The relationship between physical maltreatment and substance use among adolescents: a survey of 95,788 adolescents in Hong Kong

Association between Psychopathological Symptoms and Aggression and Selected Biochemical Parameters in Adolescents with Behavioural and Emotional Disturbances

Behavioural and emotional disturbances (F92.8) are the most recognized disorders in a developmental psychiatry. As the problem is still alarmingly increasing, the searches for their etiopathogenesis and more effective preventing and therapy methods are required. The aim of the study was to assess the association between the quality of life, some psychopathological features, concentrations of selected immunoprotective (brain-derived neurotrophin, BDNF), and endocrine (cortisol, F) factors while adolescent disturbances. The study was performed in 123 inpatients of a psychiatric ward with F92.8 diagnosis, aged 13-18 years. The complete patients' interview, physical examination, and routine laboratory tests, including serum F and BDNF tests, were performed. All patients completed standardized questionnaires to estimate: the severity of psychopathological symptoms (SCL-90), the level of aggression (Buss-Perry). The changes in the plasma BDNF and F concentrations were shown in patients raised in foster homes and institutions. The significantly lower BDNF was observed in youth from foster and suicide-experienced families. The more severe psychopathological symptoms, especially aggression and hostility, were found in these ones, who abused alcohol, attempted suicide, had lower self-esteem and cognitive processes, and were lacking safety in dysfunctional families.

A latent profile analysis of child maltreatment among at-risk youth gang members: Associations with violent delinquency, non-violent delinquency, and gang organizational structures

BACKGROUND

The relationship between child maltreatment and later delinquency is an enduring concern worldwide. However, the maltreatment-delinquency relationship is relatively underexplored in youth gang populations. Consequently, to date, studies have not examined typologies of maltreatment and their associations with violent delinquency, non-violent delinquency, and gang organizational structures.

OBJECTIVE

First, to identify the characteristics of subgroups of youth gang members who varied in abuse type and severity within type. Second, to determine in what ways the profiles differed in terms of gang organizational structures, violent delinquency, and non-violent delinquency.

PARTICIPANTS AND SETTINGS

A sample of 161 youth gang members (mean age: 16.8; range: 12-24) were recruited and surveyed by outreach social workers in Hong Kong.

METHODS

Latent profile analysis was first used to examine heterogeneity in victimization experiences (physical abuse, sexual abuse, emotional abuse, and neglect). Thereafter, non-parametric tests and post-hoc analyses were conducted to examine associations between the yielded typologies of maltreatment and gang organizational structures, violent delinquency, and non-violent delinquency.

RESULTS

Poly-victimization was prevalent in the sample, with 148 respondents (91.9 %) reporting at least two types of past abuses. Three profiles of maltreatment emerged, varying in abuse types and severity within types: 'Minimally maltreated', 'Moderately maltreated, except sexual abuse', and 'Severely maltreated'. In comparison to the 'Minimal' maltreatment profile, the 'Moderate' and 'Severe' profiles were associated with greater delinquent behaviors and being in gangs that encouraged congregate illegal behaviors.

CONCLUSIONS

There was a relationship between typologies of maltreatment and gang organizational structures, violent delinquency, and non-violent delinquency in the sample of youth gang members. Implications for practice and future research are discussed.

Physical punishment, physical abuse, and child behavior problems in South Korea

BACKGROUND

Prior literature has demonstrated the associations of parental physical punishment with child behavior problems and increased risk of physical abuse. In South Korea, physical punishment is a common parenting practice. In 2021, legislative reforms eliminated legal grounds for parental physical punishment in South Korea. However, research on physical punishment, physical abuse, and child behavior problems in the Korean context is scarce.

OBJECTIVE

This study examined whether physical punishment and physical abuse have unique associations with child behavior problems and whether physical punishment is associated with increased exposure to physical abuse.

PARTICIPANTS AND SETTING

Data came from the 2010 Korean Child and Youth Panel Survey (KCYPS), a nationally representative sample of South Korean children who attended 1st grade in 2010. Our analyses were based on three waves of the KCYPS (N = 2,180).

METHODS

We employed fixed-effects regression to examine the associations of physical punishment and physical abuse with child behavior problems and the association of physical punishment with physical abuse after controlling for time-invariant characteristics.

RESULTS

Exposure to physical punishment and physical abuse was associated with higher levels of aggression, depression, and lower levels of academic behavior regulation. Physical punishment was associated with increased risk of physical abuse.

