The impact of exposure to domestic violence on children and young people: a review of the literature

Childhood violence exposure and anxiety and depression of children and adolescents

BACKGROUND

Mental disorders constitute a global public health problem worldwide and occurs in childhood and lasts to adulthood. The purpose of this study was to explore the association between childhood violence exposure and currently diagnosed depression and anxiety in children and adolescents and investigate whether the association differs by sex and age.

METHODS

This cross-sectional study used data from 2017 to 2021 National Survey of Children's Health (NSCH). Childhood violence exposure and anxiety or depression of children were reported from caregivers. Logistic regression analyses and subgroup analyses were conducted to assess the association between the childhood violence exposure and anxiety and depression.

RESULTS

This study included 113,400 participants aged 6 to 17 years (weighted mean [SD] age, 11.5 [3.4] years; 54,539 females [weighted proportions, 48.9 %]). 9603 of them (weighted proportions, 9.0 %) had childhood violence exposure. Childhood violence exposure was associated with higher risks of anxiety (adjusted risk difference: 7.8 %, 95%CI: 6.3-9.3 %; adjusted OR: 2.11, 95%CI: 1.87-2.39) and depression (adjusted risk difference: 6.2 %, 95%CI: 5.1-7.4 %; adjusted OR: 2.94, 95%CI: 2.54-3.41) after full adjustment. Stratified analyses demonstrated that the association appeared to be stronger in younger children and the association between violence exposure and anxiety was stronger in females than in males.

CONCLUSION

In this cross-sectional study, childhood violence exposure was significantly associated with higher risks of anxiety and depression. The associations appeared to be stronger in younger and female children. Differences in sex and age-specific associations highlight the importance of building age-specific and sex-specific patterns of childhood violence prevention and intervention.

Effectiveness of Father-Focused Interventions to Prevent or Reduce Intimate Partner Violence During Pregnancy and Early Parenthood: A Systematic Review

During pregnancy and the early parenting period, women are especially vulnerable to intimate partner violence (IPV), with devastating impacts on women, children, and families. The aim of this systematic review was to determine the effectiveness of father-focused interventions to prevent or reduce IPV during pregnancy and early parenthood. Six databases were searched, using a combination of the concepts "fathers," "pregnancy/early parenthood," "IPV" and "intervention." Articles were double screened by title and abstract, and then full-text. Methodological and reporting quality was assessed using the Quality Assessment with Diverse Studies tool. Fifteen papers were eligible for inclusion; these articles were mostly of poor-to-moderate quality. Only three of the articles reported on interventions in lower- and middle-income countries. The most common forms of IPV addressed in these interventions were physical (10), psychological (8), sexual (4), and economic/financial (3). Of 12 articles reporting on data from both intervention and control groups, only six indicated statistically significant results; among these, only three reported robust analyses showing significantly greater reduction in IPV in intervention than in control groups. All three took place in lower- or middle-income countries. Two were underpinned by theoretical frameworks, which considered transforming traditional perceived gender norms. Therefore, interventions based on principles that address transformation of gender norms show promise but the success of such underlying principles needs to be confirmed, and better-quality evidence and reporting are needed for interventions targeting fathers to prevent or reduce IPV.

Physical activity interventions for the promotion of mental health outcomes in at-risk children and adolescents: a systematic review

Many young people are exposed to risk factors that increase their risk of mental illness. Physical activity provision is an increasingly popular approach to protect against mental illness in the face of these risk factors. We examined the effectiveness of physical activity interventions for the promotion of mental health outcomes in at-risk children and adolescents. We searched health databases for randomised and non-randomised intervention studies, with no date restriction, and assessed risk of bias using the Cochrane Risk of Bias tools. We present a narrative synthesis of our results accompanied with a summary of available effect sizes. Thirty-seven reports on 36 studies were included, with multi-sport or yoga interventions the most popular intervention approaches (a combined 50% of included studies). Outcomes measured included internalising, self-evaluative, wellbeing, overall symptomatology, resilience, externalising, and trauma outcomes. We found that 63% of between-groups effects favoured the intervention arm, and 83% of within-groups effects favoured an intervention effect. While recognising high risk of bias, our findings provide evidence in support of the effectiveness of physical activity interventions for promoting mental health outcomes in at-risk young people. We encourage further work designed to better understand the intervention characteristics that may lead to positive benefits.

Adverse childhood experiences and alexithymia intensity as predictors of temporal dynamics of functioning in individuals with irritable bowel syndrome: A three-wave latent transition analysis

OBJECTIVE

Despite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group.

METHOD

Based on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics.

RESULTS

The IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants.

CONCLUSION

Childhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.

Association of child maltreatment and school bullying among Chinese adolescents: the mediating role of peer relationships

BACKGROUND

School bullying, a serious problem for the physical and mental health of adolescents, is presently a significant issue in China. It is essential to recognize and comprehend potential risk factors and establish efficient preventive strategies. The purpose of this study was to examine the association between childhood maltreatment and school bullying in adolescents and to assess the mediating role of peer relationships.

METHODS

Between March and April 2024, a cross-sectional survey was conducted among 2119 adolescents aged between 12 and 18 years in Guangdong Province, China. Self-report questionnaires were employed to collect data on childhood maltreatment, school bullying, and peer relationships. Subgroup analyses and mediating effects modeling were employed to analyze the data.

RESULTS

The results indicated that adolescents who had experienced maltreatment were more at risk of bullying victimization (OR: 2.92, 95% CI: 2.34-3.64, P < 0.001), bullying perpetration (OR: 2.84, 95% CI: 1.99-4.05, P < 0.001), and bully-victimization (OR: 2.93, 95% CI: 1.95-4.41, P < 0.001), compared to adolescents who have not. Sexual abuse showed the most significant connection with all forms of bullying. The mediating effect of peer relationships was found to mediate the association between child maltreatment and bullying behaviour. The results indicated that worse peer relationships may exacerbate the adverse effects of maltreatment experiences and increase the risk of adolescents becoming bullies, either perpetrators or victims of bullying.

CONCLUSIONS

Child maltreatment has been identified as one of the most significant influences on bullying behaviour in adolescents. The quality of peer relationships has been demonstrated to play an important role in preventing and reducing the occurrence of bullying. The results underscore the crucial role of early intervention in cases of child maltreatment and the fostering of positive peer relationships in schools.

Primary healthcare practitioners' perspectives on trauma-informed primary care: a systematic review

BACKGROUND

Exposure to domestic and family violence is a pervasive form of complex trauma and a major global public health problem. At the frontline of the health system, primary healthcare practitioners are uniquely placed to support individuals with experiences of trauma, yet their views on trauma-informed primary care are not well understood. This systematic review of qualitative literature sought to explore primary healthcare practitioners' perspectives on trauma-informed primary care.

METHODS

Eight databases were searched up to July 2023. Studies were included if they consisted of empirical qualitative data, were conducted in general practice or equivalent generalist primary healthcare settings, and included the perspectives of primary healthcare practitioners where they could be distinguished from other participants in the analysis. Thematic synthesis was used for analysis.

RESULTS

13 papers met inclusion criteria, representing primary care settings from the United States, Canada, Australia, and Norway. Three key themes were developed: Changing the paradigm, Building trust, and Navigating the emotional load. Findings shed light on how primary healthcare practitioners perceive and strive to practise trauma-informed primary healthcare and the challenges of navigating complex, trauma-related work in the primary care environment.

