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Jaroenkajornkij N, Girish M, Binson B, Lev-Wiesel R. Comparison between Thai and Indian Adolescents' Self-Figure Drawing as Child Abuse Art-Based Assessment. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1101. [PMID: 39334633 PMCID: PMC11429832 DOI: 10.3390/children11091101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/17/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND/OBJECTIVES The current study compared Self-Figure drawings from Thai and Indian adolescents to assess the cross-cultural applicability of a child abuse assessment tool. The research aims to understand the extent to which distinctions or similarities arise in Self-Figure drawings among adolescents from two culturally similar yet distinct backgrounds characterized by differences in religious affiliations, socioeconomic contexts, and political environments. METHODS Employing a mixed-methods approach, the study utilized quantitative measures, including the Traumatic Events Checklist (TEQ-5) and Medical Somatic Dissociation Questionnaire (MSDQ), alongside a qualitative analysis of Self-Figure drawings. Ethical approval was obtained with waived informed consent, and a convenience sample of 386 adolescents aged 13-18 years (193 from Thailand [M = 14.8, SD = 1.73; 135 females (69.9%) and 58 males (30.1%)], and 193 from India [M = 15.2, SD = 1.64; 135 females (69.9%) and 58 males (30.1%)]), who reported experiencing child abuse, participated in the study by completing questionnaires and drawing themselves. RESULTS The analysis revealed that Thai adolescents had higher MSDQ scores, while Indian adolescents exhibited more prominent pictorial indicators. Indian participants reported experiencing a broader range of event types, whereas Thai adolescents predominantly depicted verbal or emotional abuse. Variations in pictorial indicators were found significant, except for hair, cheek or chin, omitted legs or feet, and omitted eyes. CONCLUSIONS These findings contribute to the understanding of how cultural factors influence adolescents' self-representations through drawing. The differences in pictorial indicators highlight the nuanced variations within similar cultures, emphasizing the cultural specificity of self-expression.
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Affiliation(s)
- Nisara Jaroenkajornkij
- MA Expressive Arts Therapy Programme, Chulalongkorn University, Bangkok 10330, Thailand
- The FAA-Emili Sagol Creative Arts Research and Innovation for Well-Being Center, Chulalongkorn University, Bangkok 10330, Thailand
| | - Meghna Girish
- School of Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel
| | - Bussakorn Binson
- MA Expressive Arts Therapy Programme, Chulalongkorn University, Bangkok 10330, Thailand
- The FAA-Emili Sagol Creative Arts Research and Innovation for Well-Being Center, Chulalongkorn University, Bangkok 10330, Thailand
| | - Rachel Lev-Wiesel
- The FAA-Emili Sagol Creative Arts Research and Innovation for Well-Being Center, Chulalongkorn University, Bangkok 10330, Thailand
- The Emili Sagol Research Center for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel
- Research Center for Innovation in Social Work, Tel-Hai College, Qiryat Shemona 1220800, Israel
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Vendhan K, Seth R. Diagnostic imaging of child physical abuse: an Indian perspective. Pediatr Radiol 2024:10.1007/s00247-024-06037-w. [PMID: 39187669 DOI: 10.1007/s00247-024-06037-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 08/28/2024]
Affiliation(s)
- Kanimozhi Vendhan
- Department of Paediatric Radiology, Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai, 600034, India.