CONCLUSIONS

Our findings suggest that physical punishment is a risk for child behavior problems and physical abuse in South Korea. Child maltreatment prevention efforts should focus on shifting favorable social norms around physical punishment and promoting non-physical disciplinary practices.

Exploring the Motivation Behind Discrimination and Stigmatization Related to COVID-19: A Social Psychological Discussion Based on the Main Theoretical Explanations

The novel coronavirus (COVID-19), was first detected in Wuhan province in China during late December 2019 and was designated as being highly infectious. The World Health Organization (WHO) labeled it a "pandemic" on March 11, 2020. Throughout human history, experience has shown that prejudices and viruses spread simultaneously during a viral pandemic. Outgroup members have been associated with various diseases and non-human vectors of diseases. Some epidemics have been named according to various outgroups, just as the novel coronavirus has been referred to by some as the "Wuhan virus" or the "Chinese virus." Associating a virus with a sociodemographic group builds a false illusionary correlation, which can lead to stigmatization and discrimination. Pandemics can also stimulate violent xenophobic reactions. Besides the obvious harmful consequences for the individuals targeted, pandemic-related discrimination also affects the spread of the virus through its effect on public attitudes toward prevention and restriction, health service procurement, and in the establishment of health-related policies. It is important to first understand the relevant concepts and processes, and also to understand the underlying causes of discrimination in order to fight it. Social psychology offers multidimensional and comprehensive explanations of prejudice and discrimination. This review's primary aim was to examine the motivations behind COVID-19-related discrimination based on social psychological perspectives. In line with this aim, the review first defines discrimination in detail, plus the related concepts and main social psychological theories on prejudice and discrimination. Then, pandemic-related discrimination in light of past experiences is discussed and explanations put forward for the theoretical perspectives and inferences specific to COVID-19. Finally, recommendations are made in order to prevent and combat discrimination related to infectious diseases.

Adolescent Smoking in Hong Kong: Prevalence, Psychosocial Correlates, and Prevention

Preventing adolescent smoking is important as smoking is typically initiated by young people. This article reviews the prevalence, psychosocial correlates, and prevention of smoking in Hong Kong adolescents. The past 30-day smoking prevalence in adolescents decreased from 9.6% in 2003 to 2.5% in 2017. Tobacco advertisements, parental and best friends smoking, nonintact families, poor family relationships, lower socioeconomic status, being a new immigrant, poor knowledge of smoking-related harm, positive attitudes toward smoking, overestimation of peer smoking, and depressive symptoms were positively associated with smoking outcomes, whereas positive youth development, authoritative mother and permissive father, family functioning, school competence, and stronger tobacco industry denormalization beliefs were protective against smoking. Along with tobacco tax increase, ban on tobacco advertisements, smoke-free law and pictorial warnings, educational efforts through theater performances, social norms campaigns, and positive adolescent training programs have been conducted to prevent adolescent smoking. To achieve the ultimate goal of tobacco endgame, further tax increase, plain packaging, banning point-of-sale display of tobacco products, smoke-free area extension, and raising minimum age of purchase should be implemented. The government proposed law to ban e-cigarettes, and heated tobacco products should be passed soon to protect children and adolescents from using these products.

Decreasing Caregivers' Positive Attitudes Toward Spanking

The Play Nicely program is a multimedia training program designed to teach caregivers and health care professionals how to manage early childhood aggression and to use positive parenting practices. The aim of this article is to help the practicing clinician determine whether the Play Nicely program should be incorporated into his/her practice and to evaluate whether the program is effective at decreasing positive attitudes toward spanking in a socioeconomically disadvantaged population in both a resident pediatric clinic and a community center. Thirty-three caregivers of children aged 2 to 5 years viewed the Play Nicely program and completed pre- and post-training questionnaires. Decreased positive attitudes toward spanking were reported after training. Favorable attitudes toward spanking were associated with increased use of harsher discipline and higher child externalizing behavior. This study provides support that this brief intervention is effective in a socioeconomically disadvantaged population, is portable, and can be used in a group setting. This program may serve as a prevention and population-based approach to addressing the adverse childhood experience of spanking.