CONCLUSIONS

This review supports the need for recognition of the value of primary care in supporting patients with histories of trauma and violence, the development of interventions to mitigate the emotional load worn by primary healthcare practitioners, and further work to develop a deep and consistent understanding of what trauma-informed primary care encompasses.

Depression in youths with early life adversity: a systematic review and meta-analysis

Background

Globally, early-life adversity (ELA) is linked to an increased risk of developing depression in adulthood; however, only a few studies have examined the specific effects of various types of ELA on depression in children and adolescents. This meta-analysis explores the association between the subtypes of ELA and the risk for youth-onset depression.

Methods

We searched three electronic databases for reporting types of ELA, namely, emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, family conflict/violence, divorce, low socioeconomic status, and left-behind experience, associated with depression before the age of 18 years. Our meta-analysis utilized the odds ratio (OR) and relied on a random effects model. Large heterogeneous effects were detected. Some factors moderated the association between ELA and depression in youths. The homogeneity of variance test and meta-regression analysis were used to detect these relationships.

Results

A total of 87 studies with 213,006 participants were ultimately identified via several strategies in this meta-analysis. Individuals who experienced ELA were more likely to develop depression before the age of 18 years old than those without a history of ELA (OR=2.14; 95% CI [1.93, 2.37]). The results of the subgroup analysis revealed a strong association between ELA and depression in youth, both in terms of specific types and dimensions. Specifically, emotional abuse (OR = 4.25, 95% CI [3.04, 5.94]) was more strongly related to depression in children and adolescents than other forms of ELA were. For both dimensions, threat (OR = 2.60, 95% CI [2.23, 3.02]) was more closely related to depression than deprivation was (OR = 1.76, 95% CI [1.55, 1.99]).

Conclusion

This meta-analysis revealed that the adverse effects of a broader consideration of ELA on the risk of youth-onset depression vary according to the subtypes of ELA.

Systematic review registation

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023405803, identifier 42023405803.

Exploring the interplay of parenting styles, basic empathy, domestic violence, and bystander behavior in adolescent school bullying: a moderated mediation analysis

Introduction

This study investigates how parental styles, basic empathy, and family violence influence adolescents' bystander behaviors in school bullying.

Methods

A survey was conducted with 1,067 students from three middle schools in southern China. Multifactor logistic regression and a moderated mediation model were employed to analyze the relationships between positive and negative parental styles, basic empathy, and bystander behaviors.

Results

The study found significant correlations and predictive relationships: Positive parental styles were strongly associated with increased basic empathy (r = 0.29, p < 0.01) and behaviors that protect victims (r = 0.29, p < 0.01). In contrast, negative parental styles correlated positively with behaviors that support bullying (r = 0.12, p < 0.01) and instances of family violence (r = 0.62, p < 0.01). Basic empathy negatively predicted behaviors that promote bullying (β = -0.098, p < 0.01) and positively predicted protective behaviors toward victims (β = 0.249, p < 0.001). Furthermore, family violence weakened the positive effects of positive parental styles on both empathy (β = -0.075, p < 0.001) and protective behaviors (β = -0.025, p < 0.01).

Conclusion

The findings indicate that positive parental styles indirectly promote adolescents' victim protector behaviors by enhancing their basic empathy, underscoring the importance of emotional cultivation. Meanwhile, family violence weakens the positive impact of these parental styles on basic empathy and protective behaviors, harming adolescents' emotional security and behavioral norms.

[Psychotraumatic consequences of coercive control]

Coercive control is a process of violence in which one person acts in such a way as to subject the other to persistent controlling behavior. In the majority of cases, these are men, and the targets are their spouses and children. The psychotraumatic consequences are innumerable, and need to be understood before they can be identified and treated. The repercussions of coercive control are numerous, whether somatic, psychological, familial, social, professional or academic. This article describes the psychotraumatic consequences for both the victim and the children.

"I Have to Make Sure She Is Not Sad": Children's Perceptions of Their Mothers' Experiences in Shelters for Battered Women

A qualitative study examined children's subjective perception of their mother's situation during their stay in shelters for battered women (SBW). Thirty-two children, aged 7-12 years, who were staying with their mothers in SBWs participated in this study. Thematic analysis revealed the following two core themes: children's perceptions and insights, and feelings that were related to their perceptions. The findings are discussed in light of the concepts of exposure to IPV as a lived trauma, and re-exposure to violence in new contexts, and the role of the relationship with the abused mother in shaping the child's well-being.

A Four-Wave Cross-Lagged Study of Exposure to Violent Contexts, Cognitive Distortions, and School Bullying during Adolescence

School bullying represents a widespread expression of violence in the peer context. Guided by the social-ecological model, this study investigated the longitudinal and transactional pathways linking domestic and neighborhood/community violence exposure (through direct victimization and witnessing), self-serving cognitive distortions (CDs), and school bullying perpetration. Furthermore, consistent with the previous literature, we tested the cognitive desensitization process that could develop in response to chronically violent contexts. Two four-wave cross-lagged panel mediation models were tested in a sample of 778 high school students (28.1% males; Mage [Time 1; T1] = 14.20, SD = 0.58). The results showed differential effects of multiple contexts and forms of violence exposure, with domestic violence victimization and community violence witnessing being associated with self-serving CDs and bullying perpetration over time. Moreover, significant associations between CDs and bullying perpetration over time were found, with bidirectional effects for each of these longitudinal patterns. Finally, self-serving CDs significantly mediated the relationships between both domestic violence victimization and community violence witnessing and school bullying perpetration. These findings highlight the need to consider school bullying as a social phenomenon stemming from a complex and bidirectional interplay between individuals and the environments they inhabit, confirming a basic postulate that "violence breeds violence".

Service evaluation of an independent domestic violence advocate post in a children's hospital

Domestic violence and abuse (DVA) has detrimental effects on the health and well-being of children and young people exposed to it, whether they witness or experience it. The introduction of independent domestic violence advocates in UK hospitals has enhanced the safety of victims of DVA. In 2020-2021 an independent domestic violence advocate post was piloted at a children's hospital for one year, the advocate's role being to train hospital staff and support women who had experienced DVA. A service evaluation showed that the training and support provided by the independent domestic violence advocate had benefits for women, children and staff. It also confirmed that the commissioning of services for children exposed to DVA is often underfunded and overshadowed by the provision of support to adults.

Mental health outcomes of offspring exposed to parental intimate partner violence in Rwanda

BACKGROUND

Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence.

OBJECTIVE

The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes.

METHODOLOGY

This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring.

RESULTS

The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems.

CONCLUSION

The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.

Protective factors for the risk of suffering intimate partner violence in help-seeking women survivors from a social organization in Chile

Objective

Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV.

Methods

We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study.

Results

Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication.

Conclusion

To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.

Road Blocks or Building Blocks? A Qualitative Study on Challenges and Resilience in Romantic Relationships of Youth Exposed to Family Violence

Romantic relationships are an important part of many people's lives and at least partly shaped by experiences during childhood. Youth exposed to family violence during childhood are more likely to experience difficulties in their later romantic relationships. However, a more holistic perspective on the romantic relationships of youth with a history of family violence is lacking. Using both theoretical and inductive thematic analysis, this qualitative study explored challenges as well as positive experiences within romantic relationships of youth exposed to family violence during childhood. In-depth individual interviews were conducted with 18 youth aged between 16 and 20 years, who were reported to child protection services. The narratives reflected that youth experienced challenges related to support, connection, trust, boundary setting, emotion regulation and conflict resolution. Furthermore, family violence during childhood seemed to be important in the emergence of these challenges, consistent with theoretical mechanisms described in observational learning theory and attachment theory. However, youth also described positive experiences in their romantic relationships and demonstrated an ability to learn from others (e.g., their current romantic partner) how to communicate effectively or solve problems. Therefore, with the right social or professional support, at-risk youth may be able to overcome these challenges.

