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Schneider J, Rukundo-Zeller AC, Bambonyé M, Lust S, Mugisha H, Muhoza JA, Ndayikengurukiye T, Nitanga L, Rushoza AA, Crombach A. The impact of parental acceptance and childhood maltreatment on mental health and physical pain in Burundian survivors of childhood sexual abuse. CHILD ABUSE & NEGLECT 2024; 154:106906. [PMID: 38917765 DOI: 10.1016/j.chiabu.2024.106906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Parental support has been suggested to mitigate mental and physical consequences following childhood sexual abuse (CSA). However, many CSA survivors experience parental rejection post-CSA. OBJECTIVE We aimed to understand the impact of abuse-specific parental acceptance on post-traumatic stress disorder (PTSD) and physical pain in Burundian CSA-survivors. We further assessed the significance of parental acceptance among known risk factors for predicting PTSD. METHODS, PARTICIPANTS, AND SETTINGS Participants (N = 131, 80.9 % female, mean age 16.21 years) were recruited via primary health care centers for survivors of sexual violence which survivors approached post-CSA. Survivors reported on PTSD symptoms, daytime/nighttime pain, and adverse childhood experiences in semi-structured interviews. Parental acceptance levels were categorized (acceptance, no acceptance, no contact) for mothers and fathers separately. Kruskal-Wallis tests assessed group differences. Conditional random forests (CRF) evaluated the significance of parental acceptance in predicting PTSD symptom severity. RESULTS No significant differences regarding PTSD symptoms and physical pain between levels of maternal acceptance were obtained. Pairwise comparisons revealed significant differences in PTSD symptom severity between paternal acceptance and no acceptance (d = 1.04) and paternal acceptance and no contact (d = 0.81). The CRF identified paternal acceptance as important variable for the prediction of PTSD symptom severity. Even though results were less conclusive, medium effect sizes hint at less pain perception within the paternal acceptance group. CONCLUSIONS The results highlight paternal acceptance as a potential risk or protective factor regarding psychological and possibly physical well-being in the aftermath of CSA, even in the context of other known risk factors.
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Affiliation(s)
- Julia Schneider
- Saarland University, Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents, Saarbrücken, Germany.
| | - Anja C Rukundo-Zeller
- University of Konstanz, Psychology, Clinical Psychology and Clinical Neuropsychology, Konstanz, Germany; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi; Non-Governmental Organization vivo international e.V., Konstanz, Germany
| | - Manassé Bambonyé
- Université Lumière de Bujumbura, Clinical Psychology, Bujumbura, Burundi; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Sarah Lust
- University of Konstanz, Psychology, Clinical Psychology and Clinical Neuropsychology, Konstanz, Germany
| | - Hervé Mugisha
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Jean-Arnaud Muhoza
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | | | - Lydia Nitanga
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Amini Ahmed Rushoza
- Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi
| | - Anselm Crombach
- Saarland University, Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents, Saarbrücken, Germany; Non-Governmental Organization Psychologues sans Frontières Burundi, Bujumbura, Burundi; Non-Governmental Organization vivo international e.V., Konstanz, Germany
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García-Fernández A, Martínez-Cao C, Sánchez-Fernández-Quejo A, Bobes-Bascarán T, Andreo-Jover J, Ayad-Ahmed W, Cebriá AI, Díaz-Marsá M, Garrido-Torres N, Gómez S, González-Pinto A, Grande I, Iglesias N, March KB, Palao DJ, Pérez-Díez I, Roberto N, Ruiz-Veguilla M, de la Torre-Luque A, Zorrilla I, Pérez V, Sáiz PA, García-Portilla MP. Validation of the Spanish Childhood Trauma Questionnaire-Short Form in adolescents with suicide attempts. Front Psychol 2024; 15:1378486. [PMID: 39045440 PMCID: PMC11264239 DOI: 10.3389/fpsyg.2024.1378486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Background Child maltreatment is associated with a higher probability of mental disorders and suicidal behavior in adolescence. Therefore, accurate psychometric instruments are essential to assess this. Objective To validate the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in adolescents with suicide attempts. Methods Multisite cohort study of 208 adolescents with suicide attempts using data from the following scales: Mini International Neuropsychiatric Interview (MINI), Columbia Suicide Severity Rating Scale (C-SSRS), Patient Health Questionnaire (PHQ-9), and CTQ-SF. Statistical analysis: CTQ-SF scores analyzed by descriptive statistics. Internal consistency: McDonald's omega and Cronbach's alpha. Concurrent validity with PHQ-9 and C-SSRS scores: Spearman correlation coefficient. Structural validity: Confirmatory factor analysis. Results Floor and ceiling effects: Physical abuse and neglect as well as sexual abuse demonstrated high floor effects (50.0, 35.1, and 61.1% of adolescents, respectively). No ceiling effects were found. The CTQ-SF had excellent internal consistency (McDonald's omega = 0.94), as did the majority of its subscales (Cronbach's alpha 0.925-0.831) except for physical neglect (0.624). Its concurrent validity was modest, and the emotional neglect subscale had the lowest Spearman correlation coefficients (0.067-0.244). Confirmatory factor analysis: Compared with alternative factor structures, the original CTQ-SF model (correlated 5-factor) exhibited a better fit [S-B χ 2 = 676.653, p < 0; RMSEA (90% CI = 0.076-0.097) = 0.087; SRMR = 0.078; CFI = 0.980; TLI = 0.978]. Conclusion The Spanish CTQ-SF is a reliable, valid instrument for assessing traumatic experiences in adolescents at high risk of suicide. It appears appropriate for use in routine clinical practice to monitor maltreatment in this group.
