The cycle of victimization: The relationship between childhood maltreatment and adolescent peer victimization

Psychological maltreatment by teachers and peer victimization in Chinese youth: Depression and aggression as mediators

BACKGROUND

Psychological maltreatment by teachers and peer victimization are significant public health issues among youth. However, few studies have verified transactional associations between psychological maltreatment by teachers and peer victimization at the within-person level and the mediating roles of depression and aggression have yet to be fully evaluated.

OBJECTIVE

This study examined the transactional associations between psychological maltreatment by teachers and peer victimization from middle childhood to early adolescence, separating within- and between-person variation. The study also examined whether youth's depression and aggression mediated the associations.

PARTICIPANTS AND SETTING

A total of 4945 Chinese youth (Mage = 9.92 years, SD = 0.73 53 % boys) completed a packet of measures on five occasions at 6-month intervals from May of 2017 to May of 2019.

METHODS

Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were used to distinguish between- and within-person effects.

RESULTS

The results indicated that: (a) Psychological maltreatment by teachers predicted peer victimization, and vice versa; (b) Depression (but not aggression) mediated the associations from peer victimization to psychological maltreatment by teachers.

CONCLUSIONS

The findings supported bidirectional spillover effects between adverse teacher-student and peer interactions and demonstrated at the within-person level that such effects were transmitted indirectly via youth's depression.

Bullying Victimization and Adverse Childhood Experiences: Retrospective Reports of Relative Impact on Emotional Distress

The literature suggests that there is a significant overlap in definition, measurement, and outcomes between trauma and bullying victimization, but the relative impact on current emotional distress of these events has not been explored. The goal of the current study was to explore whether traditional and cyber bullying victimization has a similar negative impact on current emotional disrtresss as other adverse childhood experiences which may also lead to a traumatic response. In addition, this study examined whether the association between bullying victimization and emotional distress is exacerbated when individuals also experience additional ACEs. Retrospective reports from a diverse sample of 576 adults were collected via an online survey. When ranked against other ACEs such as viewing family mental health problems or substance abuse, or verbal, physical, emotional, and sexual victimization not from peers, nearly 30% of participants ranked bullying victimization as having the most negative impact on their levels of emotional distress. Multi-group path analyses indicated that experiencing additional ACEs seems to exacerbate distress caused by bullying and cyber bullying victimization. The current study suggests that bullying victimization may be just as detrimental as other types of ACEs that occur in childhood.

The reciprocal relationship between child maltreatment and children's bullying victimization in China

Children who experience physical and psychological maltreatment within their family are more likely to become victims of abuse outside the family. In Chinese culture, children's victimization may also be a precursor to parenting behaviors. Nevertheless, the reciprocal relationship between child maltreatment and children's bullying victimization remains unclear, particularly in Chinese culture. This study aimed to evaluate the reciprocal association between child maltreatment and children's bullying victimization in China, as well as its gender differences. A total of 891 children aged 8-11 years in China participated in the study at four time points. The potential reciprocal link was examined using a cross-lagged model. The results indicated that physical abuse predicted children's bullying victimization across four time points, while physical neglect predicted children's bullying victimization during the first three time points. The effects of emotional abuse and neglect were negligible. Conversely, children's bullying victimization consistently predicted various types of parental maltreatment over time. Some gender differences in the relationship were found. The findings emphasized a reciprocal relationship between child maltreatment within the family and children's bullying victimization at school. Understanding the cyclical patterns between child maltreatment and bullying victimization may help improve family education approaches and reduce children's bullying victimization.

The role of child maltreatment and adolescent victimization in predicting adolescent psychopathology and problematic substance use

BACKGROUND

Maltreated children are more likely to experience adolescent victimization, which may underlie the association between maltreatment and adolescent psychopathology and substance use.

OBJECTIVE

To determine whether number of adolescent victimization types predicts adolescent psychopathology and problematic substance use over and above number of child maltreatment subtypes; whether adolescent victimization mediates the relations between maltreatment and change in adolescent psychopathology and problematic substance use; and whether maltreatment moderates the relation between adolescent victimization and changes in these outcomes.

PARTICIPANTS AND SETTING

Participants were 545 (295 maltreated, 250 non-maltreated; 328 males, 217 females) racially and ethnically diverse (52.8 % Black, 27.5 % White, 12.8 % Bi-racial; 13.4 % Latino/a) children and families from the Rochester, New York, USA area assessed across three waves of data (Wave 1, Mage = 7.6 years; Wave 2, Mage = 13.8 years; Wave 3, Mage = 16.2 years).

METHODS

Maltreatment was coded at Wave 1 using Department of Human Services records. Adolescents self-reported psychopathology, problematic substance use, and victimization at Waves 2 and 3.

RESULTS

Structural equation modeling revealed that adolescent victimization predicted adolescent psychopathology (β = 0.24, p < .001) and problematic substance use (β = 0.27, p < .001) over and above child maltreatment. Adolescent victimization did not mediate the association between child maltreatment change in psychopathology and problematic substance use and child maltreatment did not moderate the association between adolescent victimization and these outcomes.

CONCLUSIONS

We discuss the importance of future research utilizing multi-wave designs to examine relations between these constructs and of assessing for more proximal victimization.

The stress-buffering role of friendships in young people with childhood threat experiences: a preliminary report

Background: High-quality friendships have a positive impact on the mental health of young people with childhood adversity (CA). Social stress buffering, the phenomenon of a social partner attenuating acute stress responses, is a potential yet unexplored mechanism that may underlie this relationship.Objective: This study examined whether perceived friendship quality was related to better mental health and lower neural stress response in young people with CA.Method: A total of N = 102 young people (aged 16-26) with low to moderate CA were included in the study. We first investigated associations between friendship quality, mental health, and CA. In a representative subset (n = 62), we assessed neural stress responses using the Montreal Imaging Stress Task. In our sample, CA was best described along two dimensions resembling threat or deprivation like experiences. Hence, we investigated both cumulative and dimensional effects of CA.Results: We found no support for social thinning after CA, meaning that the severity of CA (cumulative or dimensional) did not differentially impact friendship quality. High-quality friendships, on the other hand, were strongly associated with better mental health. Furthermore, acute stress increased state anxiety and enhanced neural activity in five frontolimbic brain regions, including the left hippocampus. We found weak support that threat experiences interacted with friendship quality to predict left hippocampal reactivity to stress. However, this effect did not survive multiple comparison correction.Conclusion: The absence of social thinning in our sample may suggest that the risk of developing impoverished social networks is low for rather well-functioning young people with low to moderate CA. Regardless, our findings align with prior research, consistently showing a strong association between high-quality friendships and better mental health in young people with CA. Future research is needed to examine whether friendships aid neural stress responses in young people with childhood threat experiences.