Deviant Peer Affiliation as an Explanatory Mechanism in the Association between Corporal Punishment and Physical Aggression: a Longitudinal Study among Chinese Adolescents

Previous research has focused primarily on corporal punishment as a cause and adolescents' physical aggression as an outcome. However, there is a large gap in knowledge of the potentially bidirectional association and explanatory mechanism underlying the association between corporal punishment and physical aggression. The current study, using a longitudinal design across three time points (the fall semester of 7th grade, the fall of 8th grade, and the fall of 9th grade), aimed to a) examine the reciprocal processes between corporal punishment and physical aggression, and b) explore whether deviant peer affiliation may explain such reciprocal connections. Only adolescents participating in all the three time points were included in this study, resulting in a final sample of 342 adolescents (175 boys, 167 girls) who completed questionnaires regarding corporal punishment, deviant peer affiliation, and aggression. Gender, age and socioeconomic status were controlled for in the analyses. Autoregressive cross-lagged models showed that the results did not support the direct reciprocal effect between corporal punishment and physical aggression among Chinese adolescents. A direct longitudinal link from corporal punishment to physical aggression was found, however, the inverse association was not significant. Moreover, regarding the longitudinal underlying process, in one direction, corporal punishment at 7th grade predicted higher levels of deviant peer affiliation at 8th grade. In turn, higher deviant peer affiliation at 8th grade predicted increased physical aggression at 9th grade. At the same time, in the other direction, adolescent physical aggression at 7th grade significantly predicted deviant peer affiliation at 8th grade. In turn, higher deviant peer affiliation at 8th grade predicted decreased corporal punishment at 9th grade. Identifying the direct and underlying reciprocal processes between corporal punishment and adolescent physical aggression has important implications for an integrative framework of theory and prevention.

Youth self-report of child maltreatment in representative surveys: a systematic review

INTRODUCTION

This systematic review identified population-representative youth surveys containing questions on self-reported child maltreatment. Data quality and ethical issues pertinent to maltreatment data collection were also examined.

METHODS

A search was conducted of relevant online databases for articles published from January 2000 through March 2016 reporting on population-representative data measuring child maltreatment. Inclusion criteria were established a priori; two reviewers independently assessed articles to ensure that the criteria were met and to verify the accuracy of extracted information.

RESULTS

A total of 73 articles reporting on 71 surveys met the inclusion criteria. A variety of strategies to ensure accurate information and to mitigate survey participants' distress were reported.

CONCLUSION

The extent to which efforts have been undertaken to measure the prevalence of child maltreatment reflects its perceived importance across the world. Data on child maltreatment can be effectively collected from youth, although our knowledge of best practices related to ethics and data quality is incomplete.

Dimensions of physical punishment and their associations with children's cognitive performance and school adjustment

This study examined how a range of physical punishment measures, ranging from mild corporal punishment to physical abuse, are associated with cognitive performance, school engagement, and peer isolation over a 3- year span among 658 children initially observed between the ages of 8 and 14. Physical punishment was captured in three groups: mild corporal punishment, harsh corporal punishment, and physical abuse, and both caregiver- and child-reported punishment measures were considered. After accounting for socioeconomic and demographic characteristics, only Ninitial exposure to physical abuse was significantly associated with declines in cognitive performance. However, all forms of physical punishment were associated with declines in school engagement, and harsh corporal punishment was associated with increased peer isolation. Our findings were relatively consistent regardless of whether physical punishment was reported by the child or caregiver. Overall, our findings suggest that the prevention of physical abuse may enhance children's cognitive performance, but that alone may not be sufficient to ensure children are engaged and well-adjusted in school.

The comparison of violence, and the relationship with childhood trauma in Turkish men with alcohol, opiate, and synthetic cannabinoid use disorder

OBJECTIVE

The objectives of this study are, first, to explore the prevalence of lifetime violent and criminal behaviors among alcohol, opioid, and synthetic cannabinoid (SC) users in the treatment program; second, to examine and compare sociodemographic characteristics, childhood traumatic experiences, and impulsivity of these groups.

PATIENTS AND METHOD

This cross-sectional cohort study includes 110 male patients who received inpatient treatment in AMATEM (Alcohol and Substance Addiction Treatment Center) Clinic of Erenköy Training and Research Hospital for Psychiatry and Neurology between October 2014 and May 2015, diagnosed with alcohol, opioid, SC use disorder. The patients who were included in the study were given Data Collection Form, APIsoft (Addiction Profile Index), Childhood Trauma Questionnaire (CTQ-28), and Barratt Impulsiveness Scale (BIS-11). Statistical analysis was performed with SPSS 15.0 statistic software package.