| | - Rajeev Seth
- Prevention of Violence Against Children (PVAC), Indian Academy of Pediatrics, National Coordinator, Mumbai, India
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3
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Zhang Y, Zhao J, Bian Y, Zhang F. Reliability and validity of the short version of the childhood abuse self report scale in Chinese college students. BMC Psychol 2024; 12:256. [PMID: 38720387 PMCID: PMC11080228 DOI: 10.1186/s40359-024-01734-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The reliability and validity of the current scale for measuring childhood abuse in China are worrying. The development of the Short Version of the Childhood Abuse Self Report Scale (CASRS-12) helps to change this situation, but the effectiveness of the tool has not yet been tested in Chinese participants. This study aims to test the reliability and validity of the CASRS‑12 in Chinese college students. METHODS A total of 932 college students were investigated, of whom 418 were investigated for the first time, and only the CASRS‑12 was filled out. In the second survey, 514 participants filled out the CASRS‑12, Depression Scale, Self-esteem Scale and Subjective Well-being Scale in turn. After 4 weeks, 109 participants were selected for retest. RESULTS Each item of the CASRS‑12 had good discrimination. Exploratory factor analysis and confirmatory factor analysis (χ2/df = 4. 18, RMSEA = 0. 079, CFI = 0. 95, TLI = 0. 94, IFI = 0. 95, NFI = 0. 94) all supported the four-factor structure of the scale, and the cumulative contribution rate of variance was 76.05%. Cronbach's α coefficient and retest reliability were 0.86 and 0.65, respectively. Childhood abuse was positively correlated with depression (r = 0. 42, p < 0.01), and negatively correlated with self-esteem (r=-0. 33, p < 0.01) and subjective well-being (r=-0. 32, p < 0.01). CONCLUSION The Chinese version of CASRS‑12 meets the measurement standard and could be used to measure the level of childhood abuse of Chinese college students.
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Affiliation(s)
- Yali Zhang
- College of Education, Hebei Normal University, Shijiazhuang, China
| | - Jinxia Zhao
- College of Education, Hebei Normal University, Shijiazhuang, China
| | - Yuewen Bian
- College of Education, Hebei Normal University, Shijiazhuang, China
| | - Fuhai Zhang
- College of Education, Hebei Normal University, Shijiazhuang, China.
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Balamurugan G, Sevak S, Gurung K, Vijayarani M. Mental Health Issues Among School Children and Adolescents in India: A Systematic Review. Cureus 2024; 16:e61035. [PMID: 38916009 PMCID: PMC11194636 DOI: 10.7759/cureus.61035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/26/2024] Open
Abstract
Childhood and adolescence are critical developmental stages for mental health, and the environment in which they grow has an impact on their well-being and growth. This study aims to assess mental health issues among school children and adolescents in India. A systematic search was conducted on the literature published between January 2013 and August 2023 in PubMed, Scopus, Cochrane Library, and Eric database. Thirty-one studies with a sample size of 30,970 were included in the final quantitative synthesis, of which 14,381 were male. The overall mean age of the school children and adolescents was 14.58 years, with a standard deviation of 1.35. A diverse range of mental health concerns have been documented in school children and adolescents, exhibiting differing degrees of severity and frequency. The analysis showed that depression was the most prevalent mental health issue among children, followed by social, behavioral, and emotional problems, anxiety, psychological distress, internet technology addiction, stress, social phobia, sexual and emotional abuse, violence, and attention deficit hyperactive disorder. The study concludes that school mental health research in India is critical for personalizing interventions to the specific requirements of the diverse student population, decreasing stigma, and enhancing overall student well-being within the cultural and educational context of the country.
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Affiliation(s)
- G Balamurugan
- Psychiatric Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, IND
| | - Sanjay Sevak
- Mental Health Nursing, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Kusum Gurung
- Mental Health Nursing, Ramaiah Institute of Nursing Education and Research, Bengaluru, IND
| | - M Vijayarani
- Psychiatric Nursing, Employees' State Insurance Corporation (ESIC) College of Nursing, Bengaluru, IND
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Chaudhary V, Walia GK, Devi NK, Shekhawat LS, Saraswathy KN. Adverse childhood experiences in mental health of young adults: An exploratory study from Delhi-NCR, India. Int J Soc Psychiatry 2024; 70:445-456. [PMID: 38063051 DOI: 10.1177/00207640231214986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
BACKGROUND Despite the growing realization regarding the importance of adverse childhood experiences (ACEs) in adult health outcomes, this area of research has received little scientific attention in low- and middle-income countries, including India. AIMS To understand the overall and domain-specific association of exposure to ACEs with current depression, anxiety, stress, and well-being among young adults of Delhi-NCR. METHODS This cross-sectional study was carried out among 1,812 young adults (aged 18-25 years) of both sexes (68.7% females). Fieldwork was conducted on the campuses of the University of Delhi, Delhi, and Amity University, Noida, India. ACEs, depression, anxiety, stress, and well-being were screened using the Adverse Childhood Experiences International Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory, Perceived Stress Scale, and WHO-5 Well-Being Index, respectively. RESULTS Exposure to ACEs was found to increase the odds of moderate/severe depression, moderate/severe anxiety, and high stress and decreased the odds of good well-being in a dose-response manner. Being bullied, followed by emotional abuse, was associated with the highest odds of current moderate/severe depression, moderate/severe anxiety, and high stress and the lowest odds of good well-being. Further, while several domains of household dysfunction showed poor association with studied mental health outcomes, domains of abuse and violence were more consistently associated. CONCLUSIONS The present study revealed the detrimental impact of ACEs on mental health outcomes among young adults of Delhi-NCR, India, and underscored the relevance of ACEs in the Indian context. Considering the lack of trauma awareness in Indian societies, there is an urgent need to create widespread awareness regarding ACEs and associated health implications.