Shared and distinct structural brain networks related to childhood maltreatment and social support: connectome-based predictive modeling

Childhood maltreatment (CM) has been associated with changes in structural brain connectivity even in the absence of mental illness. Social support, an important protective factor in the presence of childhood maltreatment, has been positively linked to white matter integrity. However, the shared effects of current social support and CM and their association with structural connectivity remain to be investigated. They might shed new light on the neurobiological basis of the protective mechanism of social support. Using connectome-based predictive modeling (CPM), we analyzed structural connectomes of N = 904 healthy adults derived from diffusion-weighted imaging. CPM predicts phenotypes from structural connectivity through a cross-validation scheme. Distinct and shared networks of white matter tracts predicting childhood trauma questionnaire scores and the social support questionnaire were identified. Additional analyses were applied to assess the stability of the results. CM and social support were predicted significantly from structural connectome data (all rs ≥ 0.119, all ps ≤ 0.016). Edges predicting CM and social support were inversely correlated, i.e., positively correlated with CM and negatively with social support, and vice versa, with a focus on frontal and temporal regions including the insula and superior temporal lobe. CPM reveals the predictive value of the structural connectome for CM and current social support. Both constructs are inversely associated with connectivity strength in several brain tracts. While this underlines the interconnectedness of these experiences, it suggests social support acts as a protective factor following adverse childhood experiences, compensating for brain network alterations. Future longitudinal studies should focus on putative moderating mechanisms buffering these adverse experiences.

Developmental Pathway from Childhood Abuse to Adolescent Peer Victimization: The Role of Rejection Sensitivity and Aggression

Despite the well-established relationship between early experiences of victimization and later re-victimization, little is known about the exact mechanism of this cycle of victimization. The present study examined whether the route from rejection sensitivity to aggression mediates the associations between different forms of childhood abuse and later peer victimization longitudinally. A total of 3525 adolescents (56.6% male; Mage = 13.21 ± 0.85) participated in this three-wave study, with a 6-month lag and a 9-month lag respectively. The results indicated that the association between childhood emotional abuse and peer victimization were independently mediated by aggression, and sequentially mediated by rejection sensitivity and aggression in both sexes. Sex differences existed regarding the association between childhood physical abuse and aggression, such that only in adolescent boys did physical abuse show significant effect on aggression, resulting in later peer victimization. In general, these findings suggest that maladaptive social-cognitive processes and behavioral patterns are crucial for understanding the mechanism of the vicious cycle of victimization, and sex differences must be considered when examining different types of childhood abuse.

Growing relevance of reports of adolescent cyberbullying victimization among adult outpatients

In the general population, prevalence rates of cyberbullying victimization have continuously increased over the past decades. However, the extent to which these increasing numbers affect clinical populations seeking treatment in outpatient services remains an open question. The present study sought to examine whether the increase of cyberbullying victimization is also reflected by increased reports of cyberbullying victimization in a clinical outpatient population. In addition, we assessed the incremental contribution of experiences of cyberbullying in the prediction of psychological symptoms when controlling for histories of childhood maltreatment and offline peer victimization. For this purpose, we analyzed routine data from N = 827 outpatients who had sought treatment at a University outpatient clinic for psychotherapy between 2012 and 2021 in a cross-sectional study design. Analyses showed that 8.3% of the patients born in the years 1980 to 2002 indicated the experience of cyberbullying victimization in their adolescence. The rate of reported cyberbullying victimization increased from 1 to 3% in patients born in the years 1980 to 1987 to 24% in patients born in the year 2000. A logistic regression revealed that patients born in the years 1995-2002 were up to nineteen times as likely to report cyberbullying victimization as patients born in the years 1980-1982. In addition, hierarchical multiple regression analyses indicated that cyberbullying victimization significantly accounted for an incremental proportion of variance (1%) in the prediction of psychological symptom distress after controlling for child maltreatment and offline peer victimization. In conclusion, this retrospective survey indicates an increase of the clinical relevance of cyberbullying victimization both in frequency of and potential contribution to etiology. Raising attention to cyberbullying in clinical care and research seems to be justified and warranted.

Childhood trauma, peer victimization, and non-suicidal self-injury among Chinese adolescents: a latent variable mediation analysis

BACKGROUND

Childhood and peer experiences can influence adolescents' perceptions of interpersonal relationships, which can, in turn, influence their emotional states and behavior patterns. Non-suicidal self-injury (NSSI) is now a common problem behavior among adolescents. The present study examined the role of childhood trauma and peer victimization in adolescents' NSSI.

METHODS

A cross-sectional survey was conducted among 1783 adolescents (1464 girls and 318 boys) in the psychiatric outpatient clinics or wards of 14 psychiatric hospitals or general hospitals in nine provinces in China. Data were collected using the Multidimensional Peer Victimization Scale (MPVS), Short-form Childhood Trauma Questionnaire(CTQ-SF), and Functional Assessment of Self-Mutilation (FASM). Structural equation modeling (SEM) with latent variables was used to demonstrate the mediating role of peer victimization in the association between childhoodtrauma and NSSI.

RESULTS

The SEM analysis demonstrated that peer victimization plays a partial mediating role in the relationship between childhood trauma and NSSI. In addition, several covariates (such as age, gender, education level, and place of residence) effectively regulated the relationship between peer victimization and NSSI.

CONCLUSION

In future studies of NSSI among Chinese adolescents, attention should be paid to the roles of childhood trauma and peer bullying; there is a temporal sequence between these two variables and, to some extent, childhood trauma can have an impact on bullying during adolescence which, in turn, influences NSSI behavior.

Typologies of child maltreatment and peer victimization and the associations with adolescent substance use: A latent class analysis

BACKGROUND

Child maltreatment and peer victimization are pervasive public health problems associated with adolescent substance use. Although child maltreatment has been identified as a risk factor for peer victimization, few studies have investigated their co-occurrence (i.e., polyvictimization). The study objectives were to: examine sex differences in the prevalence of child maltreatment, peer victimization, and substance use; identify polyvictimization patterns; and examine the associations between the identified typologies and adolescent substance use.

METHODS

Data were self-reported from a sample of adolescents aged 14 to 17 years (n = 2910) who participated in the provincially-representative 2014 Ontario Child Health Study. Latent class analysis with distal outcomes was conducted to identify typologies of six types of child maltreatment and five types of peer victimization and examine the associations between the polyvictimization typologies and use of cigarettes/cigars, alcohol, cannabis, and prescription drugs.

RESULTS

Four typologies were identified: Low victimization (76.6 %), Violent home environment (16.0 %), High verbal/social peer victimization (5.3 %), and High polyvictimization (2.1 %). The Violent home environment and High verbal/social peer victimization typologies were associated with increased odds of adolescent substance use (adjusted odds ratio range: 2.06-3.61). The High polyvictimization typology showed increased, but non-significant, odds of substance use.

