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Farooq B, Russell AE, Howe LD, Herbert A, Smith ADAC, Fisher HL, Baldwin JR, Arseneault L, Danese A, Mars B. The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression: findings from three UK prospective population-based cohorts. J Child Psychol Psychiatry 2024. [PMID: 38613494 DOI: 10.1111/jcpp.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are well-established risk factors for self-harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co-occurring self-harm and depression. METHODS Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14-18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E-Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four-category outcome: no self-harm or depression, self-harm alone, depression alone and self-harm with co-occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self-harm and depression in adolescence. RESULTS The majority of ACEs were associated with co-occurring self-harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co-occurring self-harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10-1.25) and MCS (1.18, 1.11-1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co-occurring self-harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. CONCLUSIONS Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long-term exposure to ACEs contributing to risk of self-harm and depression in adolescence.
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Affiliation(s)
- Bushra Farooq
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Abigail E Russell
- Children and Young People's Mental Health Research Collaboration, University of Exeter Medical School, Exeter, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Annie Herbert
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Andrew D A C Smith
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Jessie R Baldwin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Louise Arseneault
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Becky Mars
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, UK
- National Institute for Health and Care Research, Biomedical Research Centre, Bristol, UK
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Hu N, Gelaw YA, Katz I, Fernandez E, Falster K, Hanly M, Newton BJ, Stephensen J, Hotton P, Zwi K, Lingam R. Developmental trajectories of socio-emotional outcomes of children and young people in out-of-home care - Insights from data of Pathways of Care Longitudinal Study (POCLS). CHILD ABUSE & NEGLECT 2024; 149:106196. [PMID: 37149427 DOI: 10.1016/j.chiabu.2023.106196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/26/2023] [Accepted: 04/08/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND There has been a limited understanding of the longitudinal trajectory and determinants of socio-emotional outcomes among children in out-of-home care (OOHC). OBJECTIVES This study aimed to examine child socio-demographics, pre-care maltreatment, placement, and caregiver factors associated with trajectories of socio-emotional difficulties of children in OOHC. PARTICIPANTS AND SETTING The study sample (n = 345) included data from the Pathways of Care Longitudinal Study (POCLS), a prospective longitudinal cohort of children aged 3-17 years who entered the OOHC system in New South Wales (NSW) Australia, between 2010 and 2011. METHODS Group-based trajectory models were used to identify distinct socio-emotional trajectory groups based on the Child Behaviour Check List (CBCL) Total Problem T-scores completed at all four Waves 1-4. Modified Poisson regression analysis was conducted to assess the association (risk ratios) of socio-emotional trajectory group membership with pre-care maltreatment, placement, and caregiver-related factors. RESULTS Three trajectories of socio-emotional development were identified: 'persistently low difficulties' (average CBCL T-score changed from 40 to 38 over time), normal (average CBCL T-score changed from 52 to 55 over time), and clinical (average CBCL T-score remained at 68 over time) trajectories. Each trajectory presented a stable trend over time. Relative/kinship care, as compared with foster care, was associated with the "persistently low" socio-emotional trajectory. Being male, exposure to ≥8 pre-care substantiated risk of significant harm (ROSH) reports, placement changes, and caregiver's psychological distress (more than two-fold increased risk) were associated with the clinical socio-emotional trajectory. CONCLUSIONS Early intervention to ensure children have a nurturing care environment and psychological support to caregivers are vital for positive socio-emotional development over time among children in long-term OOHC.
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Affiliation(s)
- Nan Hu
- Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia
| | - Yalemzewod Assefa Gelaw
- Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
| | - Ilan Katz
- Social Policy Research Centre, UNSW Sydney, High Street, Kensington 2052, Australia
| | - Elizabeth Fernandez
- School of Social Sciences, UNSW Sydney, High Street, Kensington 2052, Australia
| | - Kathleen Falster
- School of Population Health, UNSW Sydney, High Street, Kensington 2052, Australia
| | - Mark Hanly
- Centre for Big Data Research in Health, UNSW Sydney, High Street, Kensington 2052, Australia
| | - B J Newton
- Social Policy Research Centre, UNSW Sydney, High Street, Kensington 2052, Australia
| | - Jennifer Stephensen
- School of Social Sciences, UNSW Sydney, High Street, Kensington 2052, Australia
| | - Paul Hotton
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Sydney Children's Hospitals Network (SCHN), High Street, Randwick, New South Wales 2031, Australia
| | - Karen Zwi
- Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Sydney Children's Hospitals Network (SCHN), High Street, Randwick, New South Wales 2031, Australia
| | - Raghu Lingam
- Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia.