Implications of Exposure to Intimate Partner Violence in Childhood

The most recent available data show that children were present at 38% of domestic incidents reported throughout Delaware, and analysis of barriers to reporting predict this number to be much higher. Intimate partner violence (IPV) can take numerous forms, such as patterns of physical, sexual, psychological, economic, and reproductive abuse, meaning each situation manifests differently and requires individualized intervention. Children face unique short- and long-term challenges as a result of their witness status within such scenarios. Programming throughout Delaware works to support victims and mitigate the negative ramifications that IPV has on children and their families.

Spatial clustering of domestic violence attitudes toward women in Ghana

Violence against women is a global public health issue associated with increased morbidity and mortality. The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life". There is paucity of data on the spatial distribution and predictors of violence against women in sub-Saharan Africa. The objective of this study was to investigate the geographical distribution of attitudes toward wife beating in Ghana, a sub-Saharan African country, utilizing data from the 2014 Ghana Demographic and Health Survey (DHS). Participants from over eleven thousand households were surveyed on topics of demographics and justification of wife beating in at least one of five different scenarios. The identification of geographic clusters of men and women who endorsed wife beating was performed using Ripley K functions. The comparison of the spatial distributions of women and men justifying wife beating were performed using spatial relative risk surfaces. The spatial analysis indicated the presence of clusters in women and men's approval for wife beating compared to those who do not approve of wife beating, with a statistical significance level set at p < 0.01. Major spatial clusters of approval of wife beating were in the Northern region, for both men and women, and in the Upper West region of Ghana for the men participants. This is the first study to explore the geographical distribution of attitudes toward wife beating in Ghana, and revealed evidence of several regional heterogeneous clusters where wife beating was more commonly justified by both men and women. Targeted intervention for reducing the justification of wife beating in Ghana should be focused in these regions.

Childhood exposure to domestic violence: can global estimates on the scale of exposure be obtained using existing measures?

Purpose

Childhood exposure to domestic violence and abuse (DVA) can lead to major short- and long-term effects on the victim. Despite this, there is no accepted measure for children's experiences, with most existing measures being validated only in high income countries and not in low- and middle- income countries. As a result, international statistics are not comparable. This paper seeks to critically appraise existing measures and discuss whether any are fit-for-purpose on a global scale.

Method

The COSMIN PROMs approach was followed to critically appraise and compare the appropriateness of measures. A comprehensive literature search was undertaken in seven journal databases for measures mentioned in formally peer-reviewed articles exploring childhood exposure to DVA.

Results

A literature search resulted in the identification of 10 measures and, following criteria to only keep original measures and remove modifications, four measures which have been validated cross-culturally are discussed in detail in line with the COSMIN PROMs criterion: The Child Exposure to Domestic Violence Scale, Children's Perception of Interparental Conflict Scale, Juvenile Victimization Questionnaire and The Violence Exposure Scale for Children. Strengths and limitations of each are discussed, along with any validations undertaken not in the country of origin.

Conclusion

Despite childhood exposure to DVA being an urgent research priority worldwide, the current measures to explore the extent of the issue are not validated cross-culturally, leading to concerns about comparisons across different population groups. The development and implementation of interventions to reduce the levels and effects of exposure relies heavily on cross-cultural comparisons, which may indicate different strategies are needed in different contexts. The lack of these validated comparisons is constraining advances, and the paper advocates for further efforts to be made in this regard.

Early identification and awareness of child abuse and neglect among physicians and teachers

BACKGROUND

Child abuse and neglect (CAN) causes enormous suffering for those affected.

OBJECTIVE

The study investigated the current state of knowledge concerning the recognition of CAN and protocols for suspected cases amongst physicians and teachers.

METHODS

In a pilot study conducted in Mecklenburg-Western Pomerania from May 2020 to June 2021, we invited teachers and physicians working with children to complete an online questionnaire containing mainly multiple-choice-questions.

RESULTS

In total, 45 physicians and 57 teachers responded. Altogether, 84% of physicians and 44% of teachers were aware of cases in which CAN had occurred in the context of their professional activity. Further, 31% of physicians and 23% of teachers stated that specific instructions on CAN did not exist in their professional institution or that they were not aware of them. All physicians and 98% of teachers were in favor of mandatory training on CAN for pediatric residents and trainee teachers. Although 13% of physicians and 49% of teachers considered a discussion of a suspected case of CAN to constitute a breach of confidentiality, 87% of physicians and 60% of teachers stated that they would discuss a suspected case with colleagues.

CONCLUSION

Despite the fact that a large proportion of respondents had already been confronted with suspected cases of CAN, further guidelines for reporting procedures and training seem necessary. There is still uncertainty in both professions on dealing with cases of suspected CAN.

Effects on Child Development and Parent-Child Interaction of the FACAM Intervention: A Randomized Controlled Study of an Interdisciplinary Intervention to Support Women in Vulnerable Positions through Pregnancy and Early Motherhood

Health inequality can have a profound impact on a child's life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3-6, 12-13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent-child relationship, child social-emotional development, child developmental progress, parent-child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4-6 months old (b = -0.25, [-0.42; -0.08] d = -0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent-child interaction outcomes.

Global Prevalence of Childhood Exposure to Physical Violence within Domestic and Family Relationships in the General Population: A Systematic Review and Proportional Meta-Analysis

Efforts to identify and prevent childhood exposure to physical violence within domestic and family relationships must be underpinned by reliable prevalence estimates to ensure the appropriate allocation of resources and benchmarks for assessing intervention efficacy. We conducted a systematic review and meta-analysis of the global prevalence of childhood exposure to physical domestic and family violence separately as a victim or witness. Searches were conducted in Criminal Justice Abstracts, Embase, Scopus, PubMed, PsychInfo, and Google Scholar. Studies were included if they were peer-reviewed, published in English, had a representative sample, unweighted estimates, and were published between January 2010 and December 2022. One-hundred-and-sixteen studies comprising 56 independent samples were retained. Proportional meta-analysis was conducted to calculate the pooled prevalence for each exposure. Pooled prevalence estimates were also stratified by region and sex. The global pooled prevalence of childhood exposure to physical domestic and family violence as a victim or witness was 17.3% and 16.5%, respectively. Prevalence estimates were highest in West Asia and Africa (victim = 42.8%; witness = 38.3%) and lowest for the Developed Asia Pacific region (victim = 3.7%; witness = 5.4%). Males were 25% more likely than females to be the victim of physical domestic and family violence during childhood, while both were equally likely to have witnessed it. These findings suggest that childhood exposure to domestic and family violence is relatively common, affecting around one-in-six people by 18 years of age globally. Regional variations in prevalence estimates may reflect underlying economic conditions, cultural norms, and service availability.

