study explored the association between a history of childhood trauma (abuse, neglect and conflict-related trauma) and the risk of violence in adults with psychotic disorders. The strongest associations with the risk of violence were found for sexual abuse (r = .32, p < .05) and the impact of community conflict (r = .32, p < .05). An accumulative effect of trauma was found using a hierarchical regression (adjusted R(2) = .14, F(2,37) = 4.23, p < .05). There are implications for applying models of violence to psychosis, risk assessment and treatment of people with psychotic disorders as well as informing trauma models and protective factors for children in conflict-affected regions.

Typologies of Violence Exposure and Cognitive Processing in Incarcerated Male Adolescents

Incarcerated youth experience high rates of violence exposure (VE), cognitive processing (CP) deficits, and mental health (MH) problems. It is not clear whether VE combined with CP deficits are particularly salient risk factors for MH dysfunction. Male incarcerated youth offenders (n = 115) completed standardized self-reports of MH and VE. CP was measured with executive functioning tasks and academic assessments. Person-centered Ward's Squared Euclidian Distance cluster analysis was used to examine unique patterns of CP and VE. Cluster analysis defined five distinct profiles of MH functioning, CP, and VE rates within incarcerated adolescents. Two groups, with high rates of VE and CP deficits, showed high rates of MH problems. Linear techniques may obscure important differences within this population.

Childhood happiness and violence: a retrospective study of their impacts on adult well-being

OBJECTIVES

To examine the hypothesis that adult well-being is related to childhood experiences independent of current adult sociodemographic conditions.

DESIGN

A cross-sectional, stratified, randomised sample survey using self-assessed measures of current well-being and retrospective measures of childhood experiences.

SETTING

Households in North West England (September 2012-March 2013).

PARTICIPANTS

The individual with the next birthday in randomly selected households (n=11 500; compliance 89.6% of eligible households). Analysis was limited to those aged ≥18 years and answering all pertinent questions (n=11 157).

OUTCOMES

The primary outcome was a validated multicomponent measure of mental well-being (MWB). Additional outcomes included self-assessed life satisfaction (LS), life worth and trust in others.

RESULTS

Adult MWB, LS, life worth and trust were all significantly related to childhood violence and happiness. Relationships remained after controlling for sociodemographics. Thus, compared with those with happy, non-violent childhoods, respondents with unhappy, violent childhoods had adjusted ORs (95% CI, significance) of 3.10 (2.59 to 3.71, p<0.001) for low MWB, 3.62 (2.99 to 4.38, p<0.001) for low LS, 4.13 (3.40 to 5.01, p<0.001) for low life worth and 2.62 (2.20 to 3.11, p<0.001) for low trust. The impact of unhappy but non-violent childhoods were smaller but significant (p<0.001). The modelled impact of childhood factors predicted, for instance, that among unemployed white men aged 25-39 years from the most deprived communities, 27% of those with happy non-violent childhoods would have low MWB rising to 53% of those with unhappy violent childhoods.

CONCLUSIONS

Adult well-being is strongly linked to childhood experiences. The addition of well-being measures to outcomes already associated with adverse childhoods (eg, adolescent antisocial behaviour and risks of adult disease) strengthens the case for investment in interventions to improve childhood experiences. Public health systems are well placed to ensure that policy to improve adult well-being exploits the potential for this to be realised through appropriate interventions.