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Affiliation(s)
- Ainoa García-Fernández
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Clara Martínez-Cao
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | | | - Teresa Bobes-Bascarán
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Department of Psychology, Universidad de Oviedo, Oviedo, Spain
| | - Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | | | - Ana Isabel Cebriá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional (I3PT-INc-UAB), Sabadell, Barcelona, Spain
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Marina Díaz-Marsá
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Hospital Clínico San Carlos, Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Nathalia Garrido-Torres
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine of Seville (IBiS), Sevilla, Spain
- Hospital Virgen del Rocío, Sevilla, Spain
- Department of Psychiatry, University of Seville, Sevilla, Spain
| | - Sandra Gómez
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Psychiatry, UPV/EHU, Vitoria, Spain
- BIOARABA, Vitoria, Spain
- Hospital Universitario de Alava, Vitoria, Spain
| | - Iria Grande
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Noelia Iglesias
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Katya B. March
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Diego J. Palao
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional (I3PT-INc-UAB), Sabadell, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Iván Pérez-Díez
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Natalia Roberto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miguel Ruiz-Veguilla
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine of Seville (IBiS), Sevilla, Spain
- Hospital Virgen del Rocío, Sevilla, Spain
- Department of Psychiatry, University of Seville, Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Iñaki Zorrilla
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Psychiatry, UPV/EHU, Vitoria, Spain
- BIOARABA, Vitoria, Spain
- Hospital Universitario de Alava, Vitoria, Spain
| | - Víctor Pérez
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Pilar A. Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 PMCID: PMC11238702 DOI: 10.1016/j.chiabu.2024.106701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Islam MJ. The Relationship Between Childhood Abuse and Unintended Pregnancy Among Married Women of Reproductive Age in Bangladesh. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:243-261. [PMID: 38326755 DOI: 10.1080/10538712.2024.2314283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/27/2024] [Indexed: 02/09/2024]
Abstract
Childhood abuse has been associated with adverse medical, psychological, behavioral, and socioeconomic outcomes in adulthood. Despite this, limited research explores the connection between childhood abuse and unintended pregnancy during adulthood. Notably, existing studies have predominantly focused on high-income countries, leaving a significant gap regarding low- and middle-income nations. This study aims to investigate the impact of childhood physical, sexual, and psychological abuse on the prevalence of unintended pregnancies and explore the interaction effects of childhood abuse on unintended pregnancy occurrences. The cross-sectional survey study was conducted between October 2015 and January 2016 in the Chandpur District of Bangladesh. Data were collected from 426 married women aged 15-49 years who had at least one child of six months or younger. The assessment of child abuse pertains to the mother's own experiences of childhood abuse and not abuse inflicted on her child. The prevalence of childhood physical, psychological, and sexual abuse was 37%, 26%, and 15%, respectively. About 25.1% of their most recent pregnancies were unintended. Notably, women with a history of childhood sexual abuse were twice as likely to experience unintended pregnancy compared to those without such a history. Furthermore, a dose-response connection was observed between the combined exposure of all categories of childhood abuse and a higher risk of unintended pregnancy. These findings highlight the need for targeted interventions, such as comprehensive sex education, accessible mental health support, and improved child protection frameworks, to address the potential repercussions of maternal childhood abuse and reduce the incidence of unintended pregnancies.
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Aizpurua E, Caravaca-Sánchez F, Wolff N. Validation and measurement invariance of the childhood trauma questionnaire short form among incarcerated men and women in Spain. CHILD ABUSE & NEGLECT 2024; 147:106527. [PMID: 37950962 DOI: 10.1016/j.chiabu.2023.106527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND Childhood trauma is highly prevalent among incarcerated individuals and contributes to a range of negative outcomes. Assessing traumatic childhood events in prison settings requires valid, reliable, and effective instruments. OBJECTIVES AND METHODS This study evaluated the performance of the Childhood Trauma Questionnaire - Short Form (CTQ-SF), originally developed and validated in English, within a sample of incarcerated men and women (n = 1118 and n = 207, respectively) in six Spanish prisons. RESULTS The results indicated that the CTQ-SF had an acceptable fit in our sample. However, the internal consistency of the Physical Neglect subscale was found to be deficient (α = 0.57), especially among women (α = 0.43). This finding aligns with previous research across different contexts, which may signal weaknesses in the original construction of this subscale. The CTQ-SF demonstrated limited invariance between men and women, with only configural invariance being achieved, constraining the comparisons that can be made across sexes. In the absence of scalar invariance, comparisons of factor means to assess severity may be misleading, and caution is recommended when comparing prevalence estimates for men and women in Spanish prisons. Nonetheless, our findings support the convergent validity of the CTQ-SF, as trauma severity showed moderate correlations with depression, anxiety, stress, and aggression. CONCLUSIONS These results underscore the importance of evaluating the performance of instruments across various cultural contexts and populations to ensure the validity of study conclusions.
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Affiliation(s)
- Eva Aizpurua
- National Centre for Social Research, London, United Kingdom..
| | | | - Nancy Wolff
- Bloustein Center for Survey Research. Rutgers, The State University of New Jersey, 33 Livingston Avenue, Office 273, United States
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Georgieva S, Tomás JM, Navarro-Pérez JJ, Samper-García P. Systematic Review and Critical Appraisal of Five of the Most Recurrently Validated Child Maltreatment Assessment Instruments from 2010 to 2020. TRAUMA, VIOLENCE & ABUSE 2023; 24:2448-2465. [PMID: 35575249 DOI: 10.1177/15248380221097694] [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] [Indexed: 06/15/2023]
Abstract
Assessment of child maltreatment has been inconsistent across literature due to its complexity, multidimensionality, and the variety of conceptualizations of this construct. Five instruments have recurrently examined psychometric properties across the last years of research: Childhood Trauma Questionnaire, Maltreatment and Abuse Chronology of Exposure, Child Abuse Potential Inventory, Identification of Parents at Risk for child Abuse and Neglect, and Psychosocial Screening Tool. This article aims to examine and wrap up the knowledge regarding the psychometric properties of these instruments. A systematic review was performed through three of the most relevant databases in order to identify the most validated instruments to assess child maltreatment from 2010 to 2020, and 19 research articles were identified. Results indicate that there is a lack of information regarding some psychometric properties and therefore, in the light of this information, it is not possible to clearly determine if there are instruments with stronger scientific evidence for their psychometric properties, although the Maltreatment and Abuse Chronology of Exposure Scale (MACE) obtained the strongest psychometric evidence. This systematic review provided a comprehensive review on the main psychometric properties of five child maltreatment instruments in order to facilitate researchers and child welfare professionals the selection of the most suitable instrument for their specific purpose. We recommend addressing these gaps of information by further examining the psychometric properties of these instruments, and developing valid and reliable instruments for early detection in child maltreatment.
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Affiliation(s)
| | - José M Tomás
- Faculty of Psychology, University of Valencia, Spain
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Lewis MW, Webb CA, Kuhn M, Akman E, Jobson SA, Rosso IM. Predicting Fear Extinction in Posttraumatic Stress Disorder. Brain Sci 2023; 13:1131. [PMID: 37626488 PMCID: PMC10452660 DOI: 10.3390/brainsci13081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Fear extinction is the basis of exposure therapies for posttraumatic stress disorder (PTSD), but half of patients do not improve. Predicting fear extinction in individuals with PTSD may inform personalized exposure therapy development. The participants were 125 trauma-exposed adults (96 female) with a range of PTSD symptoms. Electromyography, electrocardiogram, and skin conductance were recorded at baseline, during dark-enhanced startle, and during fear conditioning and extinction. Using a cross-validated, hold-out sample prediction approach, three penalized regressions and conventional ordinary least squares were trained to predict fear-potentiated startle during extinction using 50 predictor variables (5 clinical, 24 self-reported, and 21 physiological). The predictors, selected by penalized regression algorithms, were included in multivariable regression analyses, while univariate regressions assessed individual predictors. All the penalized regressions outperformed OLS in prediction accuracy and generalizability, as indexed by the lower mean squared error in the training and holdout subsamples. During early extinction, the consistent predictors across all the modeling approaches included dark-enhanced startle, the depersonalization and derealization subscale of the dissociative experiences scale, and the PTSD hyperarousal symptom score. These findings offer novel insights into the modeling approaches and patient characteristics that may reliably predict fear extinction in PTSD. Penalized regression shows promise for identifying symptom-related variables to enhance the predictive modeling accuracy in clinical research.