What Does Child Protective Services Investigate as Neglect? A Population-Based Study

Most child protective services (CPS) investigations involve allegations of neglect. Broad and vague definitions have led to concerns that CPS-investigated neglect is driven by poverty-based material hardship. In a representative sample of 295 neglect investigations in California in 2017, structured data and narrative text fields were used to characterize the types of neglect and concurrent parental risk factors investigated by CPS and to assess the rate and nature of investigated physical neglect, defined as inadequate food, housing, or hygiene. The most common types of neglect were inadequate supervision (44%) and failure to protect (29%), followed by physical neglect (14%). Common risk factors identified in neglect investigations were parental substance use (41%), domestic violence (21%), mental illness (18%), and co-reported physical or sexual abuse (29%). Nearly all investigations of physical neglect (99%) included concerns related to substance use, domestic violence, mental illness, co-reported abuse or an additional neglect allegation (i.e., abandonment). Given concerns identified in neglect investigations, economic supports are likely insufficient without an array of behavioral-health supports.

Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care

BACKGROUND

Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019-21.

METHODS

We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention.

RESULTS

The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence.

CONCLUSIONS

Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS + . Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions.

Dimensional model of adolescent personality pathology, reflective functioning, and emotional maltreatment

Introduction

Childhood emotional abuse (CEA) is a recognized risk factor for adolescent mentalizing challenges. However, there's limited understanding about how CEA might influence personality development and elevate the risk of adolescent personality pathology. A deeper grasp of these pathways is crucial, given that adolescence is a pivotal developmental phase for identity integration, personality consolidation, and the emergence of personality disorders. As the emphasis shifts to dimensional perspectives on adolescent personality pathology, the spotlight is increasingly on adolescents' evolving personality organization (PO). Within this framework, personality disorder manifestations stem from inherent vulnerabilities in PO. A comprehensive understanding of how CEA leads to these inherent vulnerabilities in PO can inform enhanced interventions for at-risk adolescents. Nonetheless, our comprehension lacks insight into potential pathways to PO, especially those involving external factors like maltreatment and individual traits like mentalizing. This study sought to bridge these gaps by employing latent factor analysis and structural equation modeling to explore connections between emotional maltreatment, adolescent mentalizing, and PO.

Methods

A community-based cohort of 193 adolescents (aged 12-17) took part in self-report assessments: the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), the Reflective Functioning Questionnaire for Youth (RFQ-Y), and the Inventory for Personality Organization for Adolescents (IPO-A).

Results

The structural equation model revealed a significant direct influence of CEA on both RFQ-Confusion and PO, and a noteworthy direct effect of RFQ-Confusion on PO. Remarkably, the model accounted for 76.9% of the PO variance. CEA exhibited a significant indirect impact on PO through RFQ-Confusion, which was accountable for 52.3% of the CEA effect on PO, signifying a partial mediation by mentalizing.

Discussion

These insights carry substantial clinical implications, especially for devising integrated, trauma-informed strategies for adolescents with personality pathologies. This is particularly relevant for enhancing mentalizing and bolstering personality consolidation among adolescent CEA survivors.

"Does It Really Get Better After Dad Leaves?" Children's Experiences With Domestic Violence: A Qualitative Systematic Review

Domestic violence (DV) can persist and escalate post-separation. However, little focus has been given to children exposed to DV during this period. This review aims to consolidate the available evidence on children's post-separation experiences with DV caused by their fathers. A qualitative systematic review was carried out. Six electronic databases were searched from the inception of each database until July 2022. Qualitative studies of children aged below 24 years, with biological fathers that committed DV, of which each had experienced parental separation were selected. Twenty studies were included in this review after screening according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Using Sandelowski and Barroso's analysis method, a meta-summary and a meta-synthesis were conducted. Three major themes with eight subthemes were identified: (1) continued abuse post-separation, (2) child's wavering mind of their fathers, and (3) wrangling between past and present. Overall, the findings highlighted that the experience of DV persisted post-separation through various forms of abuse. Children also struggled with mixed feelings and thoughts toward their fathers. They found it hard to trust their fathers and were cautious about their fathers' intentions regarding love and interest. Some children had difficulty interacting with their fathers and were exploited by them. Different stakeholders such as healthcare professionals and court officials can play a significant role in supporting and protecting children exposed to DV and schools can play a significant role in empowering children against DV.

Interparental Coercive Control and Child and Family Outcomes: A Systematic Review

Coercive control (CC) is a core facet of intimate partner violence (IPV) and involves asserting power, dominance, and control over another person. Although the adverse impacts of childhood exposure to interparental IPV have been well documented, the outcomes of childhood exposure to interparental CC have not been systematically examined. This study aimed to address this gap by reviewing available empirical evidence on interparental CC and child and family outcomes. Articles were identified by searching electronic databases using keywords relating to CC, children and parents, and child wellbeing outcomes. The final review included 51 studies that reported on adverse outcomes pertaining to parenting and family relationships (k = 29), child internalizing and externalizing problems (k = 7), social-emotional development (k = 5), and physical/health development (k = 17). Specifically, studies reported that CC was associated with increased parental psychopathology, poorer family functioning, harsher parenting and higher levels of child abuse, strained parent-child relationships, children used as tools and co-victims of CC, increased risk of child internalizing and externalizing problems, limited socializing opportunities, increased bullying, poorer perinatal outcomes, limited access to healthcare, and increased risk of child mortality. Evidence identified CC as a unique contributor to adverse child wellbeing outcomes, independent of exposure to IPV more broadly. Results indicated that the impacts of childhood exposure to CC are complex, far reaching, and, in some cases, devastating. The limitations of the findings, as well as implications for practice, policy, and research are discussed.

Verbal, physical and sexual dating violence among a population-based sample of teens: Does exposure to intimate partner violence in the home account for the association between dating violence and mental health?

BACKGROUND

Teen dating violence (TDV) and exposure to intimate partner violence (eIPV) are associated with poorer mental health; however, few studies investigate verbal TDV or the independent contributions that TDV and eIPV have on mental health.

OBJECTIVE

Examine the prevalence of TDV (verbal, physical, sexual, multiple forms) among youth, associations between TDV and mental health, and how eIPV affects these associations.

PARTICIPANTS AND SETTING

A school-based sample of 71,635 9th and 11th grade students (51.5% assigned female, 71.9% White) completed the anonymous 2019 Minnesota Student Survey, providing data on mental/emotional/behavioral (MEB) problems and treatment, depression and anxiety symptoms, non-suicidal self-injury, suicidal ideation/attempts, TDV, and eIPV.

METHODS

Chi-square tests were used to compare the prevalence of mental health concerns by TDV form; logistic regression models controlled for demographic characteristics and eIPV. Interaction tests identified the multiplicative effects of eIPV and TDV on mental health.

RESULTS

TDV was reported by 36.4% of those with vs 13.6% of those without eIPV. Each type of TDV was significantly associated with adverse mental health (p's<0.001), even after adjusting for demographic variables and eIPV. The prevalence of each mental health outcome was significantly increased by eIPV for youth with no TDV (p's<0.001), verbal only (p's<0.001), sexual only (p's<0.05), and multiple forms of TDV (p's<0.001); findings for physical TDV varied.

CONCLUSIONS

Education on healthy, consensual dating relationships is critical, alongside regular screening for eIPV and TDV, referring affected youth for treatment. Further research on factors that attenuate the association between TDV and mental health is warranted.