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Cumming C, Bell MF, Segal L, Spittal MJ, Kinner SA, Dennison S, Dawe S, Preen DB. Maternal incarceration increases the risk of self-harm but not suicide: a matched cohort study. Epidemiol Psychiatr Sci 2023; 32:e33. [PMID: 37161898 DOI: 10.1017/s2045796023000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
AIMS Children of incarcerated mothers are at increased risk of experiencing multiple adversity such as poverty, mental illness and contact with child protection services (CPS), including being taken into out of home care (OOHC). However, little is known about whether these children are at increased risk of suicide or self-harm compared to children not exposed to maternal incarceration or about the factors that may contribute to this. We aimed to investigate differences in the risk of suicide and self-harm between children exposed to maternal incarceration and those not exposed and examine how socio-demographic factors, maternal mental illness and CPS contact (with or without OOHC) may affect these outcomes. METHODS We used a retrospective matched cohort study design, comparing 7674 children exposed to maternal incarceration with 7674 non-exposed children. We used multivariable Cox proportional hazards regression to compare the risk of suicide and self-harm between exposed and non-exposed groups, controlling for geographical remoteness, CPS contact and maternal mental illness. RESULTS There was no significant difference in the rate of suicide (rate ratio [RR] = 1.49; 95% confidence interval [CI]: 0.78, 2.87) or risk of suicide (adjusted hazard ratio [aHR] = 0.92; 95% CI: 0.43, 1.96) between the two groups. However, the exposed group had a significantly higher rate of self-harm (RR = 2.83; 95% CI: 2.50, 3.21) and a significantly higher risk of self-harm (aHR = 1.74; 95% CI: 1.45, 2.09) compared to those non-exposed. CPS contact with or without OOHC was independently associated with an increased risk of self-harm for both groups. CONCLUSION Children exposed to maternal incarceration are at an increased risk of self-harm and should be prioritized to receive targeted, multimodal support that continues after the mother's release from prison. The association between CPS contact and self-harm warrants further research.
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Affiliation(s)
- Craig Cumming
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Megan F Bell
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Leonie Segal
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Population Health, Curtin University, Perth, Australia
| | - Susan Dennison
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Australia
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, Australia
- The Hopkins Centre, Griffith University, Brisbane, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
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Soneson E, Das S, Burn AM, van Melle M, Anderson JK, Fazel M, Fonagy P, Ford T, Gilbert R, Harron K, Howarth E, Humphrey A, Jones PB, Moore A. Leveraging Administrative Data to Better Understand and Address Child Maltreatment: A Scoping Review of Data Linkage Studies. CHILD MALTREATMENT 2023; 28:176-195. [PMID: 35240863 PMCID: PMC9806482 DOI: 10.1177/10775595221079308] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND This scoping review aimed to overview studies that used administrative data linkage in the context of child maltreatment to improve our understanding of the value that data linkage may confer for policy, practice, and research. METHODS We searched MEDLINE, Embase, PsycINFO, CINAHL, and ERIC electronic databases in June 2019 and May 2020 for studies that linked two or more datasets (at least one of which was administrative in nature) to study child maltreatment. We report findings with numerical and narrative summary. RESULTS We included 121 studies, mainly from the United States or Australia and published in the past decade. Data came primarily from social services and health sectors, and linkage processes and data quality were often not described in sufficient detail to align with current reporting guidelines. Most studies were descriptive in nature and research questions addressed fell under eight themes: descriptive epidemiology, risk factors, outcomes, intergenerational transmission, predictive modelling, intervention/service evaluation, multi-sector involvement, and methodological considerations/advancements. CONCLUSIONS Included studies demonstrated the wide variety of ways in which data linkage can contribute to the public health response to child maltreatment. However, how research using linked data can be translated into effective service development and monitoring, or targeting of interventions, is underexplored in terms of privacy protection, ethics and governance, data quality, and evidence of effectiveness.