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Affiliation(s)
- Michael W. Lewis
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Christian A. Webb
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Manuel Kuhn
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Eylül Akman
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Sydney A. Jobson
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Isabelle M. Rosso
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Peng C, Cheng J, Rong F, Wang Y, Yu Y. Psychometric properties and normative data of the childhood trauma questionnaire-short form in Chinese adolescents. Front Psychol 2023; 14:1130683. [PMID: 36923147 PMCID: PMC10008899 DOI: 10.3389/fpsyg.2023.1130683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/09/2023] [Indexed: 03/01/2023] Open
Abstract
Background The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely utilized instrument of childhood maltreatment (CM). However, psychometric properties and normative data of the CTQ-SF for Chinese adolescents are still unknown. Objective To examine psychometric properties and normative data of Chinese version CTQ-SF in a nationally representative sample of Chinese adolescents, including internal consistency reliability, test-retest reliability, structural validity, and convergent validity. Method A total of 20,951 adolescents aged 12 to 18 years were recruited from five provinces across China. Item analysis was used for 25 clinical items of the CTQ-SF. Confirmatory factor analysis was performed to examine fit indices of the factor structure. The Adverse Childhood Experiences Scale (ACEs) was used to evaluate convergent validity. The percentile ranks for scores of the CTQ-SF and each subscales were presented. Results According to the results of three methods in Item analysis, Item 4 should be dropped. The remaining 24 clinical items achieved satisfactory fits in an alternative four-factor model. The alternative CTQ-SF showed acceptable internal consistency and the Cronbach's α of the four subscales was 0.824 (Neglect), 0.755 (Sexual Abuse), 0.713 (Physical Abuse), and 0.666 (Emotional Abuse), respectively. Besides, test-retest reliability and convergent validity of the alternative CTQ-SF were also acceptable. Conclusion The alternative four-factor model CTQ-SF exhibits good reliability and validity among Chinese adolescents. Additionally, the normative information of the CTQ-SF could provide practical support for determining severity of different subtypes of CM.
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Affiliation(s)
- Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hagborg JM, Kalin T, Gerdner A. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) used with adolescents - methodological report from clinical and community samples. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1199-1213. [PMID: 36439669 PMCID: PMC9684390 DOI: 10.1007/s40653-022-00443-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 05/11/2023]
Abstract
PURPOSE The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely used retrospective screening tool for childhood maltreatment in adults. Its properties are less known in adolescents. The objective was to investigate acceptability and psychometric properties when used in adolescents. METHOD A community sample of adolescents (n=1885) in four waves (from 13 or 14 to 17 years old) and a clinical sample (n=74, mean age 18), both from Sweden, were used to assess acceptability and different aspects of validity and reliability. RESULTS The CTQ-SF was found to be well-accepted. As expected, the community sample scored lower than the clinical sample on all maltreatment-scales and showed stability over-time. In the community sample, internal consistencies were substantial or excellent for all scales except Physical neglect, and in the clinical sample this was found for all scales. One-year test-retest consistencies of subscales were substantial or almost perfect, and for all scales, they increased from early to mid-adolescence. Directed inconsistencies on item level decreased from early to mid-adolescence. Convergent validity was shown in relation to scales on family climate, parental relations, and emotional health also from early adolescence. Discriminant analyses showed more moderate discriminatory ability although almost seven times better than by-chance. CONCLUSIONS The CTQ is well accepted and can be trusted to provide consistent and valid self-reports from the age of 14 on childhood maltreatment. Some caution is advised when used with younger adolescents, since the test-retest stability is then weaker, and the interpretation of the M/D scale is more ambiguous.
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Affiliation(s)
| | - Torbjörn Kalin
- School of Health and Welfare, Department of Social Work, Jönköping University, Jönköping, Sweden
| | - Arne Gerdner
- School of Health and Welfare, Department of Social Work, Jönköping University, Jönköping, Sweden
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Wu Q, Cao H, Lin X, Zhou N, Chi P. Child Maltreatment and Subjective Well-being in Chinese Emerging Adults: A Process Model Involving Self-esteem and Self-compassion. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13685-NP13706. [PMID: 33629633 DOI: 10.1177/0886260521993924] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child maltreatment is negatively associated with subjective well-being in emerging adulthood, but the understanding of the mechanisms of this relationship is incomplete. Guided by the stress process model incorporated with a life-course perspective, the present study examined the protective roles of self-related resources (self-esteem and self-compassion) in this association, while considering various maltreatment types (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse). The Childhood Trauma Questionnaire-Short Form, Rosenberg Self-esteem Scale, Self-compassion Scale, and Satisfaction with Life Scale were used to measure the key variables through an online survey of 358 Chinese college students (226 females, mean age = 19.18) Direct effect of one type of maltreatment on life satisfaction and the three indirect effects through (a) self-esteem; (b) self-compassion; and (c) self-esteem and self-compassion in sequence were examined while controlling for age, gender, and the other four maltreatment types. The results showed that psychological maltreatment was negatively associated with life satisfaction through self-esteem and through the pathway from self-esteem to self-compassion. Indirect effects of the other three types of maltreatment were not significant. This suggests that self-processes are more vulnerable to psychological maltreatment than to other maltreatment types. The type of maltreatment experienced in childhood is worth considering when investigating the extending effect of child maltreatment on individual developmental outcomes. Our findings broaden the understanding of the mechanisms of the stress process model integrated with a life-course perspective. Self-related resources appear to play substantial roles in the long-term association between early stressors of psychological maltreatment in childhood and subjective well-being in emerging adulthood. Highlighting the need to work on improved self-related resources, including self-compassion and self-esteem, might help practitioners to provide treatment for survivors of adverse childhood experiences..
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Affiliation(s)
- Qinglu Wu
- Beijing Normal University at Zhuhai, China
- University of Macau, China
| | | | - Xiuyun Lin
- Beijing Normal University at Zhuhai, China
| | - Nan Zhou
- Beijing Normal University at Zhuhai, China
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11
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Islam MJ, Broidy L, Eriksson L, Rahman M, Mazumder N. Childhood maltreatment and decision-making autonomy in adulthood: The mediating roles of self-esteem and social support. CHILD ABUSE & NEGLECT 2022; 129:105665. [PMID: 35567956 DOI: 10.1016/j.chiabu.2022.105665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/13/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) is connected with a large number of maladaptive long-term outcomes. Effective prevention and intervention hinges partly on our understanding of the key mediating mechanisms that help account for the relationship between child maltreatment and its long-term consequences. We know the consequences of CM can extend into adulthood, including the intergenerational transmission of violence, re-victimization, high-risk behavior, and persisting mental health problems. We argue that CM also likely affects decision-making autonomy in adulthood, limiting their independence and exaggerating their risk for other poor outcomes. We suggest that the effects of CM on self-esteem and access to social support mediate this relationship, helping to explain how and why CM impacts autonomy in the long term. OBJECTIVE This study aimed to examine these relationships using a cross-sectional sample of currently married women of Bangladesh aged 15-49 years (N = 426). METHOD A multi-stage random sampling technique was employed for data collection and a multivariate logistic regression technique was applied for data analysis. RESULTS Results from the multivariate logistic regression model revealed a direct effect of a history of CM on limited decision-making autonomy in adulthood and a full mediating effect of self-esteem and social support on the associations between CM and decision-making autonomy in women, even after adjusting for theoretically and empirically relevant covariates. CONCLUSIONS The study findings provide insight into the mechanisms by which early childhood experiences impact autonomous decision-making. However, causality cannot be determined because of the cross-sectional design. Finally, our findings suggest that the influence of CM on autonomy could be augmented by self-esteem recovery through social support from family, friends, and peers.