CONCLUSIONS

Adolescent-serving health and social services professionals should be aware of polyvictimization patterns and the impact on substance use. For some adolescents, polyvictimization may include exposure to multiple child maltreatment and peer victimization types. Upstream strategies to prevent child maltreatment and peer victimization are needed, which may also contribute to reductions in adolescent substance use.

Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance

BACKGROUND

Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown.

OBJECTIVE

Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings.

METHODS

Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation).

RESULTS

The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings.

CONCLUSIONS

The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f² = .16 for evaluation; f² = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.

Adverse childhood experiences and early adolescent cyberbullying in the United States

INTRODUCTION

With the increasing use of social media and online platforms among adolescents, the relationship between traumatic life events and cyberbullying remains unclear. This study aimed to determine the associations between adverse childhood experiences (ACEs) and cyberbullying victimization among a racially/ethnically and socioeconomically diverse sample of early adolescents.

METHODS

We analyzed longitudinal data from 10,317 participants in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Logistic regression analyses were used to estimate associations between ACEs and cyberbullying victimization, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site.

RESULTS

In the sample (48.7% female, 46.0% racial/ethnic minority), 81.3% of early adolescents reported at least one ACE, and 9.6% reported cyberbullying victimization. In general, there was a dose-response relationship between the number of ACEs and cyberbullying victimization, as two (adjusted odds ratio [AOR]: 1.45, 95% confidence interval [CI]: 1.13-1.85), three (AOR: 2.08, 95% CI: 1.57-2.74), and four or more (AOR: 2.37, 95% CI: 1.61-3.49) ACEs were associated with cyberbullying victimization in adjusted models. In models examining the specific type of ACE, sexual abuse (AOR: 2.27, 95% CI: 1.26-4.11), physical neglect (AOR: 1.61, 95% CI: 1.24-2.09), and household mental health problems (AOR: 1.39, 95% CI: 1.18-1.65) had the strongest associations with cyberbullying victimization.

CONCLUSION

Adolescents who have experienced ACEs are at greater risk for experiencing cyberbullying. Interventions to prevent cyberbullying could use a trauma-informed framework, including inter-peer interventions to break this cycle of trauma.

Child Maltreatment, Peer Victimization, and Mental Health: Neurocognitive Perspectives on the Cycle of Victimization

Children who experience maltreatment are at increased risk of revictimization across the life span. In childhood, this risk often manifests as peer victimization. Understanding the nature of this risk, and its impact on mental health, is critical if we are to provide effective support for those children who are most vulnerable. A systematic scoping review was conducted using Google Scholar and PsycINFO. Studies on adults, psychiatric, and/or inpatient populations were excluded. Included studies concerned all forms of child maltreatment and peer victimization. We found 28 studies about the association between maltreatment experience and peer victimization as well as peer rejection. We review the evidence documenting the relation between these adverse childhood experiences and mental health. The evidence suggests that maltreatment and peer victimization have additive effects on mental health outcomes. A number of theoretical developmental frameworks that delineate putative mechanisms that might account for an association are considered. Building on prior research, we then discuss the role of recent neurocognitive findings in providing a multilevel framework for conceptualizing mental health vulnerability following maltreatment. In addition, we consider how altered neurocognitive functioning following maltreatment may shed light on why affected children are more likely to be victimized by their peers. Specifically, we consider the threat, reward, and autobiographical memory systems and their role in relation to stress generation, stress susceptibility, and social thinning. Such a mechanistic understanding is necessary if we are to reduce the likelihood of peer victimization in children exposed to maltreatment, and move to a preventative model of mental health care.

Childhood maltreatment and parenting style associated school bullying in Chinese children and adolescents: An analytical epidemiology evidence

OBJECTIVE

The independent associations among childhood maltreatment (CM), parenting style, and school bullying in children and adolescents have not been adequately discussed. Epidemiological evidence of higher quality is still scarce. We intend to investigate this topic by using a case-control study design in a large sample of Chinese children and adolescents.

METHOD

Study participants were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega ongoing cross-sectional study. The combined database from four study sites was used. The population-based case-control study was individually matched by study site, age, sex, race, left-behind status, whether a single child, and whether a boarding student.

RESULTS

Cases were observed to have a significantly higher prevalence of CM, higher scores for parental rejection and over-protection, and lower scores for parental emotional warmth. Multiple conditional logistic regression revealed that CM, especially emotional abuse (EA) and sexual abuse (SA), were associated with a prominently increased risk of school bullying involvement, with adjusted odds ratio (OR) of 2.28 (95 % CI: 2.03, 2.57) and 1.90 (95 % CI: 1.67, 2.17). Subsequent analysis further corroborated the robustness of EA-bullying and SA-bullying associations. Although parenting style generally showed a weaker association with school bullying, a higher level of parental rejection was related to an increased risk of bullying victimization.

CONCLUSIONS

Chinese children and adolescents who are victims of EA or SA, or experienced a higher level of parental rejection, are more vulnerable to school bullying. Targeted interventions should be designed and implemented.

Child maltreatment and victimization

It is estimated that up to 25% of all children growing up worldwide experience child maltreatment, making it a global emergency with substantial individual and public health consequences. This chapter addresses one of the most societally pervasive consequences of child maltreatment which is known as the "cycle of victimization." This concept depicts the increased risk of maltreated individuals to victimize others later in life, both within and outside the family environment. To understand the architecture of this victimization cycle, the chapter further sheds light on neurocognitive mechanisms aiding different forms of victimization and the buffering role of social support that could help break the cycle of victimization. Advancing our understanding of these complex and interrelated mechanisms will ultimately facilitate the design and implementation of more targeted early treatments and (preventive) interventions and support a move toward a safer society.

The relationship between childhood maltreatment and adolescents' cyberbullying victimization: The new phenomenon of a "cycle of victimization"

BACKGROUND

The research community is showing an increasing concern about the adverse outcomes of childhood maltreatment for adolescents. However, whether childhood maltreatment is associated with cyberbullying victimization and what the underlying mechanisms of this relationship are remain to be identified.

OBJECTIVE

We aimed to examine the relationship between childhood maltreatment and cyberbullying victimization and whether self-compassion and fear of missing out (FoMO) can simultaneously moderate this relationship among adolescents.

PARTICIPANTS AND SETTING

A sample of 1025 Chinese adolescents (50.8 % male participants, age = 15.50 ± 0.52 years) completed questionnaires regarding childhood maltreatment, cyberbullying victimization, self-compassion, and FoMO.

METHODS

Our hypotheses were tested by correlation analysis and Model 3 of the PROCESS macro.