Supporting Intimate Partner Violence Survivors and Their Children in Pediatric Healthcare Settings

Intimate partner violence (IPV) is a pervasive public health epidemic that influences child health and thriving. In this article, we discuss how pediatric healthcare providers and systems can create healing-centered spaces to support IPV survivors and their children. We review the use of universal education and resource provision to share information about IPV during all clinical encounters as a healing-centered alternative to screening. We also review how to support survivors who may share experiences of IPV, focused on validation, affirmation, and connection to resources. Clinicians are provided key action items to implement in their clinical settings.

Mothers' experiences of emotional abuse from an intimate partner and its associations with children's developmental outcomes at 5 years

BACKGROUND

Intimate partner violence (IPV) is associated with an increased risk of poorer child development. Existing research has focused on physical abuse with less known about the associations with emotional IPV.

OBJECTIVE

To describe the period prevalence of mother's experiences of emotional IPV during children's preschool years and associations with child mental, physical, social, and cognitive development.

METHODS

Secondary analysis of control group data (n = 194) from an Australian randomised trial (right@home), which recruited pregnant women experiencing social adversity from antenatal clinics in 2013-14. Women reported emotional abuse (Composite Abuse Scale) at child ages 3-5 years. Measures of child development at 5 years included: Strengths and Difficulties Questionnaire, Social Skills Improvement System, Pediatric Quality of Life Inventory, Clinical Evaluation of Language Fundamentals, School Entry Alphabetic and Phonological Awareness Readiness Test, NIH executive function subtests, sleep and health. The prevalence of emotional IPV from 3 to 5 years was estimated. Regression models compared developmental outcomes according to emotional IPV exposure, adjusted for child age, child gender, and maternal education. Missing data were accounted for using multiple imputation.

RESULTS

From 3-5 years, emotional IPV was experienced by 57% of women. Emotional IPV exposure was consistently associated with poorer child developmental outcomes. Differences were most apparent for SDQ internalising (mean difference 1.2, 95% CI 0.2 to 2.1) and externalising difficulties (1.2, 95% CI -0.1 to 2.4).

CONCLUSIONS

Emotional IPV was highly prevalent amongst families experiencing social adversity. Developing acceptable and effective identification processes and interventions that prioritise families experiencing co-occurring social adversities should be a public health priority.

Examining Cases of Child Physical Abuse Evaluations to Identify Opportunities to Improve Intimate Partner Violence Screening in Pediatric Emergency Departments

The association between child maltreatment and intimate partner violence (IPV) is well supported. Universal IPV screening has been recommended by the American Academy of Pediatrics and the United States Preventative Task Force, and many children's hospitals have established screening protocols. However, the yield and best screening method in families undergoing a child physical abuse (PA) evaluation have not been fully explored. To determine if there is a discrepancy in IPV disclosures between universal IPV screening completed during pediatric emergency department (PED) triage ("triage screening") and IPV screening by a social worker ("social work screening") in families of children who were evaluated for PA. Caregivers of children who presented to an urban tertiary PED and underwent an evaluation for PA via a child abuse pediatrics consult. A retrospective chart review was completed. Data collection included: caregiver responses to both triage screening and social work screening, interview setting details and participants, the child's injuries, and details of the family's reported IPV experiences. Our study (N = 329) revealed that social work screening produced significantly more positive IPV disclosures than triage screening (14.0% vs. 4.3%, p < .001). Additionally, non-IPV violence concerns were identified in 35.7% (n = 5) of the positive triage screens, whereas social work screens had none. These results highlight the benefits of IPV screening by social work in high-risk scenarios, such as child PA evaluations, regardless of universal IPV screening results. Exploring differences between the two screening methods can inform decisions about screening protocols to improve IPV identification in high-risk populations.

Adverse Childhood Experiences: Relationship with Empathy and Alexithymia

Several studies showed that adults who have experienced childhood adversity are more likely to develop alexithymia and low empathy. Therefore, this research aims to analyze the relationship between childhood adversity and alexithymia and empathy in adulthood and verify a predictive explanatory model of alexithymia. The sample comprised 92 adults who responded to the sociodemographic questionnaire, the Childhood History Questionnaire, the Interpersonal Reactivity Index, and the Alexithymia Scale of Toronto. Childhood adversity showed a positive relationship with alexithymia and a negative relationship with empathy. Predictive validity showed that marital status, adverse childhood experiences (ACEs), and empathic concern predicted higher alexithymia scores. These results show the impact of these childhood experiences on adult life, underlining the importance of developing intervention programs in this field.

Intergenerational transmission of intimate partner violence among women: Evidence from the 2017 Philippines National Demographic and Health Survey

Intimate partner violence (IPV) substantially harms women's overall health worldwide. The intergenerational cycle of IPV among women remains underexplored from the perspective of victimization and perpetration, and by types of subsequent IPV. The 2017 Philippines National Demographic and Health Survey dataset of 12,248 currently in-union (married or cohabiting) women aged 15 to 49 were utilized in this study. The main exposure variable was measured by the question: "as far as you know, did your father ever beat your mother?". Multivariate logistic regression was performed to investigate the association between being ever exposed to parental IPV and (1) women's IPV victimization (by types: any, physical, sexual, and emotional) and (2) IPV perpetration (physical) by women against their husbands or male partners. Further, multinomial logistic regression examined the association between exposure to parental IPV and the experience of being an IPV victim only, perpetrator only, or both. We have found that women who were exposed to parental IPV were more likely to experience IPV victimization (OR: 2.1, 95% CI: 1.9, 2.4 for any IPV; OR: 2.3, 95% CI: 2.0, 2. for physical IPV; OR: 2.0, 95% CI: 1.6, 2.4 for sexual IPV; and OR: 2.0, 95% CI: 1.8, 2.2 for emotional IPV), and also perpetrate physical IPV themselves (OR: 2.1, 95% CI: 1.9, 2.4) compared to those unexposed to parental IPV. Moreover, women exposed to parental IPV were three times more likely to be both a perpetrator and a victim of IPV (OR: 3.1, 95% CI: 2.7, 3.7), much higher than the odds of being a victim only (OR: 1.9, 95% CI: 1.8, 2.2) or a perpetrator only (OR: 1.9, 95% CI: 1.6, 2.). In summary, exposure to parental IPV was associated with Filipino women being victims and perpetrators of IPV themselves. The integration of violence prevention within parenting and community programs can be considered to prevent the perpetuation of the intergenerational cycle of IPV.

The Validity and Reliability of Malay Version Child Exposure to Domestic Violence Scale

Background

Domestic violence has a significant impact on growing children. However, existing evidence is limited and often under reported. Consequently, the Child Exposure to Domestic Violence (CEDV) scale has been developed for global use. This study aims to provide a cross-cultural translation, adaptation and validation of the CEDV based on Malay language.

Methods

CEDV scale was translated from the original English version to Malay. Content and face validity were examined before field-testing. The study comprised a cross sectional study using the Malay version of the CEDV (CEDV-M) scale conducted at a secondary school in Perlis, Malaysia and investigated 235 children aged 13 years old-16 years old using an online platform. The construct validity, internal consistency and stability of the tool were assessed.

Results

The CEDV-M scale's content and face validity both yielded a value exceeding 0.80. Furthermore, the tool demonstrated has good stability reliability, using the intra-class correlation value for all items ranging from 0.659 to 1.00. The exploratory factor analysis of the 36 items of the CEDV scale revealed possibilities of five or six factor domains. However, the five factor domains were most conceptually equivalent. Consequently, this study found that the CEDV-M scale is reliable with a total Cronbach's alpha of 0.87.