RESULTS

We found that resorting to verbal and physical violence was more frequent in SC group in comparison with alcohol and opiate groups (for verbal violence 88.5%, 60%, 70%; P = 0.02; for physical violence (82%, 40%, 60%; P = 0.001). Criminal involvement was also higher for SC users than alcohol and opioid users (94%, 85%, 68.5%; P = 0.01). The average CTQ-28 scores for SC group (P = 0.017) were high whereas there was no difference in the average BIS-11 scores (P = 0.073) between groups. There was no difference between the groups in terms of severity of addiction (P = 0.2). Our study ascertained that the patients exhibited mild and moderate addiction.

CONCLUSION

Although creating a treatment for addiction, we think that a holistic treatment that will take into consideration the used substance and the individual's childhood traumatic events along with his/her impulsive and aggressive behaviors could make a significant contribution to the prevention of the patient's possible violent and criminal behaviors in the future.

Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience

Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.

Spanking and child outcomes: Old controversies and new meta-analyses

Whether spanking is helpful or harmful to children continues to be the source of considerable debate among both researchers and the public. This article addresses 2 persistent issues, namely whether effect sizes for spanking are distinct from those for physical abuse, and whether effect sizes for spanking are robust to study design differences. Meta-analyses focused specifically on spanking were conducted on a total of 111 unique effect sizes representing 160,927 children. Thirteen of 17 mean effect sizes were significantly different from zero and all indicated a link between spanking and increased risk for detrimental child outcomes. Effect sizes did not substantially differ between spanking and physical abuse or by study design characteristics. (PsycINFO Database Record

Learning to drink: How Chinese adolescents make decisions about the consumption (or not) of alcohol

BACKGROUND

The aim of the study was to provide in-depth understanding of how Chinese adolescents learn to drink and how they make decisions about the consumption (or not) of alcohol. This study explored the ways in which social and cultural factors shape the drinking trajectories of Chinese underage young people.

METHODS

The study used a qualitative design to collect and analyse the data. We recruited adolescents aged between 14 and 17 from a range of secondary schools in Hong Kong. Focus group interviews were undertaken with 22 groups encompassing 111 participants. A thematic analysis based upon grounded theory was performed using NVivo 10.

RESULTS

The traditional Chinese drinking culture, characterised by the coming together of friends and relatives for celebrations, signifies the Chinese adolescents' first alcohol experiment. The adolescents' motivations for drinking essentially reflect the value placed upon alcohol within the Chinese culture - promoting conviviality, sociability and camaraderie. Whereas a sense of commonality encouraged alcohol use among them, there was little indication that drinkers and non-drinkers separately clustered around friendship networks. A high degree of self-regulation was exercised when drinking and this emerged as an acceptable social norm amongst young drinkers within social and cultural contexts. Most respondents saw underage drinking as an entirely normal and accepted part of social lives provided that it is kept under control.

CONCLUSIONS

This study sheds light on the Chinese adolescents' own understandings and interpretations of their drinking. Our findings suggest that interventions aimed to curtail underage drinking need to reflect social and cultural contexts within which alcohol comes into play and importantly, consider social environments that are conducive to underage drinking.

A meta-analysis of child physical abuse prevalence in China

This study estimated the prevalence of child physical abuse in China, compared Chinese prevalence with international and Asian estimates, and ascertained whether some differences in sample characteristics and methodological factors (e.g., time prevalence, definitional or regional difference) help explain variations in Chinese rates. Based on a meta-analysis of 47 studies found in English- and Chinese-language peer-reviewed journals that involved general populations of students or residents reporting child physical abuse prior to age 18, the life time prevalence of any child physical abuse in China was estimated at 36.6% (95% CI: 30.4-42.7), which was significantly higher than either the international or the Asian estimate in Stoltenborgh et al.'s (2013) study. Chinese prevalence was estimated at 43.1% (95% CI: 36.6-52.5) for minor physical abuse, 26.6% (95% CI: 21.4-31.8) for severe physical abuse, and 7.8% (95% CI: 5.0-10.5) for very severe physical abuse. Subgroup analysis found a significant difference between lifetime and 12-month or less prevalence only for minor physical abuse. The prevalence of any and minor child physical abuse in mainland China was significantly higher than that in non-mainland China. The mainland and non-mainland difference was significant even controlling for definitional and methodological factors as well as sample characteristics. The findings suggested the need to develop educational programs to promote non-violent parenting particularly in mainland China.

The burden of child maltreatment in China: a systematic review

OBJECTIVE

To estimate the health and economic burdens of child maltreatment in China.

METHODS

We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment.

FINDINGS

From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product - i.e. 50 billion United States dollars - in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively.

CONCLUSION

In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.