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Affiliation(s)
| | | | | | - Lokesh Singh Shekhawat
- Department of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, India
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Zhou J, Hu T, Xue S, Dong Z, Tang W. The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem. J Clin Psychol 2024; 80:664-677. [PMID: 38265412 DOI: 10.1002/jclp.23646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients. METHODS Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships. RESULTS Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality. CONCLUSIONS Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.
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Affiliation(s)
- Jing Zhou
- Department of Psychosomatic Medicine, Leshan People's Hospital, Leshan, Sichuan, China
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- School of Education and Psychology, Chengdu Normal University, Chengdu, China
- Business School, Sichuan University, Chengdu, China
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Brühl A, Ward CL, Lachman JM, Foran HM, Raleva M, Baban A, Heinrichs N. Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe. Violence Against Women 2023; 29:2439-2463. [PMID: 37475529 PMCID: PMC10496420 DOI: 10.1177/10778012231188090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N1 = 112, N2 = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Motheŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence.
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Affiliation(s)
- Antonia Brühl
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Catherine L. Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jamie M. Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Centre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Heather M. Foran
- Department of Health Psychology, University of Klagenfurt, Klagenfurt, Carinthia, Austria
| | - Marija Raleva
- Department of Psychiatry and Medical Psychology, Medical Faculty, University of Skopje, Skopje,
North Macedonia
| | - Adriana Baban
- Department of Psychology, Babeș-Bolyai University, Cluj County, Cluj-Napoca, Romania
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
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Ahad MA, Parry YK, Willis E, Ullah S, Ankers M. Maltreatment of child labourers in Bangladesh: Prevalence and characteristics of perpetrators. Heliyon 2023; 9:e19031. [PMID: 37809976 PMCID: PMC10558293 DOI: 10.1016/j.heliyon.2023.e19031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/18/2023] [Accepted: 08/07/2023] [Indexed: 10/10/2023] Open
Abstract
Background Child labourers are highly prone to maltreatment mostly perpetrated by members of their immediate family as well as employers and co-workers. This maltreatment is considered to be a serious public health issue. However, little is known about this form of violence. Purpose This study aimed to explore the views of key informants on the prevalence and attributes of perpetrators of the maltreatment of child labourers in Bangladesh. Methods The key experts were paediatricians, journalists, academics, and government bureaucrats such as policy makers and Non-Government Organisation employees working in the area of child abuse or labour relations. Interviews were purposefully conducted via TEAMS with 17 expert participants. A thematic analysis using NVivo was used to analyse the data. Results The key informants were of the opinion that the prevalence of the maltreatment of child labourers was unknown. However, they were of the view that physical maltreatment of child labourers occurred between 70% and 100% of the time, while emotional abuse and neglect was estimated to be 100% followed by 50% for financial exploitation. Child maltreatment is more likely to occur in informal workplace environments. Biological and foster parents were considered the primary perpetrators, while employers and adult co-workers were considered secondary perpetrators. Perpetrators of child labour maltreatment were often characterized as having a history of childhood maltreatment themselves, a lack of knowledge of social awareness and parenting, and suffer from economic difficulties. Conclusion The finding also calls into question the validity of key informant interviewing. Only the journalists, academics and medical experts had first-hand knowledge of the maltreatment of child labourers with experts in the NGO sector and government policy makers lacking detailed knowledge of the field.