RESULTS

Childhood maltreatment significantly predicted adolescents' cyberbullying victimization (β = 0.28, p < .001). High self-compassion weakened the relationship between childhood maltreatment and cyberbullying victimization (β = -0.10, p < .001). Furthermore, self-compassion and FoMO simultaneously interacted with childhood maltreatment to predict cyberbullying victimization (β = 0.08, p < .001). Specifically, high FoMO weakened the moderating effect of self-compassion on the relationship between childhood maltreatment and cyberbullying victimization. Childhood maltreatment significantly predicted cyberbullying victimization among adolescents high in FoMO, regardless of self-compassion levels. In contrast, childhood maltreatment non-significantly predicted cyberbullying victimization when adolescents were high in self-compassion and low in FoMO.

CONCLUSIONS

Childhood maltreatment is positively associated with cyberbullying victimization. Moreover, increasing self-compassion and decreasing FoMO can mitigate the effect of childhood maltreatment on cyberbullying victimization.

Preventing Revictimization Through a Web-Based Intervention for Primary Caregivers of Youth in Care (EMPOWERYOU): Protocol for a Randomized Factorial Trial

Background

Children in foster care are at a higher risk for relationship problems than their counterparts raised by their biological family because of higher exposure to or prevalence of neglect or maltreatment early in life. Consequently, these children may also show more challenging behavior in their foster families, which in turn increases the parental stress experience of foster caregivers. Furthermore, the children may engage in a vicious cycle of risky relationship behaviors and expectations that put them at a greater risk for revictimization.

Objective

To support foster caregivers in reducing the risk for revictimization, several intervention modules delivered via the internet were developed using a consumer-based approach (phase 1 of the multiphase optimization strategy). This project (phase 2 of the multiphase optimization strategy) aimed to develop a sustainable intervention by selecting promising intervention components based on their contribution to the outcome.

Methods

In a 24 factorial trial, a total of 317 foster caregivers with children aged 8 to 13 years are randomly assigned to 1 of 16 conditions. The primary outcome is the rate of revictimization from baseline to 3 months after intervention. Secondary outcomes include risk-taking and functional behaviors in relationships. All caregivers will receive access to all the intervention components after the follow-up assessment. The participants assigned to the condition with all component levels on are expected to show the best improvement in the primary and secondary outcomes.

Results

Recruitment and data collection for the factorial trial started in March 2022 and is ongoing. As of October 2022, we recruited 181 families. Although it is difficult to predict the exact study timeline owing to COVID-19 pandemic–related delays, results are expected in February 2024.

Conclusions

There is a need for easily accessible information related to raising children in foster care who have experienced early life adversities to interrupt the cycle of violence and enhance the developmental pathway of health and emotional stability. It might be useful, in addition to generally useful parenting information (eg, parental self-care or emotion regulation management), to specifically focus on the needs of these caregivers (eg, how to support the child to reduce dysfunctional relationship behaviors that may have developed because of early adverse experiences).

Trial Registration

ClinicalTrials.gov NCT05235659; https://clinicaltrials.gov/ct2/show/NCT05235659

International Registered Report Identifier (IRRID)

DERR1-10.2196/38183

Social thinning and stress generation after childhood maltreatment: a neurocognitive social transactional model of psychiatric vulnerability

Childhood maltreatment is associated with significant, enduring risk of psychiatric disorder. In this paper, we review how neurocognitive alterations after maltreatment might indirectly increase the risk of psychiatric disorder via their impact on social functioning. We propose a neurocognitive social transactional model, within which the neurocognitive sequelae of maltreatment are postulated to affect how an individual's social architecture is constructed across development, including the quality and quantity of relationships in an individual's social network. We review extant evidence in two areas in relation to maltreatment: stress generation (a process by which individuals are more likely to experience interpersonal stressor events) and social thinning (an attenuation in the number and quality of relationships over time). We consider how neurocognitive alterations could contribute to these interactive and autocatalytic social processes, which gradually impoverish an individual's actual or potential social environment and ultimately increase psychiatric risk. We conclude by considering the implications of this neurocognitive social transactional model for the prevention of psychiatric disorder after childhood maltreatment.

Childhood Sexual Abuse and Exposure to Peer Bullying Victimization

Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing further victimization in adolescence. Associations between CSA and several forms of cyber and in-person peer bullying victimization were assessed in a prospective, longitudinal study. Females exposed to substantiated CSA and a matched comparison group (N = 422) were followed over a two-year period. Bullying experiences were assessed in both survey and qualitative interviews. Qualitative data were coded and used to describe the types (e.g., cyber, physical, verbal), and foci (e.g., threats, physical appearance) of bullying victimization. Logistic regression was used to assess the odds that CSA was associated with subsequent bullying victimization, adjusted for demographics, social networking use, and prior bullying. CSA-exposed females were at an increased risk of multiple forms of bullying victimization with a persistent risk of bullying victimization over time. Specifically, they had 2.6 times higher odds of experiencing any bullying at follow-up, 2.9 times higher odds of experiencing cyberbullying at follow-up, and 2 times higher odds of experiencing combined cyber/in-person bullying at follow-up. CSA-exposed females were more likely than comparison females to experience bullying regarding their appearance/weight and dating relationships. Findings provide further insight into the unique circumstances of the cyberbullying and in-person bullying experienced by CSA-exposed females. Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing bullying victimization, specifically cyberbullying and combined cyber/in-person bullying, as well as bullying about their appearance and dating relationships. These findings indicate that bullying prevention needs to include trauma-focused components to target these uniquely vulnerable females.

Sexual Trauma Informed Understanding of Longitudinal Depression among Repeat Juvenile Offenders

Childhood sexual assault (CSA) victimization and depression are global public health concerns that disproportionately affect youths involved in the juvenile justice system. Little research has examined the influence of CSA on the stability of depressive symptoms among repeat juvenile offenders. The present study tested a gendered model of the association between lifetime CSA victimization and depression for three time points: baseline juvenile assessment entry; second reentry; and third reentry. Further, covariate analyses were conducted to explore the impact of socio-demographics on CSA victimization and depression. Results indicate that CSA victimization was associated directly with baseline depression and indirectly with depression at second reentry for both male and female justice-involved youths. For white, male youth, there were significantly higher rates of depression over time, than other males. However, age, African American or Hispanic race/ethnicity, living situation, and urbanity were not significantly associated with CSA victimization at baseline or depression over time. These findings underscore the need for juvenile justice services that address exposure to childhood trauma and mental illness more effectively.