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Affiliation(s)
- Md Jahirul Islam
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland 4122, Australia; Ministry of Public Administration, Bangladesh Secretariat, Dhaka, Bangladesh.
| | - Lisa Broidy
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland 4122, Australia; Department of Sociology, University of New Mexico, Albuquerque, NM 87131, United States
| | - Li Eriksson
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland 4122, Australia
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh
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Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients. Schizophr Res Cogn 2022; 28:100234. [PMID: 35024348 PMCID: PMC8728100 DOI: 10.1016/j.scog.2021.100234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022]
Abstract
Introduction The MATRICS consensus cognitive battery (MCCB) is the gold standard for neuropsychological assessment in psychotic disorders but is rarely used in low resource settings. This study used the MCCB to determine the prevalence, profile and associations of various exposures with cognitive impairment in Ugandan first-episode psychosis patients. Methods Patients and matched healthy controls were recruited at Butabika Hospital in Uganda. Clinical variables were first collated, and after the resolution of psychotic symptoms, a neuropsychological assessment of seven cognitive domains was performed using the MCCB. Cognitive impairment was defined as two standard deviations (SD) below the mean in one domain or 1SD below the mean in two domains. Descriptive statistics determined the prevalence and profile of impairment while regression models determined the association between various exposures with cognitive scores while controlling for age, sex and education. Results Neuropsychological assessment with the MCCB found the burden of cognitive impairment in first-episode psychosis patients five times that of healthy controls. The visual learning and memory domain was most impaired in first-episode psychosis patients, while it was the working memory domain for the healthy controls. Increased age was associated with impairment in the domains of the speed of processing (p < 0.001) and visual learning and memory (p = 0.001). Cassava-rich diets and previous alternative and complementary therapy use were negatively associated with impairment in the visual learning (p = 0.04) and attention/vigilance domains (p = 0.012), respectively. There were no significant associations between sex, history of childhood trauma, or illness severity with any cognitive domain. Conclusion A significant burden of cognitive impairment in Ugandan first-episode psychosis patients is consistent with prior data from other contexts. However, the profile of and risk factors for impairment differ from that described in such work. Therefore, interventions to reduce cognitive impairment in FEP patients specific to this setting, including dietary modifications, are required.
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Sevenoaks T, Fouche JP, Phillips N, Heany S, Myer L, Zar HJ, Stein DJ, Hoare J. Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:353-363. [PMID: 35600517 PMCID: PMC9120333 DOI: 10.1007/s40653-021-00362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 06/03/2023]
Abstract
This study aimed to assess the association of childhood trauma, stressful life events and HIV stigma with mental health in South African adolescents from the Cape Town Adolescent Antiretroviral Cohort (CTAAC). The Childhood Trauma Questionnaire, Life Events Questionnaire and the HIV Stigma Scale for South African Adolescents Living with HIV was used to assess childhood trauma, stressful life events and stigma in adolescents living with perinatally acquired HIV and healthy controls enrolled in the CTAAC. These measures were associated with mental health outcomes including the Beck-Youth Inventories, Child Behaviour Checklist, Columbian Impairment Scale, Childrens Motivation Scale, Conners Scale for Attention Deficit Hyperactivity Disorder using Pearson correlations and self-reported alcohol use, using Spearman-rank correlation. 63.7% of adolescents reported at least one childhood trauma on the CTQ. Significant associations were reported between CTQ measures and Beck-Youth Inventories. Emotional abuse was associated with anxiety, anger, depression and disruptive behaviour. Emotional neglect was associated with poor self-concept and disruptive behaviour. LEQ total score was significantly associated with Beck-Youth Inventories including anxiety, depression, anger and disruptive behaviour scales. HIV stigma was significantly associated with Beck-Youth Inventories including depression, anger and disruptive behaviour. Childhood trauma, stressful life events and HIV stigma in South African adolescents are associated with anxiety, depression, anger, disruptive-behaviour and poor self-concept. This study highlights the importance of enquiring about exposure to a variety of traumas, particularly those commonly experienced by South African adolescents. In addition, it is important to understand the impact of trauma exposure on each individuals mental health and functioning.
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Affiliation(s)
- Tatum Sevenoaks
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Nicole Phillips
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Sarah Heany
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Álvares LGGS, Alves MTSSDBE, Santos AMD, Oliveira BLCAD, Chagas DCD. [Association between psychological violence and posttraumatic stress disorder in a cohort of Brazilian adolescents]. CAD SAUDE PUBLICA 2021; 37:e00286020. [PMID: 34932686 DOI: 10.1590/0102-311x00286020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
The study analyzed the impact of psychological violence on the development of posttraumatic stress disorder (PTSD). This was a cross-sectional study nested in a cohort in which the second follow-up was conducted in 2016. A questionnaire was applied to 2,486 adolescents and approached individual, family, and social aspects and experience with psychological violence. Propensity score was used to create inverse probability weighting (IPW). Thus, a probability was assigned to each adolescent, where 1/IPW represent those in the exposed group and 1/(1-IPW) those in the unexposed group. This procedure made the two groups more homogeneous and mutually comparable. The association between the occurrence of psychological violence and PTSD was estimated by odds ratios (OR) and 95% confidence intervals (95%CI) via crude binary logistic regression and adjusted logistic regression (weighted by IPW). According to the results, 30.3% reported having suffered severe violence. Prevalence of PTSD was 4.8% among exposed and 1.5% in unexposed to psychological violence. An association was observed between severe violence and PTSD in the two analyses, but the magnitude in the model structured by the propensity score (OR = 1.97; 95%CI: 1.08-3.56) indicated an adjustment to the measure from the crude analysis (OR = 3.40; 95%CI: 2.03-5.69). The current study contributes to the scarce literature on exposure to psychological violence and its association with the development of PTSD, confirming the negative impact of this form of abuse on the individual´s mental health.