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Affiliation(s)
- Md Abdul Ahad
- Department of Rural Sociology and Development, Sylhet Agricultural University, Sylhet-3100, Bangladesh
- College of Nursing and Health Sciences, Flinders University, SA, 5042, Australia
| | - Yvonne Karen Parry
- College of Nursing and Health Sciences, Flinders University, SA, 5042, Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, SA, 5042, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, SA, 5042, Australia
| | - Matthew Ankers
- College of Nursing and Health Sciences, Flinders University, SA, 5042, Australia
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Wang H, Guo X, Song Q, Liang Q, Su W, Li N, Ding X, Qin Q, Chen M, Sun L, Liang M, Sun Y. Adverse childhood experiences of emotional and physical abuse and emotional and behavioral problems: the mediating effects of family function and resilience. PSYCHOL HEALTH MED 2023; 28:2121-2136. [PMID: 37184334 DOI: 10.1080/13548506.2023.2208365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/17/2023] [Indexed: 05/16/2023]
Abstract
Adverse childhood experiences are a widespread phenomenon that can have a variety of negative effects on children. Emotional and behavioral problems (EBP) in children have been gaining interest in recent years. Therefore, this study aims to explore the association between emotional and physical abuse (EPA) and preschool children's EBP, as well as to assess the mediating effects of family function and resilience in this association. A cross-sectional study was conducted, and we recruited 3,636 participants from 26 kindergartens in three cities. Correlation analysis and regression analysis were used to test the relationships between EPA, mediators (family function and resilience), and EBP. Structural equation modeling was used to perform the mediation analyses. The results of this study showed that EPA predicted EBP in preschool children, family function, and resilience independently and in combination to mediate the relationship. Therefore, improving family function and increasing children's level of resilience are beneficial methods for the prevention and intervention of EBP in preschool children who experience EPA, but most fundamentally to avoid or reduce the occurrence of abuse. Further longitudinal studies are needed to confirm our findings and explore possible mediating mechanisms.
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Affiliation(s)
- Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Department of Hospital infection Prevention and Control, Children's Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qirong Qin
- Department of Chronic Disease Prevention and Health Management, Ma'anshan Center for Disease Control and Prevention, Ma'anshan, Anhui, China
| | - Mingchun Chen
- Department of AIDS Prevention and Control, Changfeng County Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Chaohu Hospital, Anhui Medical University, Hefei, Anhui, China
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China
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Verma A, Govindan R, Ramu R, Thomas B. Effectiveness of structured teaching program on parents' knowledge about child physical abuse. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:209. [PMID: 37545999 PMCID: PMC10402794 DOI: 10.4103/jehp.jehp_73_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/28/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The issue of child physical abuse (CPA) is complex and challenging to study. According to World Health Organization fact sheets for 2020, about 3 in 4 children between 2 and 4 years of age regularly face physical maltreatment by parents or caregivers. It may cause a lifelong impact on physical and mental health. OBJECTIVE To assess the parents' knowledge and to evaluate the effectiveness of the structured teaching program (STP) regarding child physical abuse (CPA) among parents. METHODS AND MATERIALS The pre-experimental, "One-group Pre-test Post-test design" was adopted for this study. Parents of children who were admitted for treatment in the child psychiatry centre (CPC) of a tertiary care referral center between January 2019 and January 2020 were recruited for this study. Thirty parents were recruited with a convenience sampling technique. The study was conducted through an online platform (Zoom). Pre-test and post-tests were conducted through Google survey form. Data were collected with a self-developed knowledge questionnaire on CAP. An online structured teaching program (STP) was administered for three alternative days after the pre-test assessment. The post-test assessment was conducted at a two-point time, that is immediately after the STP and after the one-week gap. Descriptive and inferential statistics were used to analyze the data. "One-group Pre-test Post-test design" was adopted for this study. Parents of children who were admitted for treatment in the child psychiatry centre (CPC) of a tertiary care referral center between January 2019 and January 2020 were recruited for this study. Thirty parents were recruited with a convenience sampling technique. The study was conducted through an online platform (Zoom). Pre-test and post-tests were conducted through Google survey form. Data were collected with a self-developed knowledge questionnaire on CAP. An online structured teaching program (STP) was administered for three alternative days after the pre-test assessment. The post-test assessment was conducted at a two-point time, that is immediately after the STP and after the one-week gap. Descriptive and inferential statistics were used to analyze the data. RESULTS The pre-test knowledge assessment means score regarding child physical abuse was found to be 12, with a standard deviation of 1.73. In the post-test one, 17.30 ± 1.39 and in the post-test two, 16 ± 1.55 with P < 0.001. Analysis revealed statistically significant improvement was found in the post-test knowledge regarding child physical abuse among the parents. There was no significant (p < 0.05) relationship found between the socio-demographic variables of the participants and their pre-intervention knowledge scores on child physical abuse. CONCLUSIONS The study findings reveal that parents have a fair knowledge of CPA and the STP was effective and feasible to administer in improving the subjects' knowledge regarding child physical abuse.