Emotional maltreatment and neglect impact neural activation upon exclusion in early and mid-adolescence: An event-related fMRI study

Child maltreatment gives rise to atypical patterns of social functioning with peers which might be particularly pronounced in early adolescence when peer influence typically peaks. Yet, few neuroimaging studies in adolescents use peer interaction paradigms to parse neural correlates of distinct maltreatment exposures. This fMRI study examines effects of abuse, neglect, and emotional maltreatment (EM) among 98 youth (n = 58 maltreated; n = 40 matched controls) using an event-related Cyberball paradigm affording assessment of both social exclusion and inclusion across early and mid-adolescence (≤13.5 years, n = 50; >13.5 years, n = 48). Younger adolescents showed increased activation to social exclusion versus inclusion in regions implicated in mentalizing (e.g., superior temporal gyrus). Individual exposure-specific analyses suggested that neglect and EM coincided with less reduction of activation to social exclusion relative to inclusion in the dorsal anterior cingulate cortex/pre-supplementary motor area (dACC/pre-SMA) among younger versus older adolescents. Integrative follow-up analyses showed that EM accounted for this dACC/pre-SMA activation pattern over and above other exposures. Moreover, age-independent results within respective exposure groups revealed that greater magnitude of neglect predicted blunted exclusion-related activity in the parahippocampal gyrus, while EM predicted increased activation to social exclusion in the precuneus/posterior cingulate cortex.

Internalizing and Externalizing Symptoms in Adolescents With and Without Experiences of Physical Parental Violence, a Latent Profile Analysis on Violence Resilience

Questionnaire data from a cross-sectional study on social resilience in adolescence, with a sample of N = 1,974 Swiss seventh grade high school students ages 12-14 (M = 11.76; SD = 0.65) was used to identify and compare violence resilience profiles. Person-centered latent profile analysis (LPA) was applied and allowed for the grouping of adolescents into profiles of internalizing (depression/anxiety, dissociation) and externalizing symptoms (peer aggression, peer victimization, classroom disruption) and differentiation of adolescents with (n = 403) and without (n = 1,571) physical parental violence experiences. Subsequently, a multinomial logistic regression analysis was conducted to further investigate the sociodemographic predictors of violence resilience profiles. With LPA, we identified four distinct profiles for both adolescent groups (with and without parental physical violence experiences). The results showed three particularly burdened profiles of adolescents, one with higher externalizing and one with higher internalizing symptoms, which did not occur simultaneously to the same extent. Furthermore, the third profile contained adolescents with both elevated internalizing and externalizing symptoms, the comorbid profile. The fourth profile consisted of the majority of adolescents, who exhibited little or no internalizing and externalizing symptoms, the so-called no/low symptomatic profile. A differentiated view of the symptoms can create added value regarding the understanding of violence resilience. Moreover, in the multinomial logistic regression, significant associations were found between the profiles and adolescents' gender in the group of adolescents with parental physical violence experiences, but none were found in relation to sociocultural status and migration background.

Adverse Childhood Experiences and Adolescent Exposure to Violence

Adverse childhood experiences (ACEs) are relatively common and can lead to harmful outcomes in adolescence and adulthood. The current study investigates the relationship between ACEs and exposure to violence in adolescence, an important area of research given the high rates of victimization in adolescence and the need for evidence-based strategies to prevent and reduce the negative consequences of victimization. The study also examines sex differences in the effects of ACEs, given that some research finds that the prevalence and impact of ACEs vary for females and males. Research questions were analyzed using prospective data from 766 to 773 high-risk youth and caregivers participating in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). A total of 10 ACEs were assessed, including five types of child maltreatment measured using official data from child protective services agencies and five types of household dysfunction reported primarily by caregivers. Exposure to three types of violence (verbal intimidation, physical victimization, and witnessing violence) were measured using youth self-reports. Logistic regression analyses examined the relationship between the number of ACEs experienced before age 12 and the likelihood of violence exposure from ages 15 to 18. Youth experiencing more ACEs had a significantly greater likelihood of physical victimization (with an adjusted odds ratio of 1.15), but not intimidation (Adjusted Odds Ratio [AOR] = 1.10) or witnessing violence (AOR = 1.11). Sex did not significantly moderate these relationships, but in sex-specific analyses, ACEs significantly increased intimidation and victimization for girls and witnessing violence for boys. Although the findings showed inconsistent evidence of a relationship between ACEs and exposure to violence, they support the need for interventions to reduce ACEs and their impact on exposure to violence during adolescence.

Estimation of the Development of Depression and PTSD in Children Exposed to Sexual Abuse and Development of Decision Support Systems by Using Artificial Intelligence

The most common diagnoses after childhood sexual abuse are Post-Traumatic Stress Disorder and depression. The aim of this study is to design a decision support system to help psychiatry physicians in the treatment of childhood sexual abuse. Computer aided decision support system (CADSS) based on ANN, which predicts the development of PTSD and Major Depressive Disorder, using different parameters of the act of abuse and patients was designed. The data of 149 girls and 21 boys who were victims of sexual abuse were included in the study. In the designed CADDS, the gender of the victim, the type of sexual abuse, the age of exposure, the duration until reporting, the time of abuse, the proximity of the abuser to the victim, number of sexual abuse, whether the child is exposed to threats and violence during the abuse, the person who reported the event, and the intelligence level of the victim are used as input parameters. The average accuracy values for all three designed systems were calculated as 99.2%. It has been shown that the system designed by using these data can be used safely in the psychiatric assessment process, in order to differentiate psychiatric diagnoses in the early post-abuse period.

Characteristics of Disclosing Childhood Victimization and Risk of Revictimization in Young Adulthood

Experiencing victimization in childhood increases risk of adulthood revictimization, and it is important to understand what may contribute to such risk. One factor that may help to explain the increased risk of future victimization is disclosure. However, the literature is mixed as to whether disclosure of prior victimization is helpful for protecting against adverse outcomes, and much of the research on disclosure focuses solely on sexual victimization. The current study examines the relationship between various forms of childhood and adulthood victimization and whether disclosure moderates this relationship. In addition, this study investigates whether characteristics of disclosure are associated with revictimization risk. The sample included 275 undergraduates (M age = 19.52 years; 75.6% female, 77.5% non-Hispanic White or Caucasian). Participants reported on previous history of various forms of childhood and adulthood victimization. They also reported whether or not they had disclosed childhood victimization, and, if so, characteristics related to disclosure. Results revealed that number of childhood victimization experiences significantly predicted number of adulthood victimization experiences, and nearly every type of childhood victimization significantly increased risk of experiencing each type of adulthood victimization. Disclosure did not moderate the relationship between childhood and adulthood victimization. Participants who disclosed were more likely to disclose crime and peer/sibling victimization and disclose to parents or friends. Positive reactions to disclosure were more common than negative reactions; however, 75% of disclosers received at least one negative reaction. Finally, revictimized individuals received more overall negative reactions than nonrevictimized individuals. They also received more reactions characterized by the person they disclosed to trying to take control of their decisions or treating them differently. Results highlight the importance of examining relationships between various forms of victimization, considering how characteristics of disclosure relate to risk of revictimization, and the importance of educating potential support networks about appropriate responses to disclosure.