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Charak R, De Jong JTVM, Berckmoes LH, Ndayisaba H, Reis R. Intergenerational maltreatment in parent-child dyads from Burundi, Africa: Associations among parental depression and connectedness, posttraumatic stress symptoms, and aggression in children. J Trauma Stress 2021; 34:943-954. [PMID: 34644415 DOI: 10.1002/jts.22735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 11/06/2022]
Abstract
Studies investigating the associations between histories of childhood maltreatment (CM) in parent-child dyads have primarily involved samples from high-income countries; however, CM rates are higher in low- and middle-income countries. The present study aimed to examine the (a) association between maltreatment in parents and maltreatment of their children through risk (i.e., parent depression) and protective (i.e., parent-child connectedness) factors and (b) associations between CM in children with aggression through posttraumatic stress symptoms (PTSS) and peer/sibling victimization. Participants were 227 parent-child dyads from Burundi, Africa, a low-income country. Parents were 18 years of age or older, and children were 12-18 years (M = 14.76, SD = 1.88, 57.7% female). Among parents, 20.7%-69.5% of participants reported a history of physical and emotional abuse and neglect; among children, the rates of sexual, physical, and emotional abuse ranged from 14.5% to 89.4%. A history of CM in parents was associated with CM in children, B = 0.19, p < .01, and CM in parents was indirectly associated with CM in children through parent-child connectedness, β = .04, 95% CI [.01, .10], and parental depression, β = .08, 95% CI [.03, .15]. In children, maltreatment was positively associated with peer/sibling victimization, and CM was associated with aggression, β = .07, 95% CI [.04, 0.11], through PTSS but not via peer/sibling victimization. Continued efforts to improve CM-related preventive strategies and the accessibility of prevention services are needed to reduce CM in low-income countries such as Burundi.
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Affiliation(s)
- Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - J T V M De Jong
- Amsterdam University Medical Center, Amsterdam, The Netherlands.,School of Medicine, Boston University, Boston, Massachusetts, USA
| | | | - Herman Ndayisaba
- Transcultural Psychosocial Organisation, Burundi, Amsterdam, The Netherlands
| | - Ria Reis
- Leiden University Medical Center, Leiden University, Leiden, The Netherlands.,Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.,The Children's Institute, University of Cape Town, Cape Town, South Africa
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Georgieva S, Tomas JM, Navarro-Pérez JJ. Systematic review and critical appraisal of Childhood Trauma Questionnaire - Short Form (CTQ-SF). CHILD ABUSE & NEGLECT 2021; 120:105223. [PMID: 34352686 DOI: 10.1016/j.chiabu.2021.105223] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/03/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child maltreatment is a complex and multidimensional construct that encompasses a great number of risk factors. The Childhood Trauma Questionnaire - Short Form, one of the most widely used and validated instruments to assess childhood maltreatment in the past ten years, is a retrospective instrument that assesses several types of childhood abuse and maltreatment which is divided into five dimensions. OBJECTIVE The objectives of this systematic review are to critically appraise, compare, and summarize the methodological quality and psychometric properties of published research articles validating the Childhood Trauma Questionnaire - Short Form utilizing the COSMIN checklist. METHOD Articles published in English or Spanish, in the past ten years in the databases of Scopus, Web of Science, and ProQuest, and which, directly or indirectly analyzed psychometric properties of the CTQ-SF were screened, examined, and assessed utilizing the COSMIN checklist. RESULTS Main results indicate that there is a general pattern of assessing the same three psychometric properties (internal consistency, structural validity, and hypothesis testing) in a variety of samples, but leaving unassessed the rest of properties examined by the COSMIN checklist. Additionally, there are some problems with the internal consistency of several factors. IMPLICATIONS AND CONCLUSIONS While replicability and internal consistency are good psychometric indicators of the CTQ-SF, there is a big scientific gap of information regarding some psychometric properties. It is suggested that future research should address the remaining psychometric properties, reliability, measurement error, content validity, cross cultural and criterion validity, as well as re-examining internal consistency of some dimensions, in order to advance in the knowledge on childhood maltreatment assessment.
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Affiliation(s)
- Sylvia Georgieva
- Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, Valencia 46010, Spain.
| | - Jose M Tomas
- Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, Valencia 46010, Spain.
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Singh A, Nemiro A, Malik A, Guimond MF, Nduwimana E, Likindikoki S, Annan J, Tol WA. Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study. Confl Health 2021; 15:73. [PMID: 34579750 PMCID: PMC8477522 DOI: 10.1186/s13031-021-00391-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/25/2021] [Indexed: 11/26/2022] Open
Abstract
Background There is an urgent need for evidence-based, scalable, psychological interventions to improve the mental health of adolescents affected by adversity in low-resource settings. Early Adolescents Skills for Emotions (EASE) was developed by the WHO as a brief, transdiagnostic, group intervention for early adolescents exhibiting internalising problems, delivered by trained and supervised lay providers. This study describes the cultural adaptation of EASE for Burundian adolescents living in Mtendeli refugee camps in Tanzania. Methods A phased approach to adaptation of the EASE intervention and its implementation, was adopted and comprised of: (1) a desk review to synthesize existing research on mental health issues in conflict-affected Burundian communities, (2) a rapid qualitative assessment involving free listing and key informant interviews with multiple stakeholders, (3) cognitive interviews with end users, and (4) a two-part adaptation workshop involving the implementing partner staff, members of the refugee community and mental health experts. We applied the Bernal framework to systematically document and track adaptations across eight dimensions of the intervention. Results Problems associated with worry, stress, sadness, shame and fear were identified as amongst the most critical mental health concerns, alongside a range of experiences of different forms of violence (such as gender-based violence, violence when fleeing from their homes) and associated problems. Problems associated with violence that included past experiences of fleeing as well as ongoing problems of gender-based violence in the camp. The most significant adaptations that were required included providing options for low literacy of participants, safety planning to address the high prevalence of sexual violence, simplification of strategies for the benefit of the end users and of lay facilitators, and implementation changes to consider involvement of refugee incentive workers. A majority of changes were across dimensions of language, people, metaphors, content, methods and context, while there were fewer changes regarding the goals and concepts of EASE. Conclusions The approach to adaptation of a psychological intervention suggested both minor and major required changes. Adaptations based on the findings of this study are anticipated to enhance relevance and acceptability of the EASE intervention and its delivery for camp-residing Burundian refugees in Tanzania. Supplementary Information The online version contains supplementary material available at 10.1186/s13031-021-00391-4.
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Affiliation(s)
- Aneeha Singh
- International Rescue Committee, 122 E 42nd Street, New York, NY, 1068, USA
| | - Ashley Nemiro
- International Rescue Committee, 122 E 42nd Street, New York, NY, 1068, USA
| | | | | | - Estella Nduwimana
- International Organization for Migration, Kabondo Ouest, Av. Ririkumutima, 13, Bujumbura, Burundi
| | - Samuel Likindikoki
- Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam, Tanzania
| | - Jeannie Annan
- International Rescue Committee, 122 E 42nd Street, New York, NY, 1068, USA
| | - Wietse A Tol
- Section of Global Health, Department of Public Health, CSS, Øster Farimagsgade 5, bg 9, DK-1014, Copenhagen K, Denmark. .,HealthRight International, 14 E 4th Street, New York, NY, 10012, USA. .,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, 8th Floor, Baltimore, MD, 21205, USA.