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Affiliation(s)
- Anamika Verma
- Department of Nursing, National Institute of Mental Health and Neuro Science (INI), Bengaluru, Karnataka, India
| | - Radhakrishnan Govindan
- Department of Nursing, National Institute of Mental Health and Neuro Science (INI), Bengaluru, Karnataka, India
| | - Rajalakshmi Ramu
- Department of Nursing, National Institute of Mental Health and Neuro Science (INI), Bengaluru, Karnataka, India
| | - Bino Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Science (INI), Bengaluru, Karnataka, India
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Li J, Li J, Zhang W, Wang G, Qu Z. Effectiveness of a school-based, lay counselor-delivered cognitive behavioral therapy for Chinese children with posttraumatic stress symptoms: a randomized controlled trial. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 33:100699. [PMID: 36785644 PMCID: PMC9918421 DOI: 10.1016/j.lanwpc.2023.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023]
Abstract
Background Improving children's access to mental health services need more innovative solutions, especially in low- and middle-income countries. School-based psychosocial interventions delivered by lay counselors may be an efficient way to improve children's access to mental health services. But few studies were conducted to examine the effectiveness of these interventions. Therefore, this study is to evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) in a group format delivered by lay counselors to children with trauma-related symptoms in China. Methods A total of 234 children (aged 9-12 years) with full or subthreshold posttraumatic stress disorder (PTSD) were randomly assigned to group-based TF-CBT or treatment as usual (TAU). In the intervention group, 118 children received 10-12 sessions of group-based TF-CBT delivered by lay counselors for 9 consecutive weeks. In the TAU group, 116 children received the usual school services provided by psychology teachers. The primary outcome was the reduction in PTSD severity, which was assessed with the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5). The secondary outcomes included the reduction in PTSD severity and the remission of PTSD, both of which were measured with the PTSD checklist-5 (PCL-5). Secondary outcomes also included the reduction in depression severity and the reduction in generalized anxiety severity. Blinded assessments were collected at baseline, posttreatment (primary endpoint), and 3-month follow-up. This trial is registered with Chinese Clinical Trial Registry, ChiCTR1900027131. Findings At posttreatment, the intervention group scored significantly lower than the TAU group on PTSD-RI-5 PTSD (30.98 vs. 39.22; adjusted mean difference [AMD], -7.35; 95% CI, -11.66 to -3.04), PCL-5 PTSD (28.78 vs. 38.04; AMD, -8.49; 95% CI, -13.23 to -3.75), depression (5.52 vs. 7.96; AMD, -1.63; 95% CI, -2.50 to -0.76), and generalized anxiety (7.23 vs. 8.64; AMD, -1.21; 95% CI, -2.20 to -0.23). The remission of PCL-5 PTSD was also significantly higher in the intervention group (42.86% vs. 13.54%, χ 2 = 13.10, P < 0.001). These two groups showed a similar level of symptoms at the 3-month follow-up. Interpretation The group-based TF-CBT can significantly alleviate PTSD, depression, and generalized anxiety right after treatment in Chinese children who suffer from different types of trauma. But the long-term effects of this intervention need to be further tested. This intervention can be delivered by trained lay counselors in low- and middle-income countries. Funding None.