Associations between childhood victimization, inflammatory biomarkers and psychotic phenomena in adolescence: A longitudinal cohort study

Exposure to victimization in childhood has been linked to the development of psychosis. However, little is known about how childhood victimization is translated into biological risk for psychosis. One possibility is via increased inflammation. This study aimed to investigate the association between childhood victimization, psychotic experiences (PEs) in adolescence and inflammatory markers using data from a general population cohort. Participants were 1,419 British-born children followed from birth to age 18 years as part of the Environmental Risk Longitudinal Twin Study. Childhood victimization was measured prospectively using multiple sources from birth to age 12 years. PEs were assessed during private interviews with participants at age 18 years for the period since age 12. Plasma C-reactive protein (CRP), interleukin-6 (IL-6), and soluble urokinase plasminogen activator receptor (suPAR) levels were measured from plasma samples collected from participants at 18 years. Young people with both PEs and childhood victimization were more likely to belong to a group with elevated suPAR, CRP and IL-6 levels at 18 years of age (OR = 3.34, 95% CI 1.69-6.59, p = 0.001) than those with no childhood victimization and without PEs. However, this association was attenuated when adjusted for other risk factors for elevated inflammation at age 18 (OR = 1.94, 95% CI 0.94-4.04, p = 0.075). In contrast, presence of PEs without childhood victimization was not significantly associated with age-18 inflammatory markers and neither was childhood victimization without PEs (all p's greater than 0.05). The current study highlights that inflammatory dysregulation is mostly present in adolescents reporting PEs who also experienced childhood victimization, though this seemed to be largely due to concurrent inflammation-related risk factors.

Longitudinal Relations among Adolescent Risk Behavior, Family Cohesion, Violence Exposure, and Mental Health in a National Sample

Violence is a public health concern linked with mental health problems among adolescents, and risk behavior increases the likelihood of violence exposure. Family cohesion may attenuate the negative effects of risk behavior. The purpose of this study was to examine family cohesion as a moderator in the relation between risk behavior (substance use and delinquency) and violence exposure, and to explore longitudinal associations among cohesion, violence exposure, and subsequent mental health outcomes (PTSD and depression). Data were drawn from the National Survey of Adolescents-Replication, a nationally representative sample of 3604 adolescents, with data collected via structured phone interviews at three waves spanning a two-year period. Hypotheses were tested using longitudinal structural equation modeling. Findings revealed that high family cohesion attenuated the relation between risk behavior and subsequent violence exposure. Wave 2 violence exposure was associated with more Wave 3 mental health problems, but high family cohesion was related to fewer subsequent symptoms. Follow-up analyses revealed that family cohesion moderated the relation between risk behavior and experiencing, but not witnessing, violence. Several demographic associations were observed. Although risk behavior increases exposure to violence, and in turn, mental health problems, family cohesion may serve as a protective factor, attenuating the link between risk behavior and subsequent negative consequences. This effect emerged even when accounting for demographic and socioeconomic covariates. Interventions with adolescents should target family relationships as a protective factor to reduce risk of violence exposure and mental health problems, particularly for adolescents who are engaging in high-risk behaviors.

Psychological and physical abuse towards four-year-old children as reported by their parents: A national Finnish survey

BACKGROUND

In Finnish society, child maltreatment is a health and social problem with harmful consequences. Identifying families at risk may help preventing child maltreatment recurrence.

OBJECTIVE

The aim of this nationwide retrospective cross-sectional study was to describe the child- and family-related risk factors associated with physical and psychological abuse experienced by 4-year-old children.

METHODS

This study analyzed nationwide survey data collected by the Finnish Institute for Health and Welfare. Overall, 17,009 parents (46%) visiting at a child health clinic filled out the survey consent form. For 8720 children, one or both parents completed the questionnaire (24%). Analyses were carried out using χ² tests and binary logistic regression.

RESULTS

Of the 4-year-olds, 44% had experienced at least one form of psychological abuse and 14% physical abuse. These forms of violence co-occurred in 25% of the reported cases (p < 001). Intimate partner violence (IPV) and child maltreatment co-occurred in 19.6% of psychological abuse (p < .001) and 22.5% of physical abuse cases (p < .001). Parents exposed to IPV was the risk factor most likely to predict an increased risk for both psychological abuse (OR 4.01, CI 3.41-4.72; p < .001), and physical abuse (OR 2.19, CI 1.81-2.64; p < .001). Approving of hair-pulling or pinching the child (i.e., using corporal punishment) was most likely to predict an increased risk of physical abuse (OR 13.70, CI 11.69-16.06; p < .001).

CONCLUSIONS

The findings emphasize the importance of preventing all forms of child maltreatment by identifying families at risk and supporting parenthood according to families' needs.

Child maltreatment and adolescent externalizing behavior: Examining the indirect and cross-lagged pathways of prosocial peer activities

BACKGROUND

There is a well-established relation between child maltreatment and externalizing behaviors in adolescence. A gap in this scientific literature is the identification of pathways, particularly protective pathways, explaining this relation prior to the transition to adulthood.

OBJECTIVE

This study examined the indirect and cross-lagged pathways of peer engagement in prosocial activities to explain the relation between child maltreatment and adolescent externalizing behaviors.

PARTICIPANTS AND SETTINGS

Children and their caregivers (N = 1354) participated in a multi-site, multi-wave, prospective cohort study of child maltreatment in the U.S.

METHODS

Child maltreatment, peer engagement in prosocial activities, and externalizing behaviors were assessed at ages twelve, fourteen, and sixteen. A cross-lagged path model evaluated whether peer engagement in prosocial activities was an indirect pathway of the relation between prior child maltreatment and subsequent externalizing behaviors. Cross-lagged relations were examined to determine directionality of risk among these variables during adolescence.

RESULTS

The path model did not support peer engagement in prosocial activities as an indirect or cross-lagged pathway to externalizing behaviors in adolescence. Instead, prior child maltreatment had a direct relation with greater externalizing behaviors, which had indirect and cross-lagged effects with less peer engagement in prosocial activities at multiple points later in adolescence.

CONCLUSIONS

The degree of peer engagement in prosocial activities may not be a risk or protective pathway to externalizing behaviors in adolescence for those exposed to child maltreatment. In fact, externalizing behaviors appear to limit subsequent engagement with peers in prosocial activities, providing an opportunity for future research and intervention.

Sex-Based Differences in Criminal Victimization of Adolescents: A Meta-Analysis

While general criminological theories, including low self-control, social bonds, routine activities, and risky lifestyles are increasingly used to explain criminal victimization, there is some evidence these theories may omit important sex differences. To date, the empirical evidence remains mixed, which may be an artifact of methodological differences. This study used three-level meta-analytic methods to assess the use of various predictors derived from criminological theory on a variety of criminal victimization types, sample characteristics, and differences in research design. In a total sample of 166,650 females and 129,988 males in 115 studies using 95 unique datasets of adolescents (average age = 10-19), the meta-analysis revealed that elements of risky lifestyles are largely sex-neutral, while some sex-specific effects of bonds, routine activities, and prior victimization are observed. Implications for criminological theory, developmental and life course research on adolescent victimization, and avenues for prevention are discussed.