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Sekoni O, Mall S, Christofides N. Prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study. BMC Public Health 2021; 21:1546. [PMID: 34384401 PMCID: PMC8359091 DOI: 10.1186/s12889-021-11508-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 07/19/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Little is known about the prevalence of and factors associated with PTSD among adult females in Nigeria, particularly those who live in slums. PTSD is a mental health condition that develops among some individuals who experience or witness a traumatic event. Several other factors could place individuals at heightened risk of PTSD including stress and comorbid mental disorders. Therefore, this study aimed to examine the prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria. METHODS We conducted a cross sectional survey using multistage sampling of 550 women aged 18 and above from selected slums. Interviewer administered questionnaires were used to elicit information on experience of childhood trauma, recent stressors, intimate partner violence, other mental disorders, sociodemographic characteristics and PTSD. PTSD was measured using the Harvard Trauma Questionnaire (HTQ) which is based on DSM IV. A multivariable linear regression model was built to test associations between PTSD and independent variables. RESULTS The prevalence for PTSD was found to be 4.18% and the mean PTSD score was 5.80 ± 7.11. Sexual abuse in childhood, past year intimate partner violence and anxiety were significantly associated with higher PTSD scores. PTSD was not significantly associated with a history of recent stressors. Education, employment and marital status were not associated with PTSD however, age and wealth index showed marginal association with PTSD. CONCLUSION The prevalence of PTSD among women living in Ibadan slums was relatively low. Both child sexual abuse and intimate partner violence can be prevented. We also recommend longitudinal studies to better understand risk and protective factors.
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Affiliation(s)
- Olutoyin Sekoni
- Department of Community Medicine, College of Medicine, University of Ibadan, Queen Elizabeth Road, Ibadan, Nigeria.
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa.
| | - Sumaya Mall
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa
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Fine SL, Malik A, Guimond MF, Nemiro A, Temu G, Likindikoki S, Annan J, Tol WA. Improving mental health in low-resource settings: A feasibility randomized controlled trial of a transdiagnostic psychological intervention among Burundian refugee adolescents and their caregivers. Behav Res Ther 2021; 145:103944. [PMID: 34392115 DOI: 10.1016/j.brat.2021.103944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 05/21/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
There is a paucity of evidence regarding interventions that can improve the mental health of adversity-affected young adolescents living in low-resource settings. We evaluated the feasibility, acceptability, relevance, and safety of the World Health Organization's Early Adolescent Skills for Emotions (EASE) intervention among Burundian refugee adolescents and their caregivers in Tanzania. This study consisted of a feasibility cluster randomized controlled trial (cRCT) and a process evaluation. The feasibility cRCT included 82 young adolescents and their 64 caregivers, with two clusters randomized to EASE and two to an enhanced control condition. EASE was delivered by adult refugees without prior training in mental health. The process evaluation consisted of 36 semi-structured qualitative interviews with key stakeholders, including adolescents, caregivers, and facilitators. EASE participants and facilitators gave positive feedback about its format, accessibility, and content. Trained non-specialist refugee facilitators were able to deliver EASE with high fidelity. The research protocol functioned well in terms of balanced randomization, limited loss to follow-up, and psychometrically promising measures, but discordance was observed between the short screener and psychological distress symptom checklist. This formative study suggests the potential of EASE in targeting psychological distress among displaced young adolescents and lays the groundwork for a future definitive trial.
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Affiliation(s)
- Shoshanna L Fine
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA.
| | - Aiysha Malik
- World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | | | - Ashley Nemiro
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Getruda Temu
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Samuel Likindikoki
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Jeannie Annan
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Wietse A Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark; HealthRight International, 14 East 14th St., New York, NY, 10012, USA
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Ashaba S, Cooper-Vince C, Maling S, Satinsky EN, Baguma C, Akena D, Nansera D, Bajunirwe F, Tsai AC. Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100094. [PMID: 34841384 PMCID: PMC8623847 DOI: 10.1016/j.jadr.2021.100094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors. METHODS We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support. RESULTS Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted. LIMITATIONS Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse. CONCLUSIONS Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.
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Affiliation(s)
- Scholastic Ashaba
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | | | - Samuel Maling
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Emily N. Satinsky
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Charles Baguma
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere College of Health Sciences, Makerere, Uganda
| | - Denis Nansera
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Francis Bajunirwe
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
| | - Alexander C. Tsai
- Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Ruzibiza Y, Berckmoes L, Neema S, Reis R. Lost in freedom: ambivalence on sexual freedom among Burundian adolescents living in the Nakivale refugee settlement, Uganda. Sex Reprod Health Matters 2021; 29:1889750. [PMID: 33645469 PMCID: PMC8009026 DOI: 10.1080/26410397.2021.1889750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
This paper explores how Burundian adolescents in the Nakivale refugee settlement, Uganda, experience umwidegemvyo, loosely translated as "freedom", with regard to their sexuality. We draw on ethnographic research conducted between August and November 2017 with adolescents aged 13-19 years. Our research included in-depth individual interviews, focus group discussions, and participant observation. We present a context-sensitive appreciation of "freedom" and its social implications for adolescents' sexual and love relationships. We show how adolescents attribute their sexual experiences and practices, including experimental sex, stress-relief sex and transactional sex, to the freedom experienced in the refugee context. Yet they also view this freedom with ambivalence: while some degree of freedom is desirable, too much is referred to in terms of kutitabwaho n'ababyeyi, loosely translated as "parental neglect", implying a lack of parental involvement, care and provisioning.
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Affiliation(s)
- Yvette Ruzibiza
- PhD Fellow, Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands. Correspondence:
| | - Lidewyde Berckmoes
- Assistant Professor, African Studies Centre Leiden, Leiden University, Leiden, The Netherlands
| | - Stella Neema
- Associate Professor, Department of Sociology and Anthropology, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Ria Reis
- Professor of Medical Anthropology, Leiden University Medical Center, Leiden University, Leiden, The Netherlands; Associate Professor, Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands; Honorary Professor, The Children's Institute, University of Cape Town, Cape Town, South Africa
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22
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Chen X, Zhang S, Huang G, Xu Y, Li Q, Shi J, Li W, Wang W, Guo L, Lu C. Associations Between Child Maltreatment and Depressive Symptoms Among Chinese College Students: An Analysis of Sex Differences. Front Psychiatry 2021; 12:656646. [PMID: 34305672 PMCID: PMC8298832 DOI: 10.3389/fpsyt.2021.656646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/28/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Depressive symptoms and child maltreatment are both global public health problems among young adults. This study aimed to investigate the associations between five types of child maltreatment and depressive symptoms among Chinese college students, with a focus on potential sex differences. Methods: A cross-sectional study of a nationally representative sample of Chinese college students was conducted from March to June 2019 with a multistage, stratified cluster, random sampling method. In total, 30,179 college students from 60 colleges of 10 Chinese province-level regions completed standard questionnaires, including a history of child maltreatment and current depressive symptoms. Results: The prevalence of depressive symptoms among college students in China was 7.3%. After adjusting for control variables, physical abuse (adjusted odds ratio [aOR] = 1.20, 95% confidence interval [CI] = 1.17-1.23), emotional abuse (aOR = 1.21, 95% CI = 1.19-1.23), sexual abuse (aOR = 1.19, 95% CI = 1.16-1.22), physical neglect (aOR = 1.14, 95% CI = 1.12-1.16) and emotional neglect (aOR = 1.08, 95% CI = 1.07-1.09) were all positively associated with depressive symptoms. Notably, a cumulative effect of child maltreatment on depressive symptoms among Chinese college students was observed. Moreover, sex differences in the associations of emotional abuse, emotional neglect, and the number of maltreatment types with depressive symptoms were statistically significant (P < 0.05). Further stratification analyses showed that female students who experienced emotional abuse and emotional neglect had a higher risk of depressive symptoms than male students, and the cumulative effect of maltreatment types was stronger for females than males. Conclusion: Five types of child maltreatment and their co-occurrence were associated with an increased risk of depressive symptoms among college students. Furthermore, the effects of emotional abuse, emotional neglect and the number of maltreatment types on depressive symptoms were stronger for females than for males. These findings can promote understanding of the effects of child maltreatment on depressive symptoms, and prevention and intervention strategies for depressive symptoms should consider the type of child maltreatment and sex differences.