Conclusion

CEDV-M scale is a valid and reliable tool for measuring a child's experience of domestic violence. Future studies recommend confirmatory factor analysis and standard settings for scoring systems.

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.

Mediators and moderator of the effects of early exposure to intimate partner violence on children's mental health

Childhood intimate partner violence (IPV) exposure increases the likelihood of internalizing and externalizing problems. There is substantial variability in children's outcomes following IPV exposure, but the reasons behind this are unclear, particularly among preschool-age children. The current study aimed to examine the direct and indirect effects of IPV on preschoolers' mental health through parent factors (parenting and parental depression), exploring child temperament as a potential moderator of the relation between IPV and child outcomes. Participants were 186 children (85 girls) and their parents living in the United States. Data were initially collected when children were age three, with follow-up at ages four and six. Both parents' baseline IPV perpetration had adverse effects on child outcomes. Mothers' IPV was associated with greater paternal depression, paternal overractivity, and maternal laxness, whereas fathers' IPV was associated with more paternal overreactivity. Only paternal depression mediated the effect of mothers' IPV on child outcomes. Parenting did not mediate nor did child temperament moderate the relation between IPV and child outcomes. Results shed insight into the need to address parental mental health in families experiencing IPV and underline the need for a further exploration of individual- and family-level mechanisms of adjustment following IPV exposure.

Gender and role associations between domestic violence during childhood and dating violence: Victimization among male college students mediated through violence justification beliefs

BACKGROUND

Although the victimization experiences of male college students in dating relationships are gaining increasing scholarly attention, there is still limited empirical evidence and theoretical understanding of the mechanism through which male victims of domestic violence experience subsequent dating violence.

OBJECTIVE

This study aims to gain a deeper understanding of the specific mechanisms through which male victimization of domestic violence during childhood transmits to dating violence experience in adulthood. Whether the intergenerational transmission of violence may be explained by gendered pathways or by male participants' identification with the victim's position will be tested.

PARTICIPANTS AND SETTING

Participants included 526 South Korean male college students in Seoul.

METHODS

Child abuse, witnessing interparental violence, and beliefs justifying and accepting violence were divided based on the gender of the offender and victim to assess distinct effects. Structural equation modeling (SEM) was used to evaluate the relationships between dating violence victimization and child abuse/witnessing interparental violence and the mediation effect of beliefs justifying violence in the relationships between the variables.

RESULTS

Both paternal and maternal abuse have significant direct relationships with male dating violence victimization. Witnessing mother-to-father violence had a significant and direct relationship with male victimization while witnessing father-to-mother violence did not. The mediation effect of justification of female-to-male violence was confirmed between witnessing mother-initiated violence and male victimization, whereas justification of male-to-female violence did not show a mediating effect between witnessing father-initiated violence and male victimization.

CONCLUSION

Both role and gender associations were confirmed. The results imply that there are different ways through which children learn about violence. More specific targets should be addressed in education programs to break the vicious cycle of violence.

The impact of child maltreatment on mental health outcome improvements among children and youth accessing community mental health care

BACKGROUND

Although children with histories of maltreatment are more likely to engage with mental healthcare than non-maltreated children, few studies have examined the impact of maltreatment on children's mental health outcome improvement over time.

OBJECTIVE

The current study addresses this gap in the present literature by exploring the ways that histories of physical, sexual, and emotional abuse and exposure to domestic violence can influence children's improvement on mental health outcomes commonly associated with trauma.

PARTICIPANTS AND SETTING

De-identified routine care data from 58 community mental health agencies across Ontario, Canada, representing 16,517 children was obtained. This data represented assessments that occurred between February 2015 and December 2021.

METHODS

General linear models were used to illustrate the effect of each trauma type on change scores computed between baseline and follow-up assessments of externalizing behaviours, risk of harm to others, depressive symptoms, risk of suicide and self-harm, and anxiety, while adjusting for baseline scores, inpatient status, time between assessments, and select demographic variables.

RESULTS

When the effects of each trauma type was considered separately, children without histories of trauma consistently showed greater improvement than those with that trauma across all mental health outcomes (0.07-0.44, p < 0.01). When all trauma types were considered together, sexual abuse was associated with some of the most significant negative impacts on children's mental health improvements.

CONCLUSIONS

Our findings highlight an urgent need for the implementation of standardized, evidence-based assessments that screen trauma histories of children accessing mental health supports and research examining the impact of trauma on children's treatment responsiveness.

Exposure to Intimate-Partner Violence and Resilience Trajectories of Adolescents: A Two-Wave Longitudinal Latent Transition Analysis

Despite the serious emotional and social consequences of adolescents' exposure to intimate-partner violence (IPV) and the high prevalence of this exposure, few analyses have focused on person-centered models or considered psychological IPV. Studies that address exposure to violence tend to focus on physical IPV. Therefore, in this study, we examine (across two waves) the trajectories of resilience among adolescents who have witnessed psychological IPV by conducting a latent transition analysis and predicting class membership through socio-demographic and individual-level protective factors. Using a sample of 879 (T1, fall 2020) and 770 (T2, spring 2022) adolescent Swiss students with mean ages of 11.74 (SD = 0.64) and 13.77 (SD = 0.53), we identified four distinct time-invariant resilience classes: comorbid-frustrated, internalizing-frustrated, comorbid-satisfied, and resilient. The classes characterized by some level of psychopathological symptoms and basic psychological-needs frustration were the most stable over time. Furthermore, we found the four typical resilience trajectories: recovery, chronic, delayed, and improving. Gender, socioeconomic background, and protective factors showed a significant prediction of class membership in wave 1, highlighting the importance of increasing sensitivity to psychological-IPV exposure on the one hand, and reinforcing the relevance of prevention in schools regarding the promotion of protective factors on the other.

Virtual reality for the rehabilitation and prevention of intimate partner violence - From brain to behavior: A narrative review

Rehabilitation and prevention strategies to reduce intimate partner violence (IPV) have limited effectiveness in terms of improving key risk factors and reducing occurrence. Accumulated experimental evidence demonstrates that virtual embodiment, which results in the illusion of owning a virtual body, has a large impact on people's emotional, cognitive, and behavioral responses. This narrative review discusses work that has investigated how embodied perspective - taking in virtual reality has been used as a tool to reduce bias, to enhance recognition of the emotional state of another, and to reduce violent behaviors, in particular in the realm of IPV. Some of the potential neurological mechanisms behind these affective and behavioral changes are also discussed. The process of rehabilitation and prevention is complex and not always effective, but the integration of neuroscience-inspired and validated state-of-the-art technology into the rehabilitation process can make a positive contribution.

Association between Exposure to Domestic Violence during Childhood and Depressive Symptoms in Middle and Older Age: A Longitudinal Analysis in China

Exposure to domestic violence (EDV) is a constant threat to social stability and global solidarity and may be associated with an increased risk of depression in later life. This study assessed the association between EDV during childhood and depressive symptoms in middle and older age. A total of 10,521 respondents obtained from the China Health and Retirement Longitudinal Study were enrolled in our analysis. Depressive symptoms were measured using the 10-item form of the Center for Epidemiological Studies Depression (CES-D) scale, and EDV included parental conflict and corporal punishment. A random-effects linear regression was used to assess associations. The results showed positive relationships between "not very often" (β = 0.862; 95% CI:0.512 to 1.211; p < 0.001), "sometimes" (β = 1.692; 95% CI:1.227 to 2.158; p < 0.001) and "often" (β = 2.143; 95% CI:1.299 to 2.987; p < 0.001) in parental conflict and the CES-D scores, compared with that of those reported "never" in parental conflict. Similarly, positive relationships between "sometimes" (β = 0.389; 95% CI:0.091 to 0.687; p = 0.011) and "often" (β = 1.892; 95% CI:1.372 to 2.413; p < 0.001) in corporal punishment and the CES-D scores were observed. EDV is associated with an increased risk of depression in later life. Future research could develop interventions that target EDV and explore the mechanisms in China to further decrease lifetime depression risk and improve the population's mental health.