The consequences of maltreatment on children's lives: a systematic review of data from the East Asia and Pacific Region

This study explores the consequences of child maltreatment in East Asia and the Pacific region based on the results of a systematic review of 16 English and non-English databases for journal articles and "gray" literature published between January 2001 and November 2010. This review shows that children in the region experiencing maltreatment are at increased risk of experiencing mental health consequences, physical health sequelae, high-risk sexual behaviors, and increased exposure to future violence including intimate partner violence (IPV) as an adult. Children who suffer from child sexual abuse have a median twofold increased risk of experiencing mental health disorders than those who have never experienced child maltreatment.  Similar findings were found for those who experience physical abuse.  Children who have been maltreated in the region are also at an increased risk of suicide ideation and attempts than those that have experienced child sexual or physical abuse being at a median fourfold increased risk. Children who have experienced physical abuse or those who have witnessed parental domestic abuse as a child are at median twofold increased risk of experiencing IPV as an adult, while children who have been sexually abused have a median threefold increase in risk of IPV later in life. There are still gaps in our understanding of the consequences of child maltreatment, but we do know that the consequences are profound and far-reaching. The findings indicate that there is an urgent need for governments, civil society organizations, development agencies, and academia to advocate for, invest in, and collaborate across sectors for the strengthening of child protection systems in the East Asia and Pacific Region, with a focus on evidence-based child maltreatment prevention policies and programs.

Health compromising behaviors among Chinese adolescents: role of physical abuse, school experience, and social support

This study examined the influence of immediate social environment on health compromising behaviors (HCB) among 6564 high school students in China. Results showed that physical abuse by parents was a major risk factor that accounted for high rates of HCB. Perceived positive school experience and social support were protective factors associated with low rates of HCB. These two protective factors also buffered the adverse influence of abuse on the practice of individual HCB. In particular, parental abuse was associated with sexual experimentation, non-fatal self-harm, and suicide behaviors only at low levels of protective factors.

Family structure, parent-child conversation time and substance use among Chinese adolescents

BACKGROUND

The family plays a vital role in shaping adolescent behaviours. The present study investigated the associations between family structure and substance use among Hong Kong Chinese adolescents.

METHODS

A total of 32,961 Form 1 to 5 (grade 7-12 in the US) Hong Kong students participated in the Youth Smoking Survey in 2003-4. An anonymous questionnaire was used to obtain information about family structure, daily duration of parent-child conversation, smoking, alcohol drinking and drug use. Logistic regression was used to calculate the adjusted odds ratios (OR) for each substance use by family structure.

RESULTS

Adjusting for sex, age, type of housing, parental smoking and school, adolescents from non-intact families were significantly more likely to be current smokers (OR = 1.62), weekly drinkers (OR = 1.72) and ever drug users (OR = 1.72), with significant linear increases in ORs from maternal, paternal to no-parent families compared with intact families. Furthermore, current smoking (OR = 1.41) and weekly drinking (OR = 1.46) were significantly more common among adolescents from paternal than maternal families. After adjusting for parent-child conversation time, the ORs for non-intact families remained significant compared with intact families, but the paternal-maternal differences were no longer significant.

CONCLUSIONS

Non-intact families were associated with substance use among Hong Kong Chinese adolescents. The apparently stronger associations with substance use in paternal than maternal families were probably mediated by the poorer communication with the father.

Comparing early adult outcomes of maltreated and non-maltreated children: A prospective longitudinal investigation

Using prospective data from the Chicago Longitudinal Study, this investigation examined associations between child maltreatment and an array of outcomes in early adulthood. Findings from bivariate and multivariate analyses indicated that verified maltreatment victims fared significantly worse than participants without an indicated maltreatment report on indicators of educational and economic attainment, criminal offending, and behavioral and mental health. Results also revealed that, while many maltreated children appeared to function well on individual outcomes, a large majority did not achieve criteria for resilience when development was assessed across domains. For example, non-maltreated participants were more than twice as likely to attain five or more positive outcomes (38.2%) on an aggregate seven-item index as the maltreated group (15.7%). These findings suggest that child maltreatment is associated with extensive and enduring impacts, reinforcing the need to develop and implement effective maltreatment prevention and intervention strategies.

Reduced prefrontal cortical gray matter volume in young adults exposed to harsh corporal punishment

OBJECTIVE

Harsh corporal punishment (HCP) during childhood is a chronic, developmental stressor associated with depression, aggression and addictive behaviors. Exposure to traumatic stressors, such as sexual abuse, is associated with alteration in brain structure, but nothing is known about the potential neurobiological consequences of HCP. The aim of this study was to investigate whether HCP was associated with discernible alterations in gray matter volume (GMV) using voxel-based morphometry (VBM).