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Affiliation(s)
- Emma Soneson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Shruti Das
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marije van Melle
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Mina Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, Headington, Oxford, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ruth Gilbert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Katie Harron
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Emma Howarth
- School of Psychology, University of East London, London, UK
| | - Ayla Humphrey
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anna Moore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Goblet M, Glowacz F. Slut Shaming in Adolescence: A Violence against Girls and Its Impact on Their Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6657. [PMID: 34205692 PMCID: PMC8296320 DOI: 10.3390/ijerph18126657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
Slut shaming is defined as the stigmatization of an individual based on his or her appearance, sexual availability, and actual or perceived sexual behavior. It can take place in physical or virtual spaces. The present study questions the impact of this form of sexism in virtual spaces on girls and interrogates the interaction between the values that girls integrate through their life experiences, especially in the family sphere, and slut shaming victimization. We conducted a paper-pencil questionnaire with 605 girls between the ages of 10 and 18 (average age: 15.18 years). Our data confirm the impact of slut shaming on the physical and psychological well-being of young girls as early as adolescence. Second, mediation analyses provide insights into the revictimization and Poly-victimization processes, from childhood adverse experiences to sexist victimization in virtual spaces and their combined impact on the physical and psychic health of girls. Finally, we address prevention strategies and the involvement of socializing institutions in the deconstruction of gender stereotypes.
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Affiliation(s)
- Margot Goblet
- Department of Psychology, Université de Liège, 4000 Liège, Belgium;
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Leckning B, He VYF, Condon JR, Hirvonen T, Milroy H, Guthridge S. Patterns of child protection service involvement by Aboriginal children associated with a higher risk of self-harm in adolescence: A retrospective population cohort study using linked administrative data. CHILD ABUSE & NEGLECT 2021; 113:104931. [PMID: 33461112 DOI: 10.1016/j.chiabu.2021.104931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/04/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND A history of child maltreatment is known to elevate the risk of self-harm in adolescence. However, this link has not been investigated for Aboriginal children who experience a greater burden of both. OBJECTIVE Identify patterns of involvement with child protection services by Aboriginal children associated with a higher risk of self-harm in adolescence. PARTICIPANTS AND SETTING A cohort study was established using linked administrative records of Aboriginal children born in the Northern Territory (NT) of Australia. METHODS Survival analysis techniques were used to determine the risk of self-harm in adolescence associated with different levels and timing of child protection involvement throughout childhood. RESULT The relative risk of self-harm was greatest for children with substantiated maltreatment in both early and middle childhood had nine times higher risk for self-harm (aHR: 9.11, 95% CI: 3.39-24.46,p < 0.001) and six times higher for children who experienced notifications in early childhood and substantiated maltreatment in middle childhood (aHR: 6.72, 95% CI:2.16-20.90, p < 0.001). Other patterns of child protection involvement observed in middle childhood alone also conferred a higher relative risk of self-harm in adolescence. CONCLUSION This study confirms a higher risk of self-harm in adolescence is associated with child maltreatment, especially in middle childhood. Addressing the intergenerational trauma in Aboriginal families is crucial to preventing child maltreatment and informing reforms to child protection responses that can better identify and address the culturally-specific unmet needs of Aboriginal families. This would go some way to fostering the healthy growth and development of Aboriginal children and reduce self-harm risk.
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Affiliation(s)
- Bernard Leckning
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Australia.
| | - Vincent Y F He
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Australia
| | - John R Condon
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Australia
| | - Tanja Hirvonen
- College of Medicine and Public Health, Flinders University, Australia
| | - Helen Milroy
- Faculty of Health and Medical Sciences, University of Western, Australia
| | - Steven Guthridge
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Australia
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Affiliation(s)
- Stephanie Streb
- Stephanie Streb is an assistant professor at the University of Maryland School of Nursing, Department of Family and Community Health, Baltimore, Md
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Lang CM, Edwards AJ, Mittler MA, Bonavitacola L. Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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