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Affiliation(s)
- Xiaoliang Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Sheng Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Guoliang Huang
- Center for ADR (Adverse Drug Reaction) Monitoring of Guangdong, Guangzhou, China
| | - Yan Xu
- Center for ADR (Adverse Drug Reaction) Monitoring of Guangdong, Guangzhou, China
| | - Qian Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
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23
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Kobulsky JM, Dubowitz H, Xu Y. The global challenge of the neglect of children. CHILD ABUSE & NEGLECT 2020; 110:104296. [PMID: 31831190 DOI: 10.1016/j.chiabu.2019.104296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/02/2019] [Accepted: 11/24/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND The neglect of children is a serious global problem. The 1989 United Nations Convention on the Rights of the Child (CRC) was a major international achievement spurring national efforts to prevent and address neglect. However, the scope of neglect worldwide and progress in addressing it remain unclear. OBJECTIVE This analysis assessed the current state of child neglect through much of the world, including its prevalence and efforts to address it. METHOD The scope of neglect was assessed through a literature review of recent peer-reviewed research and analysis of the United Nations Children's Fund (UNICEF) child protective services (CPS) and early childhood development data. National responses to neglect in 73 countries were described in the International Society for the Prevention of Child Abuse and Neglect's World Perspectives 2016 data and through illustrative case studies of recent CRC country reports for Australia, China, India and Mozambique. RESULTS Neglect is prevalent throughout the world, although its extent and form vary. Most countries recognize neglect as a form of maltreatment and have basic CPS policies and some system in place, but implementation of prevention and intervention services remains inadequate even in high-income countries. Economic and other barriers inhibit progress to address the neglect of children. CONCLUSIONS Progress has been made in establishing basic child protections and other safeguards for neglect in most countries, but significant barriers and inadequacies remain. Implementation of the CRC is uneven and there are large gaps in needed services. Much work remains to better assess and address this serious problem, in every country.
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Affiliation(s)
- Julia M Kobulsky
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore, Philadelphia, PA 19122, United States.
| | | | - Yanfeng Xu
- University of South Carolina College of Social Work, United States
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24
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Fuel to the fire: The escalating interplay of attachment and maltreatment in the transgenerational transmission of psychopathology in families living in refugee camps. Dev Psychopathol 2020; 33:1308-1321. [DOI: 10.1017/s0954579420000516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Maltreatment by parents can be conceptualized as pathogenic escalations of a disturbed parent–child relationship that have devastating consequences for children's development and mental health. Although parental psychopathology has been shown to be a risk factor both for maltreatment and insecure attachment representations, these factors` joint contribution to child psychopathology has not been investigated. In a sample of Burundian refugee families living in refugee camps in Western Tanzania, the associations between attachment representations, maltreatment, and psychopathology were examined by conducting structured interviews with 226 children aged 7 to 15 and both their parents. Structural equation modeling revealed that children's insecure attachment representations and maltreatment by mothers fully mediated the relation between maternal and child psychopathology [model fit: comparative fit index (CFI) = 0.96; root mean square error of approximation (RMSEA) = 0.05]. A direct association between paternal and child psychopathology was observed (model fit: CFI = 0.96; RMSEA = 0.05). The findings suggest a vicious cycle, wherein an insecure attachment to a mother suffering from psychopathology may be linked to children's risk to be maltreated, which may reinforce insecure representations and perpetuate the pathogenic relational experience. Interventions targeting the attachment relationship and parental mental health may prevent negative child outcomes.
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Flores-Torres MH, Comerford E, Signorello L, Grodstein F, Lopez-Ridaura R, de Castro F, Familiar I, Ortiz-Panozo E, Lajous M. Impact of adverse childhood experiences on cardiovascular disease risk factors in adulthood among Mexican women. CHILD ABUSE & NEGLECT 2020; 99:104175. [PMID: 31710961 DOI: 10.1016/j.chiabu.2019.104175] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/12/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Childhood adversities are prevalent worldwide and might affect adult cardiovascular health. However, in middle-income countries such as Mexico, research on the impact of childhood adversities on cardiovascular disease (CVD) in adulthood is lacking. OBJECTIVE To evaluate the prevalence of adverse childhood experiences (ACEs) and their association with risk factors for CVD in adult Mexican women. PARTICIPANTS AND SETTING The study population comprised 9853 women from the Mexican Teachers´ Cohort. METHODS Participants responded to an online questionnaire including a 10-item instrument on ACEs and questions on CVD risk factors, between 2014 and 2017. Multivariate logistic regression models were used to evaluate the association between ACEs and adult behavioral and medical CVD risk factors. RESULTS About 61% of participants reported at least one ACE and 14% reported four or more. After multivariable adjustment, women who reported ≥4 ACEs had 58% (95%CI 1.37, 1.81) higher odds of having ever smoked and 17% (95%CI 0.69, 0.99) lower odds of being physically active, compared with women who reported no ACEs. Women who reported ≥4 ACEs also had higher odds of hypertension (OR = 1.19; 95%CI 1.00, 1.43), diabetes (OR = 1.49; 95%CI 1.13, 1.96), high cholesterol (OR = 1.49; 95%CI 1.26, 1.75), and obesity (OR = 1.37; 95%CI 1.19, 1.57). In addition, individual ACE components were independently associated with several CVD risk factors. CONCLUSION ACEs are common and associated with CVD risk factors in adult Mexican women.
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Affiliation(s)
- Mario H Flores-Torres
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico City, 14000, Mexico
| | - Erin Comerford
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, United States
| | - Lisa Signorello
- Division of Cancer Prevention, National Cancer Institute, NIH, 9609 Medical Center Drive, Bethesda, MD, 20892-9712, United States
| | - Francine Grodstein
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, United States
| | - Ruy Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico City, 14000, Mexico
| | - Filipa de Castro
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico City, 14000, Mexico
| | - Itziar Familiar
- Department of Psychiatry, Michigan State University, 220 Trowbridge Rd, East Lansing, MI, 48824, United States
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico City, 14000, Mexico
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico City, 14000, Mexico; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, United States.