METHODS

1455 young adults (18-25 years) were screened to identify 23 with exposure to HCP (minimum 3 years duration, 12 episodes per year, frequently involving objects) and 22 healthy controls. High-resolution T1-weighted MRI datasets were obtained using Siemens 3 T trio scanner.

RESULTS

GMV was reduced by 19.1% in the right medial frontal gyrus (medial prefrontal cortex; MPFC, BA10) (P=0.037, corrected cluster level), by 14.5% in the left medial frontal gyrus (dorsolateral prefrontal cortex; DLPFC, BA9) (P=0.015, uncorrected cluster level) and by 16.9% in the right anterior cingulate gyrus (BA24) (P<0.001, uncorrected cluster level) of HCP subjects. There were significant correlations between GMV in these identified regions and performance IQ on the WAIS-III.

CONCLUSIONS

Exposing children to harsh HCP may have detrimental effects on trajectories of brain development. However, it is also conceivable that differences in prefrontal cortical development may increase risk of exposure to HCP.

Prevalence and determinants of child maltreatment among high school students in Southern China: a large scale school based survey

BACKGROUND

Child maltreatment can cause significant physical and psychological problems. The present study aimed to investigate the prevalence and determinants of child maltreatment in Guangzhou, China, where such issues are often considered a taboo subject.

METHODS

A school-based survey was conducted in southern China in 2005. 24 high schools were selected using stratified random sampling strategy based on their districts and bandings. The self-administered validated Chinese version of parent-child Conflict Tactics Scale (CTSPC) was used as the main assessment tool to measure the abusive experiences encountered by students in the previous six months.

RESULTS

The response rate of this survey was 99.7%. Among the 6592 responding students, the mean age was 14.68. Prevalence of parental psychological aggression, corporal punishment, severe and very serve physical maltreatment in the past 6 months were 78.3%, 23.2%, 15.1% and 2.8% respectively. The prevalence of sexual abuse is 0.6%. The most commonly cited reasons for maltreatment included 'disobedience to parents', 'poor academic performance', and 'quarrelling between parents'. Age, parental education, places of origins and types of housing were found to be associated with physical maltreatments whereas gender and fathers' education level were associated with sexual abuse.

CONCLUSION

Though largely unspoken, child maltreatment is a common problem in China. Identification of significant determinants in this study can provide valuable information for teachers and health professionals so as to pay special attention to those at-risk children.

Family breakup and adolescents' psychosocial maladjustment: public health implications of family disruptions

OBJECTIVES

Recent changes in family structure are associated with an increase in psychosocial maladjustment in adolescents. We examined, from a public health intervention perspective, the association between family breakup and psychosocial maladjustment in adolescents and assessed the mediating role of family-functioning variables.

METHODS

We analyzed data from the Social and Health Survey of Children and Adolescents in Quebec, Montreal, Canada, which was conducted in 1999. Sample-weighted logistic regression analyses were performed to determine the risk of internalizing disorders, externalizing disorders, substance abuse, and alcohol consumption in relation to family breakups and family-functioning variables, after adjusting for socioeconomic factors.

RESULTS

All 4 of the indicators of psychosocial maladjustment were significantly associated with family breakup. The association between family breakups and internalizing disorders was mediated by parental psychological distress and low paternal emotional support. Independently, the witnessing of interparental violence was also strongly associated with internalizing disorders. For the other 3 outcomes, that is, externalizing disorders, substance abuse, and alcohol consumption, family breakup and family-functioning variables had independent effects.

CONCLUSIONS

Family-based interventions and social approaches are complementary support modalities for adolescents experiencing family disruptions.

Multiple pathways from stress to suicidality and the protective effect of social support in Hong Kong adolescents

Two theoretical models were constructed to illustrate how stressful events, family and friends support, depression, substance use, and death attitude mutually influence to create cumulative risks for suicide. The models were evaluated using structural equation modeling. Results showed that suicidality was strongly predicted by death attitude, depression, and substance use which together form a dangerous combination of risk factors at the personal level. Within the adolescent's social environment, stressful events increased suicidality through intensifying depression, substance use, and death acceptance, whereas family and friends support lowered it, partly through reducing stress and death acceptance. The effect (direct and indirect combined) of family support was much stronger than that of friends support. Enhancing stress coping ability, promoting positive family relationships, and attacking attitudes supportive of death might be the best strategies to prevent youth suicide.