Physical Activity, Mental Health, and Quality of Life among School Students in the Jazan Region of Saudi Arabia: A Cross-Sectional Survey When Returning to School after the COVID-19 Pandemic

Increasing evidence suggests that physical activity (PA) can reduce depression and anxiety in adolescents. At the same time, quality of life (QoL) is sensitive to both mental health and PA, but little is known about the mechanism between these three variables among adolescents. This study aimed to assess the physical activity, mental health, and quality of life of school students when they returned to school after two years of distance learning in the Jazan region. This current investigation represented an observational cross-sectional survey conducted in January 2022 among a random sample of 601 students from intermediate and high schools in the Jazan region, Saudi Arabia. Three standardized questionnaires were used for data collection; the Arabic version of the Pediatric Quality of Life Inventory (PedsQL), Depression Anxiety Stress Scales (DASS21), and the Fels PAQ for children. The analysis revealed a moderate level of physical activity, decreased HRQoL, and symptoms of mental health problems (anxiety, depression, and stress) among the schools’ students when they returned to school following COVID-19 lockdown. The overall Pediatric Quality of Life mean score was (81.4 ± 16.4), which differed significantly according to gender, age groups, and grade levels (p < 0.05 for all). There was a negative correlation between the overall quality of life and mental health domains. Sport was negatively correlated with mental illness symptoms and positively correlated (p < 0.05) with Pediatric Quality of Life. The regression models revealed that stress was a significant predictor for the quality of life of male and female adolescents ([β = −0.30, (95% CI (−0.59) to (−0.02), p < 0.05)] and [β = −0.40, (95% CI (−0.70) to (−0.01), p < 0.05)], respectively). The analysis revealed a moderate level of physical activity among the schools’ students when they returned to school following COVID-19 lockdown. Children’s involvement in physical activity was associated with improved quality of life and mental health. The results call for the need to develop appropriate intervention programs to increase school students’ physical activity levels.

[Prevention perspective: mental health of schoolchildren in Germany]

BACKGROUND

The COVID-19 pandemic has impacted the learning and health of children and adolescents. The aim of this paper is to examine school students' mental health problems, family burden, and support needs during the pandemic depending on the type of school. Approaches to school-based prevention and health promotion are discussed.

METHODS

Findings are based on data from the population-based COPSY study (T1: 05/2020 - T4: 02/2022) and the BELLA study (T0, pre-pandemic comparison). Approximately 1600 families with children aged 7 to 19 years were surveyed at each measurement point (T). Mental health problems were assessed using the SDQ, while family burden and support needs were captured with individual items in the parent report.

RESULTS

Mental health problems increased among students in all school types at the beginning of the pandemic and have stabilized at a high level. Elementary school students are particularly affected (increase from 16.9% pre-pandemic to 40.0% at T2), especially in behavioral problems (11.7% to 24.6%) and hyperactivity (13.9% to 34.0%). Secondary school students also show higher levels of mental health problems (21.4% to 30.4%). Pandemic-related burden is consistently high, as is the need for family support received from schools/teachers and experts.

DISCUSSION

There is a high need for mental health promotion and prevention measures in the school setting. These should start at primary school age in the sense of a "whole school approach" at different levels and include external stakeholders. In addition, binding legal requirements are needed in all federal states to create framework conditions and structures for school-based health promotion and prevention, including access to necessary resources.

Routine conversations about violence conducted in Swedish child health services-A mixed methods study of nurses' experiences

AIM

To evaluate an intervention where nurses in child health care services routinely talk to and inform parents about violence.

METHODS

The intervention included providing information during home visits and individual conversations with mothers and fathers/partners in connection with screening for parental depression. A convergent mixed-methods design was used with a documentation form for each child (n = 475) and results from focus group interviews with nurses. Quantitative data were analysed using descriptive statistics and qualitative with manifest content analysis.

RESULTS

Almost all families participated in the intervention; individual conversations were conducted with nearly all the mothers, and to a somewhat lesser extent with the fathers/partners. Initially, the nurses felt slightly uncomfortable about these conversations, but described experiencing development and professionalisation in their role of talking about violence. Parents' reactions were generally positive and they expressed appreciation for this topic being raised.

CONCLUSION

The results show that the intervention has been carried out successfully. The newborn period is a phase in which mothers and fathers are interested and receptive to knowledge and support in sensitive matters. Prerequisites for implementation were the preparation phase for the nurses, the use of routine questioning and a questionnaire as a basis for the conversations.

Parenting in the Context of Intimate Partner Violence: Understanding Mothers' Perceptions

Despite existing research, which has focused on the impacts of intimate partner violence (IPV) on mothers and their children, there is a paucity of research specifically examining mothers' perceptions of parenting in the context of IPV. This qualitative study explored parenting capacity and meaning making among a purposive sample of 16 female survivors of IPV who experienced IPV during both childhood and adulthood and had at least one school-aged child. Participants completed semi-structured in-person interviews during which they were asked a series of questions about their experiences with IPV and their parenting practices. Analysis revealed that parenting capacity could be categorized by two capacities: relational and operational. Based on these descriptive accounts of the experiences of parenting in contexts of IPV, a preliminary model suggesting a Dual-Part Model of Parenting (relational and operational capacity) is presented to aid in understanding the complexity and nuance of how parenting capacity may be impacted by IPV exposure throughout the lifespan. Strengths-based approaches to supporting survivors in parenting are explored, and future implications for strengths-based approaches to clinical practice with IPV survivors as well as improved research practices and social policies that emphasize an intersectionality approach are discussed.

Cognitive variations following exposure to childhood adversity: Evidence from a pre-registered, longitudinal study

Background

Different methodological approaches to studying the effects and timing of childhood adversity have been proposed and tested. While childhood adversity has primarily been operationalized through specificity (effects of individual adversity types) and cumulative risk (sum of all adversities reported by an individual) models, dimensional models (probeable through latent class and other cluster analyses) have recently gained traction given that it can overcome some of the limitations of the specificity and cumulative risk approaches. On the other hand, structured lifecourse modelling is a new statistical approach that examines the effects of the timing of adversity exposure on health outcomes by comparing sensitive periods and accumulation hypotheses. In this study, we apply these sets of methodological approaches and theoretical models to better understand the complex effects of childhood adversity on cognitive outcomes.

Methods

We analysed data obtained from the Avon Longitudinal Study of Parents and Children for 2965 participants (Male = 1125; Female = 1840). This included parental report of 11 types of childhood adversity when participants were between 8 months and 8.7 years, and performance on inhibition, working memory and emotion recognition neurocognitive tasks when participants were 24 years of age (April 1, 1992-October 31, 2017). We used latent class analysis to classify the participants into subgroups, while we used Kruskal-Wallis test to examine differences in cognitive performance among the adversity subgroups. Additionally, to test whether sensitive period or accumulation models better explain the effects of childhood adversity on cognitive functioning, we carried out separate analyses using structured lifecourse modelling approaches.