Autobiographical memory as a latent vulnerability mechanism following childhood maltreatment: Association with future depression symptoms and prosocial behavior

Objectives

Childhood maltreatment is associated with altered neural reactivity during autobiographical memory (ABM) recall and a pattern of overgeneral memory (OGM). Altered ABM and OGM have been linked with psychopathology and poorer social functioning. The present study investigated the association between altered ABM and subsequent socio-emotional functioning (measured two years later) in a sample of adolescents with (N = 20; maltreatment group, MT) and without (N = 17; non-MT group) documented childhood maltreatment histories.

Method

At baseline, adolescents (aged 12.6 ± 1.45 years) were administered the Autobiographical Memory Test to measure OGM. Participants also recalled specific ABMs in response to emotionally valenced cue words during functional MRI. Adolescents in both groups underwent assessments measuring depressive symptoms and prosocial behavior at both timepoints. Regression analyses were carried out to predict outcome measures at follow-up controlling for baseline levels.

Results

In the MT group, greater OGM at baseline significantly predicted reduced prosocial behavior at follow-up and showed a trend level association with elevated depressive symptoms. Patterns of altered ABM-related brain activity did not significantly predict future psycho-social functioning.

Conclusions

The current findings highlight the potential value of OGM as a cognitive mechanism that could be targeted to reduce risk of depression in adolescents with prior histories of maltreatment.

Peer Victimization of Maltreated Youth: Distinct Risk for Physically Abused Versus Neglected Children

BACKGROUND

Although child abuse is associated with peer victimization in adolescence, few studies have assessed if maltreated children experiencing only neglect are at increased risk as well. The purpose of this study is to assess the risk of peer victimization for maltreated youth who have been physically abused versus neglected to guide targeted bully prevention efforts in schools.

METHODS

Utilizing LONGSCAN archived data collected between 1991 and 2012, children physically abused or neglected in the first 12 years of life were assessed for physically aggressive peer victimization at age 16, compared to nonmaltreated children, with a total sample size of 650 participants. Logistic regression analysis assessed odds of peer victimization based on maltreatment profile.

RESULTS

Children physically abused were twice as likely to experience physically aggressive peer victimization, compared to the nonmaltreated group. Children experiencing only neglect were not at greater odds of being physically victimized by peers.

CONCLUSIONS

This study demonstrates physically abused children's risk of problems with aggressive peer victimization, in contrast to children neglected who are not at increased risk. These results contribute to our understanding of risk of peer victimization, and can inform targeted bully prevention efforts in schools for the child with a history of maltreatment.

Childhood maltreatment and DNA methylation: A systematic review

DNA methylation (DNAm) - an epigenetic process that regulates gene expression - may represent a mechanism for the biological embedding of early traumatic experiences, including childhood maltreatment. Here, we conducted the first systematic review of human studies linking childhood maltreatment to DNAm. In total, 72 studies were included in the review (2008-2018). The majority of extant studies (i) were based on retrospective data in adults, (ii) employed a candidate gene approach (iii) focused on global maltreatment, (iv) were based on easily accessible peripheral tissues, typically blood; and (v) were cross-sectional. Two-thirds of studies (n = 48) also examined maltreatment-related outcomes, such as stress reactivity and psychiatric symptoms. While findings generally support an association between childhood maltreatment and altered patterns of DNAm, factors such as the lack of longitudinal data, low comparability across studies as well as potential genetic and 'pre-exposure' environmental confounding currently limit the conclusions that can be drawn. Key challenges are discussed and concrete recommendations for future research are provided to move the field forward.

Child maltreatment, peer victimization, and social anxiety in adulthood: a cross-sectional study in a treatment-seeking sample

BACKGROUND

Childhood adversities, especially emotional abuse, emotional neglect, and peer victimization are considered to be crucial risk factors for social anxiety disorder (SAD). We investigated whether particular forms of retrospectively recalled childhood adversities are specifically associated with SAD in adulthood or whether we find similar links in other anxiety or depressive disorders.

METHODS

Prevalences of adversities assessed with the Childhood Trauma Questionnaire (CTQ) and a questionnaire of stressful social experiences (FBS) were determined in N = 1091 outpatients. Adversity severities among patients with SAD only (n = 25), specific phobia only (n = 18), and generalized anxiety disorder only (n = 19) were compared. Differences between patients with anxiety disorders only (n = 62) and depressive disorders only (n = 239) as well as between SAD with comorbid depressive disorders (n = 143) and SAD only were tested.

RESULTS

None of the adversity types were found to be specifically associated with SAD and severities did not differ among anxiety disorders but patients with depressive disorders reported more severe emotional abuse, physical abuse, and sexual abuse than patients with anxiety disorders. SAD patients with a comorbid depressive disorder also reported more severe adversities across all types compared to SAD only.

CONCLUSION

Findings indicate that particular forms of recalled childhood adversities are not specifically associated with SAD in adulthood. Previously established links with SAD may be better explained by comorbid depressive symptoms.

Prevalence of family violence and mental health and their relation to peer victimization: A representative study of adolescent students in Southwestern Uganda

BACKGROUND

Despite global efforts to end violence against children in all settings, reports reveal that violence against children is still highly prevalent, especially in low-and middle- income countries. Violence in childhood is associated with a host of negative outcomes, and exposure in one setting can easily spill over to other contexts. For instance, exposure to family violence was not only related to mental health problems but also seems to be a risk factor for peer victimization.

OBJECTIVES

The present study aimed to examine the prevalence of maltreatment within the family and adolescents' mental health problems and their relation to peer victimization. We also aimed to gain new insights into the perceptions of adolescents concerning maltreatment within their families.

METHODS

Data were collected from April to November 2017 in a representative sample of 702 students from 12 public secondary schools in Southwestern Uganda who responded to self-administered questionnaires.

RESULTS

Overall, 95% of the students experienced at least one type of family violence in the past month. Students (81.3%) had endorsed some level of acceptance of violent discipline as a valid strategy in response to any misbehavior. Maltreatment within the family was related to peer victimization (β = .47) and this relation was mediated by mental health problems (0.002, 95%-CI: 0.001-0.004).

CONCLUSIONS

The results indicated a high prevalence of maltreatment within Ugandan families that was associated with peer victimization. This underscores the need to implement interventions aiming to reduce maltreatment and violence in order to protect children from potentially negative consequences.