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Affiliation(s)
- Jina Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Jia Li
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China
| | - Weijun Zhang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China
| | - Gengchao Wang
- State Key Laboratory of Liver Research, University of Hong Kong, Hong Kong, 999077, China
| | - Zhiyong Qu
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875, China,Corresponding author. Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875, China.
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Girish M, Lev-Wiesel R, Bhattacharyya A, Binson B. Emotional, Physical, and Sexual Abuse Reflected in Self-Figure drawings of Indian Street Children. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Li K, Zhan X, Ren L, Liu N, Zhang L, Li L, Chen T, Feng Z, Luo X. The Association of Abuse and Depression With Suicidal Ideation in Chinese Adolescents: A Network Analysis. Front Psychiatry 2022; 13:853951. [PMID: 35418891 PMCID: PMC8995894 DOI: 10.3389/fpsyt.2022.853951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Abuse experiences in adolescents are associated with the risk of depression and suicide. Thus, there is an urgent need to develop prevention and intervention measures for clinicians, policymakers, and researchers. Methods Network analysis method was used to analyze the cross-sectional data of Chinese adolescents in this study. The Patient Health Questionnaire for Adolescents (PHQ-A) was used for assessing depression, in which item 9 of the PHQ-A was used to assess suicide ideation, and International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Children's Home Version (ICAST-CH) was used for assessing abuse. Results The prevalence of suicidal ideation among Chinese adolescents was 21.46% (95% CI, 20.79-22.16%). The prevalence of moderate or severe depression was 16.76%, and the prevalence of violence exposure, psychological victimization, neglect, and physical victimization was 33.5%, 59.5%, 28.37%, and 31.51% in the past years, respectively. Network analysis results showed that the most central nodes in the network of abuse and depression were "unimportant," "not cared," and "pushed." The bridge nodes were "suicidal ideation" and "unimportant." The nodes "sadness," "failure," and "unimportant" explained the largest proportion of the variance of suicidal ideation in our network. Differences were found in the structure of both abuse and depression networks between adolescents with or without suicidal ideation. Limitations The self-reporting-based cross-sectional surveys and community sample groups limit the inference of causality and the generalization of the results. Conclusion This study shows that "unimportant" is the central and bridge nodes in the abuse and depression networks and also explains a part of variance of suicidal ideation. The effect of "unimportant" should be considered in the prevention and intervention of depression and suicide in adolescents with abuse experience. Future study is needed to confirm its role in clinical intervention.
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Affiliation(s)
- Kuiliang Li
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
- School of Psychology, Army Medical University, Chongqing, China
| | - Xiaoqing Zhan
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Lei Ren
- Department of Military Medical Psychology, Fourth Military Medical University, Xi’an, China
| | - Nan Liu
- Department of Health Examination, People’s Hospital of Wansheng Economic Development Zone, Chongqing, China
| | - Lei Zhang
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Ling Li
- College of General Education, Chong Qing Water Resources and Electric Engineering College, Chongqing, China
| | - Ting Chen
- Department of Health Examination, People’s Hospital of Wansheng Economic Development Zone, Chongqing, China
| | - Zhengzhi Feng
- School of Psychology, Army Medical University, Chongqing, China
| | - Xi Luo
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
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14
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Chen C, Ji S, Jiang J. Psychological Abuse and Social Support in Chinese Adolescents: The Mediating Effect of Self-Esteem. Front Psychol 2022; 13:852256. [PMID: 35401363 PMCID: PMC8989465 DOI: 10.3389/fpsyg.2022.852256] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/10/2022] [Indexed: 11/26/2022] Open
Abstract
Although previous studies have explored relationships between psychological abuse and social support, the pathways from psychological abuse to social support are still unclear, particularly in Chinese adolescents. This cross-sectional study attempts to delineate the prevalence of psychological abuse and explore the relationships between psychological abuse, social support, and self-esteem under the Chinese cultural context. Data were obtained from 417 Chinese adolescents aged 15-18 years old. All of them completed the Child Psychological Abuse and Neglect Scale, Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). Results indicated that the prevalence of psychological abuse in Chinese adolescents was 25.66%, and psychological abuse was negatively associated with self-esteem and social support, respectively. Self-esteem partially mediated the relationships between psychological abuse and social support. Findings highlight the importance of improving self-esteem in survivors of psychological abuse for decreasing the negative effects on social support. Additionally, the significance and limitations of the results were discussed.