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Park J, Catani C, Hermenau K, Elbert T. Exposure to family and organized violence and associated mental health in north Korean refugee youth compared to south Korean youth. Confl Health 2019; 13:46. [PMID: 31636698 PMCID: PMC6794884 DOI: 10.1186/s13031-019-0230-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies on populations affected by organized violence have shown elevated levels of family violence against children. This form of violence has been found to contribute to children's psychopathology independently of traumatic experiences related to war, persecution or flight. Little is known, so far, about the exposure to family violence and its relation to mental health in North Korean refugee youth affected by political violence. The aim of this study was to examine the amount of organized and family violence and associated psychopathology in a sample of North Korean refugee youth living in South Korea compared to their South Korean peers. METHODS Sixty-five North Korean refugee youth and 65 South Korean youth were recruited. Trained researchers conducted the survey in group meetings of five to ten participants. Using questionnaires researchers assessed traumatic experiences, family and organized violence, PTSD symptoms, depressive symptoms and other mental health problems. RESULTS Higher rates of violence and trauma, and higher levels of mental health problems were found in the North Korean sample compared to the South Korean sample. Linear regression analyses including the various types of trauma as potential predictors showed that the severity of PTSD and depressive symptoms in the North Korean sample were associated with the amount of traumatic events and family violence but not with higher levels of organized violence. CONCLUSIONS The findings suggest that in a context of organized violence, abusive experiences by family members constitute an important problem that is strongly linked to the psychopathology of adolescents. Our data suggest that psychological treatment and prevention approaches for North Korean refugees should be carefully tailored to fit the specific requirements of this population and address the mental health of the individual as well as potential problems at the family level.
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Affiliation(s)
- Jinme Park
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Claudia Catani
- Department of Psychology, Clinical Psychology and Psychotherapy Unit, University of Bielefeld, Postbox 100131, 33501 Bielefeld, Germany
| | | | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Abstract
PURPOSE OF REVIEW This paper reviews recent research on the depression in young people following exposure to catastrophic stresses such as disasters, terrorism and political violence. RECENT FINDINGS Depression is one of the commonest outcomes following mass trauma, for all ages including children and adolescents. Recent articles continue to report high prevalence of depression which often continues for years. It is often comorbid with other psychiatric disorders, especially PTSD. Post-traumatic depression in children and adolescence affects purpose of life, impairs scholastic achievements, increases suicidality and has extensive comorbidity. Besides the trauma, individual constructs, personality factors, social support, exposure to other traumatic events are some of the predicting factors. Biological and genetic basis of post-traumatic depression has been reported. Studies suggest some benefit to psychotherapeutic interventions such as trauma-focussed cognitive behavioural therapy and web-based therapy. A considerable proportion of youths develop depression following mass traumatic events. More research is required regarding the effectiveness of interventions in this population.
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Affiliation(s)
- Nilamadhab Kar
- Black Country Partnership NHS Foundation Trust, Steps to Health, Showell Circus, Low Hill, Wolverhampton, WV10 9TH, UK.
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28
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Islam MJ, Mazerolle P, Broidy L, Baird K. Does the type of maltreatment matter? Assessing the individual and combined effects of multiple forms of childhood maltreatment on exclusive breastfeeding behavior. CHILD ABUSE & NEGLECT 2018; 86:290-305. [PMID: 30391785 DOI: 10.1016/j.chiabu.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 09/26/2018] [Accepted: 10/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) has been associated with a range of adult health outcomes; however, extant research has focused more on exposure to a single form of abuse rather than multiple forms. Moreover, very few studies have specifically investigated the impact of CM on exclusive breastfeeding (EBF) outcomes. OBJECTIVES This study aims to examine: (1) the individual and combined effects of multiple forms of CM on EBF outcomes; and (2) whether postpartum depression and maternal stress act to mediate or moderate the association between CM and EBF. METHOD Cross-sectional survey data were collected between October 2015 and January 2016 from 426 women of Bangladesh who were six months postpartum. RESULTS Based on the adjusted multivariate logistic regression model, women who experienced childhood sexual abuse (CSA) were significantly less likely to exclusively breastfeed babies than their non-abused counterparts (AOR: 0.38, 95% CI [0.15, 0.92]). When a composite measure was created to examine the additive effects of adverse childhood experiences, a dose-response association was observed between the reported number of different types of CM and early termination of EBF. Though experiencing postpartum depression and maternal stress do not mediate the effect of CSA on EBF, they do moderate them such that the odds of early termination of EBF are notably higher among women who experienced CSA in combination with postpartum depression or high levels of stress. CONCLUSIONS Findings from this study offer some insight into the intergenerational effects associated with CM experiences, and underpin the need for effective policies and programs to prevent or reduce its occurrence and improve the EBF outcomes.
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Affiliation(s)
- Md Jahirul Islam
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland 4122, Australia; Ministry of Planning, Bangladesh Planning Commission, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh.
| | - Paul Mazerolle
- Arts, Education and Law, Griffith University, Queensland, Australia
| | - Lisa Broidy
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland 4122, Australia; Department of Sociology, 1 University of New Mexico, Albuquerque, NM, 87131, United States
| | - Kathleen Baird
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Berckmoes LH, de Jong JTVM, Reis R. Intergenerational transmission of violence and resilience in conflict-affected Burundi: a qualitative study of why some children thrive despite duress. Glob Ment Health (Camb) 2017; 4:e26. [PMID: 29299333 PMCID: PMC5745362 DOI: 10.1017/gmh.2017.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Research suggests that in environments where community conflict and violence are chronic or cyclical, caregiving can impact how children may begin to reproduce violence throughout the various stages of their lives. The aim of this study is to understand how caregiving affects processes of reproducing violence and resilience among children in conflict-affected Burundi. METHODS We combined a socio-ecological model of child development with a child-actor perspective. We operationalized the core concepts 'vulnerable household', 'resilience', and 'caregiving' iteratively in culturally relevant ways, and put children's experiences at the center of the inquiry. We carried out a comparative case study among 74 purposively sampled vulnerable households in six collines in three communes in three provinces in the interior of Burundi. Burundian field researchers conducted three consecutive interviews; with the head of the household, the main caregiver, and a child. RESULTS Our findings reveal a strong congruence between positive caregiving and resilience among children. Negative caregiving was related to negative social behavior among children. Other resources for resilience appeared to be limited. The overall level of household conditions and embedment in communities attested to a generalized fragile ecological environment. CONCLUSIONS In conflict-affected socio-ecological environments, caregiving can impact children's functioning and their role in reproducing violence. Interventions that support caregivers in positive caregiving are promising for breaking cyclical violence.
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Affiliation(s)
- L. H. Berckmoes
- The Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, Noord-Holland, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Noord-Holland, The Netherlands
| | - J. T. V. M. de Jong
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Boston University School of Medicine, Boston, USA
| | - R. Reis
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- School of Child and Adolescent Health, The Children's Institute, University of Cape Town, Leiden, Zuid-Holland, South Africa
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