Findings

Latent class analysis showed evidence of 5 classes, namely: low adversity (71.6%), dysfunctional family (9.58%); parental deprivation (9.65%); family poverty (6.07%) and global adversity (3.1%). We observed group differences in cognitive performance among the adversity classes in an inhibition control task, χ2(4) = 15.624, p = 0.003 and working memory task, χ2(4) = 15.986, p = 0.003. Pairwise comparison tests showed that participants in the family poverty class performed significantly worse than those in the low adversity class, for the inhibition control task (p = 0.007) while participants in the global adversity class significantly performed worse than participants in the low adversity class (p = 0.026) and dysfunctional family class (p = 0.034) on the working memory task. A further analysis revealed that the associations between each individual adversity type and cognitive outcomes were mostly consistent with the observed class performance in which they co-occurred. Follow-up analyses suggested that adversity during specific sensitive periods, namely very early childhood and early childhood, explained more variability in these observed associations, compared to the accumulation of adversities.

Interpretation

These findings suggest that dimensional approaches e.g., latent class analysis or cluster analysis could be good alternatives to studying childhood adversity. Using latent class analysis for example, can help reveal the population distribution of co-occurring adversity patterns among participants who may be at the greatest health risk and thus, enable a targeted intervention. In addition, this approach could be used to investigate specific pathways that link adversity classes to different developmental outcomes that could further complement the specificity or cumulative risk approaches to adversity. On the other hand, findings from a separate analysis using structured lifecourse modelling approaches also highlight the vital developmental timeframes in childhood during which the impact of adversity exposure on cognitive outcomes is greatest, suggesting the need to provide comprehensive academic and mental health support to individuals exposed during those specific timeframes.

Funding

T.N. received funding from Cambridge Trust (University of Cambridge).

Stay-Leave Decision-Making Among Women Victims of Domestic Violence in Israel: Background, Interactional, and Environmental Factors

The study examined the factors that contribute to stay-leave decision-making of women who are domestic violence victims, focusing on background factors (origin, education, and occupational status); interactional factors (severity of violence, previous separations, and previous stays in a shelter); and social factors (social support and woman's expectations of the shelter). In addition, it examined the contribution of the interaction of woman's expectations of the shelter × psychological violence to the woman's decision to leave/stay with her partner. Six months after returning to the community, 221 women who had stayed in a shelter for at least 3 months were located: 92 were Israeli-born Jews (41.6%), 49 were Israeli-born Arabs (22.2%), 51 were Former Soviet Union immigrants (23.1%), and 29 were Ethiopian immigrants (13.1%). Of them, 56.6% reported returning to their partners, and 43.4% reported leaving their partners. Education, occupational status, psychological violence severity, previous shelter stays, familial support, and expectations of having concrete needs fulfilled by the shelter made a significant contribution to the woman's leaving the abusive relationship. Furthermore, Israeli Arab women were more likely to stay with their partners. Finally, the interaction of the expectation that concrete needs would be met × psychological violence made a significant contribution to leaving the relationship. The study emphasizes the need to expand the resources of domestically abused women and also highlights specific groups requiring special attention upon shelter entry: Arab women, women who previously stayed in shelters, and women characterized by a lack of resources and a high degree of psychological violence.

Domestic Violence From a Child Perspective: Impact of an Immersive Virtual Reality Experience on Men With a History of Intimate Partner Violent Behavior

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child's body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim's personal space. We show that embodiment from a child's perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children.

Intimate partner violence against Peruvian women and adequate regulation of emotions and behaviors of their children between 24 and 59 months of age: A cross-sectional study at the national level

OBJECTIVE

Determine the association between intimate partner violence against Peruvian women and adequate regulation of the emotions and behaviors of children between 24 and 59 months old.

METHODS

This cross-sectional study analyzed secondary data obtained from the ENDES-2019. The dependent variable was the regulation of emotions and behaviors in 24 to 59-month-old children. The independent variable was partner violence (physical, sexual, verbal or psychological) against mothers at some point in their life. Prevalence ratios (PR) were calculated and adjusted with their 95% confidence interval (CI) to evaluate the association between intimate partner violence and adequate regulation of emotions and behaviors.

RESULTS

Data from 8,473, 15 to 49-year-old mothers and their children aged 24 to 59 months were analyzed. Intimate partner violence was reported by 57.1% of the women, and 31.6% of the children showed adequate regulation of emotions and behaviors. The probability of children of mothers who were victims of intimate partner violence adequately regulating their emotions and behaviors was low (aPR = 0.81, 95% CI: 0.75-0.88), with an aPR = 0.82 (95% CI: 0.76-0.89) and an aPR = 0.84 (95% CI: 0.76-0.93) for those with mothers suffering psychological or physical violence, respectively, with no differences in children of mothers suffering sexual violence by their partner.

CONCLUSIONS

Six out of 10 Peruvian women have suffered partner violence at some point in their life, and only three out of 10 children between 24 and 59 months old adequately regulate their emotions and behaviors. Children of mothers suffering physical and verbal or psychological violence by their partners were less likely to regulate their emotions and behaviors adequately.

Psychosocial work stress and parent-child bonding during the COVID-19 pandemic: clarifying the role of parental symptoms of depression and aggressiveness

BACKGROUND

Parental work stress and impaired mental health seem to have intensified during the current COVID-19 pandemic. Both can have a negative impact on parent-child bonding: psychosocial work stress in the course of a spillover effect from work to family and symptoms of impaired mental health as part of a crossover effect from parent to child. This potentially affects the child's development in the long term.

METHOD

This cross-sectional study examined the relationship between psychosocial work stress and parent-child bonding during the early COVID-19 pandemic (May-June 2020). Symptoms of depression and aggressiveness were considered as mediators of this relationship. The sample consisted of employees in Eastern Germany (n = 380; 42.9% mothers, 57.1% fathers), aged 24-55 years, with children aged 0-36 months.

RESULTS

In the total sample, an association was only found after adjusting for potential confounders, indicating that higher psychosocial work stress is associated with weaker bonding between the parent and child (β = 0.148, p = .017, 95% CI [0.566, 5.614]). The separate analyses for mothers and fathers did not reveal a statistically significant relationship between psychosocial work stress and parent-child bonding. In the total sample, the higher the psychosocial work stress was, the higher were the parental symptoms of depression (β = 0.372, p < .001, 95% CI [3.417, 5.696]) and aggressiveness β = 0.254, p < .001, 95% CI [1.008, 3.208]). The mental health symptoms in turn were related to weaker parent-child bonding (symptoms of depression β = 0.320, p < .001, 95% CI [0.345, 0.749]; symptoms of aggressiveness β = 0.394, p < .001, 95% CI [0.697, 1.287]). The results furthermore suggested that parental mental health symptoms mediate the association between psychosocial work stress and parent-child bonding (symptoms of depression, ab = 2.491, 95% CI [1.472, 3.577] and of aggressiveness, ab = 2.091, 95% CI [1.147, 3.279]). The mediation effect was also found in the separate analyses for the mothers and fathers.

DISCUSSION

The results of this study during the early COVID-19 pandemic in Germany highlight the importance of prevention as well as intervention measures in relation to psychosocial work stress that may play a debilitating role in the context of family relationships. In addition, the results suggest that both employers and employees should be made aware of the importance of psychosocial work stress, as it can have a negative impact on mental health, which in turn may have a major influence on family relationships.