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Affiliation(s)
- Chen Chen
- Center for Educational Science and Technology, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Shengkai Ji
- Teachers’ College, Jiaxing University, Jiaxing, China
| | - Juan Jiang
- Department of Preschool Education, Liaoning National Normal College, Shenyang, China
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15
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Al-Mendalawi M. Bezoar: An unusual cause of acute surgical abdomen. HAMDAN MEDICAL JOURNAL 2022. [DOI: 10.4103/hmj.hmj_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Fernandes GS, Spiers A, Vaidya N, Zhang Y, Sharma E, Holla B, Heron J, Hickman M, Murthy P, Chakrabarti A, Basu D, Subodh BN, Singh L, Singh R, Kalyanram K, Kartik K, Kumaran K, Krishnaveni G, Kuriyan R, Kurpad S, Barker GJ, Bharath RD, Desrivieres S, Purushottam M, Orfanos DP, Toledano MB, Schumann G, Benegal V. Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort. BMC Public Health 2021; 21:1920. [PMID: 34686158 PMCID: PMC8539836 DOI: 10.1186/s12889-021-11892-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse. The study aims to determine the prevalence of ACEs and its association with substance misuse. METHODS Data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used (n = 9010). ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure. RESULTS 1 in 2 participants reported child maltreatment ACEs and family level ACEs. Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. 12.7%). In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5-11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4-31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1-3.5). CONCLUSION ACEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. The results suggest enhancing current ACE resilience programmes and 'trauma-informed' approaches to tackling longer-term impact of ACEs in India. FUNDING Newton Bhabha Grant jointly funded by the Medical Research Council, UK (MR/N000390/1) and the Indian Council of Medical Research (ICMR/MRC-UK/3/M/2015-NCD-I).
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Affiliation(s)
- G S Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - A Spiers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - N Vaidya
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India.,Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - Y Zhang
- Centre for Innovation in Mental Health, Department of Psychology, University of Southampton, Southampton, UK
| | - E Sharma
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - B Holla
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - J Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - M Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - P Murthy
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - A Chakrabarti
- ICMR-Centre on Non-Communicable Diseases, Kolkata, India
| | - D Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B N Subodh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - L Singh
- Department of Psychiatry, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India
| | - R Singh
- Department of Psychiatry, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India
| | - K Kalyanram
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, Andhra Pradesh, India
| | - K Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Chittoor, Andhra Pradesh, India
| | - K Kumaran
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - G Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - R Kuriyan
- Department of Psychiatry and Medical Ethics, St John's Medical College & Hospital, Bangalore, India
| | - S Kurpad
- Department of Psychiatry & Department of Medical Ethics, St. John's Medical College & Hospital, Bangalore, India
| | - G J Barker
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK.,Department of Neuroimaging, King's College London, London, UK
| | - R D Bharath
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - S Desrivieres
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - M Purushottam
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - D P Orfanos
- NeuroSpin, CEA, Université Paris-Saclay, Paris, France
| | - M B Toledano
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - G Schumann
- Centre for Population Neuroscience and Precision Medicine, Kings College London, London, UK
| | - V Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
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17
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Fernandes G, Fernandes M, Vaidya N, De Souza P, Plotnikova E, Geddes R, Holla B, Sharma E, Benegal V, Choudhry V. Prevalence of child maltreatment in India and its association with gender, urbanisation and policy: a rapid review and meta-analysis protocol. BMJ Open 2021; 11:e044983. [PMID: 34373291 PMCID: PMC8354262 DOI: 10.1136/bmjopen-2020-044983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION India is home to 20% of the world's children and yet, little is known on the magnitude and trends of child maltreatment nationwide. The aims of this review are to provide a prevalence of child maltreatment in India with considerations for any effects of gender; urbanisation (eg, urban vs rural) and legislation (Protection of Children from Sexual Offences (POCSO) Act 2012). METHODS AND ANALYSIS A rapid review will be undertaken of all quantitative peer-reviewed studies on child maltreatment in India between 2005 and 2020. Four electronic databases will be systematically searched: PubMed, EMBASE, Cochrane and PsychInfo. The primary outcomes will include all aspects of child maltreatment: physical abuse, sexual abuse, emotional abuse, emotional neglect and physical neglect. Study participants will be between 0 and 18 years and will have reported maltreatment experiences using validated, reliable tools such as the Adverse Childhood Experiences Questionnaire as well as child self-reports and clinician reports. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Newcastle-Ottawa Quality assessment scale. A narrative synthesis will be conducted for all included studies. Also, if sufficient data are available, a meta-analysis will be conducted. Effect sizes will be determined from random-effects models stratified by gender, urbanisation and the pre-2012 and post-2012 POCSO Act cut-off. I2 statistics will be used to assess heterogeneity and identify their potential sources and τ2 statistics will indicate any between-study variance. ETHICS AND DISSEMINATION As this is a rapid review, minimal ethical risks are expected. The protocol and level 1 self-audit checklist were submitted and approved by the Usher Research Ethics Group panel in the Usher Institute (School of Medicine and Veterinary Sciences) at the University of Edinburgh (Reference B126255). Findings from this review will be disseminated widely through peer-reviewed publications and in various media, for example, conferences, congresses or symposia. PROSPERO REGISTRATION NUMBER CRD42019150403.
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Affiliation(s)
- Gwen Fernandes
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Megan Fernandes
- Department of Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Nilakshi Vaidya
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Philip De Souza
- Department of Medicine, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Evgeniya Plotnikova
- College of Medicine and Veterinary Medicine, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Rosemary Geddes
- College of Medicine and Veterinary Medicine, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Bharath Holla
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Eesha Sharma
- Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Vivek Benegal
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Vikas Choudhry
- Public Health, Sambodhi Research and Communications Pvt Ltd, Noida, Uttar Pradesh, India
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18
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Abbas SS, Jabeen T. Child Sexual Abuse in Pakistan: Using Evidence Based Social Ecological Model for Explanation and Policy Formulation. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 43:219-228. [PMID: 33906542 DOI: 10.1177/0272684x211013151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Due to recent high profile media reported cases of child sexual abuse in Pakistan a serious public concern is observed with a strong punitive public demand rather than proactive and preventive approach as solution. Instead of reactive approach, it is needed to formulate a policy based on valid causal ground for solution of this problem. Purpose of this cross sectional study is to provide a causal ground based on evidence based social ecological model for holistic policy response for addressing issue of CSA. Using ICAST-R, equal number of male and female 274 university students were asked about experience of CSA, re-victimization, age at the time of CSA, perpetrators, disclosure patterns and social support after disclosure of CSA. On the basis of data, evidence based social ecological model was used for explanation of individual, family, societal and institutional factors related to CSA in Pakistan for formulation of effective prevention strategy. According to findings most frequent age at the time of CSA is between 6th to 18th year of age with 9th year as most frequently reported. Experience of CSA was reported more frequently by boys than girls. Peers were identified as highest reported perpetrators and majority of the perpetrators were known to the child. Instead of reactive and punitive approach towards issue of CSA it is needed to formulate a policy based on social ecological factors of society.
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Affiliation(s)
- Syed Saleem Abbas
- Health Department, Govt. Kot Khawaja Saeed Teaching Hospital, King Edward Medical University, Lahore, Pakistan
| | - Tahira Jabeen
- Social Work Department, University of the Punjab, Lahore, Pakistan
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19
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Brassard MR, Hart SN, Glaser D. Psychological maltreatment: An international challenge to children's safety and well being. CHILD ABUSE & NEGLECT 2020; 110:104611. [PMID: 32660756 DOI: 10.1016/j.chiabu.2020.104611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment. OBJECTIVES This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment. PARTICIPANTS AND SETTINGS NA. METHOD Literature review, intervention description of fabricated or induced illness, and expert opinion. RESULTS PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence. CONCLUSIONS PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.
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Affiliation(s)
| | - Stuart N Hart
- Indiana University Purdue University at Indianapolis, USA
| | - Danya Glaser
- Great Ormond Street Hospital for Children and University College, London, UK
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