Neurocognitive Adaptation and Mental Health Vulnerability Following Maltreatment: The Role of Social Functioning

Childhood maltreatment is associated with a lifetime increase in risk of mental health disorder. We propose that such vulnerability may stem in large part from altered patterns of social functioning. Here, we highlight key findings from the psychological and epidemiological literature indicating that early maltreatment experience compromises social functioning and attenuates social support in ways that increase mental health vulnerability. We then review the extant neuroimaging studies of children and adolescents, focusing on three domains implicated in social functioning: threat processing, reward processing, and emotion regulation. We discuss how adaptations in these domains may increase latent vulnerability to mental health problems by impacting on social functioning via increased stress susceptibility as well as increased stress generation. Finally, we explore how computational psychiatry approaches, alongside systematically reported measures of social functioning, can complement studies of neural function in the creation of a mechanistic framework aimed at informing approaches to prevention and intervention.

Associations of Child Maltreatment and Intimate Partner Violence With Elder Abuse in a US Chinese Population

IMPORTANCE

People who have experienced abuse as a child or violence with an intimate partner might have higher odds of being abused again, but this has been insufficiently investigated regarding elder abuse. More conclusive evidence might be critical to assessment and prevention strategies.

OBJECTIVE

To examine the associations of child maltreatment and intimate partner violence with elder abuse.

DESIGN, SETTING, AND PARTICIPANTS

Cross-sectional data of 3157 community-dwelling US Chinese older adults (60 years or older) in Chicago, Illinois, were collected during 2011 through 2013.

EXPOSURES

Cases of child maltreatment and intimate partner violence.

MAIN OUTCOMES AND MEASURES

Cases of elder abuse.

RESULTS

Of the 3157 US Chinese older adults included in the study, 1328 (42.1%) were men, and the mean (SD) age was 72.8 (8.3) years. The prevalence of elder abuse, child maltreatment, and intimate partner violence in the cohort was 15.2%, 11.4%, and 6.5%, respectively. After adjusting for sociodemographic variables, health status, quality of life, and health change, individuals reporting child maltreatment had increased odds of intimate partner violence (13.4% vs 5.6%; adjusted odds ratio [aOR], 2.57; 95% CI, 1.78-3.71) and elder abuse (25.2% vs 13.8%; aOR, 2.08; 95% CI, 1.57-2.75) than those not reporting child maltreatment. Individuals reporting intimate partner violence had increased odds of elder abuse than those not reporting intimate partner violence (48.8% vs 12.9%; aOR, 5.53; 95% CI, 4.01-7.64).

CONCLUSIONS AND RELEVANCE

Prior abuse across major lifespan stages is associated with higher odds of elder abuse. Health care professionals should be more aware of the possibility of abuse when there is a known history of violence in a patient and consider the cumulative effect of violence among those exposed to elder abuse.

Repeat Assault Injury Among Adolescents Utilizing Emergency Care: A Statewide Longitudinal Study

BACKGROUND

Violent injuries are a leading cause of morbidity and mortality among youths. Little is known about adolescents' patterns of and risk factors for repeat assault injuries, yet understanding who is at risk for repeated assaults is important for intervention and prevention efforts. Investigating these questions in population-based adolescent samples is particularly critical.

OBJECTIVE

Our aim was to estimate the 5-year cumulative incidence of and risk factors for repeat emergency department (ED) visits for assault injury among adolescents experiencing an index assault visit, and compare the method of injury for adolescents' first and second visits.

METHODS

Statewide, longitudinal data from California were used to follow 17,845 adolescents who reported to an ED with assault-related injuries in 2010. Incidence rate ratios were estimated to examine risk factors for repeat assault injury within 1 year and 5 years following the index visit.

RESULTS

A total of 3273 (18.3%) assaulted adolescents experienced one or more additional assault injury ED visits during the full follow-up period. Only 37.3% of these repeat assaults occurred within the first year following the index assault. Of adolescents with a repeat assault injury, the method of injury often changed and followed no clear pattern. Sociodemographic characteristics (e.g., older age, black race) and history of prior ED visits for assault and mental health problems predicted increased risk of repeat assault.

CONCLUSIONS

Previous work may underestimate the rate of repeated assault among adolescents. Adolescents with a history of violence involvement and mental health problems are at elevated risk for repeated assault, and should be targeted for intervention.

Maternal- versus paternal-perpetrated maltreatment and risk for sexual and peer bullying revictimization in young women with depression

BACKGROUND

Childhood maltreatment is one of the strongest predictors of sexual and peer bullying re-victimization. However, it is not clear which types of maltreatment are associated with the greatest risk.

OBJECTIVE

The current study examined the differential relations of maternal- versus paternal-perpetrated emotional maltreatment, neglect, and physical maltreatment, as well as sexual maltreatment, to sexual victimization and peer bullying victimization outside the home. It was hypothesized that paternal-perpetrated emotional maltreatment would be the strongest predictor of later sexual and peer bullying victimization, and that sexual maltreatment would predict sexual re-victimization.

PARTICIPANTS AND SETTING

Participants included data from 263 adolescent and young adult women who had previously taken part in one of three larger studies conducted in an academic research setting investigating the relation between stress and depression. All participants had been recruited from the wider community or clinician referral and met criteria for a unipolar depressive disorder.

METHODS

Psychiatric diagnoses were assessed with a structured diagnostic interview. Childhood maltreatment and victimization were assessed retrospectively with a semi-structured contextual interview that includes standardized ratings.

RESULTS

Paternal-perpetrated emotional abuse was the only maltreatment type that was independently associated with sexual (OR = 3.09, p =  .004) and peer bullying (OR = 1.41, p =  .05) re-victimization over other forms of maltreatment and indicators of depression severity.

CONCLUSIONS

These findings provide an important foundation for future research examining the mechanisms driving the relation between father's hostility, criticism, and rejection and daughters' revictimization that can ultimately provide targets for prevention in girls at highest risk.

A pernicious cycle: Finding the pathways from child maltreatment to adolescent peer victimization

The purpose of this study was to identify the pathways from childhood physical and sexual abuse to adolescent physical and sexual victimization by assessing behavior symptoms (both internalizing and externalizing) and peer popularity as potential mediating variables. The data derive from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which tracks the consequences of child abuse and neglect using five study sites across the US. Child physical and sexual abuse was measured at age 12 using self-reports of life-time maltreatment experiences. Internalizing and externalizing symptoms were assessed at age 12 using the Child Behavior Checklist (CBCL). Peer popularity was assessed at age 14 by teachers. Peer victimization was assessed at age 16 using the modified version of the Juvenile Victimization Questionnaire. The results indicated that physical abuse had no direct effect on either physical or sexual peer victimization, whereas sexual abuse had significant direct effect on both physical and sexual victimization. Assessed at age 12, children who had been physically or sexually maltreated were found to have higher levels of internalizing and externalizing symptoms. These increased symptoms are associated with lower peer popularity at age 14, which in turn is associated with greater physical and sexual peer victimization at age 16. The findings suggest that multiple points for interventions may exist to disrupt the cycle of victimization. Early assessment and treatment for externalizing symptoms and for low peer popularity may be helpful in preventing physical peer victimization among adolescents who have been physically and/or sexually abused.