1
|
de Vries I, Baglivio M, Reid JA. Examining Individual and Contextual Correlates of Victimization for Juvenile Human Trafficking in Florida. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241243332. [PMID: 38567549 DOI: 10.1177/08862605241243332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Despite extant literature on individual-level risk factors for sex trafficking among children and adolescents, little is known about the impact of social and ecological contexts on risk of human trafficking victimization. The purpose of this study was to examine the correlates signaling risk of human trafficking victimization at the individual, family, social, and community levels utilizing a sample of 40,531 justice-involved male and female youth, a small fraction of whom were suspected or verified victims of human trafficking between 2011 and 2015 (N = 801, including 699 female and 102 male youth). Using this sample, we examined differences across individual, family, social, and community characteristics of youth involved in the juvenile justice system who have a history of trafficking victimization and youth without such histories. Series of logistic regression analyses were conducted using varying control groups, created through exact matching and randomized matching groups to address sample imbalances. These analyses indicate that, at the individual level, youth who had experienced childhood adversities were more likely to report human trafficking victimization. Sex differences were found regarding risk factors pertaining to the family and broader socio-ecological contexts. Female youth who had witnessed family violence had an antisocial partner or antisocial friends, or resided in a community with a greater proportion of the population being foreign-born or speaking English less than very well were at heightened risk for human trafficking victimization. Little evidence was found for community-level risk factors of victimization in this specific sample of justice-involved youth. These findings encourage more research to unpack the multilevel correlates of victimizations at the individual, family, social, and community levels, recognizing potential differences between female and male youth regarding the factors that put them at heightened risk for juvenile sex trafficking victimizations. Practice and policy should direct awareness and prevention measures to social and ecological contexts.
Collapse
Affiliation(s)
| | - Michael Baglivio
- University of South Florida, Tampa, USA
- Youth Opportunity Investments, LLC, Tampa, FL, USA
| | - Joan A Reid
- University of South Florida, St. Petersburg, USA
| |
Collapse
|
2
|
Petrov ME, Calvin S, Wyst KBV, Whisner CM, Meltzer LJ, Chen ACC, Felix KN, Roe-Sepowitz D. Sleep Disturbances and Hygiene of Adolescent Female Survivors of Domestic Minor Sex Trafficking. J Pediatr Health Care 2024; 38:52-60. [PMID: 37610406 DOI: 10.1016/j.pedhc.2023.07.006] [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: 05/03/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION This cross-sectional quantitative study investigated the sleep hygiene and disturbances of adolescent female survivors of domestic minor sex trafficking (DMST) compared to an online sample of community-dwelling adolescent females. METHOD Community-dwelling adolescent females (aged 13-17 years, n = 61) and survivors of DMST housed in residental care (aged 12-17 years, n = 19) completed the Children's Report of Sleep Patterns (adolescent version). Descriptive statistics on sleep health in both samples were computed and compared using chi-square and t-tests. RESULTS Among the survivors of DMST, the majority reported insufficient sleep duration, okay-to-poor sleep quality, waking thirsty, and frequent nightmares. Compared with community-dwelling adolescents, survivors of DMST had more symptoms of insomnia, sleepiness, nightmares, and waking thirsty (p < .05). DISCUSSION Sleep disturbances among adolescent female survivors of DMST may be more prevalent than in community-dwelling adolescent females. Further empirical research on appropriate assessment and trauma-informed treatment of sleep in this population is needed.
Collapse
|
3
|
Mak J, Bentley A, Paphtis S, Huq M, Zimmerman C, Osrin D, Devakumar D, Abas M, Kiss L. Psychosocial interventions to improve the mental health of survivors of human trafficking: a realist review. Lancet Psychiatry 2023; 10:557-574. [PMID: 37353265 DOI: 10.1016/s2215-0366(23)00105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 06/25/2023]
Abstract
More than 50 million people globally are subjected to modern slavery and human trafficking. Adverse mental health consequences of extreme exploitation are prevalent and often severe. We conducted a systematic and realist review on evaluations of psychosocial interventions for survivors of human trafficking. The review aimed to identify the influence of these interventions on the mental health and wellbeing of trafficked people and examine how they worked for which survivors in which contexts. We searched eight databases (MEDLINE, MEDLINE In-Process, Embase, PsycINFO, Global Health, CINAHL Plus, Web of Science, and Cochrane) for published evaluations of psychosocial interventions for survivors of human-trafficking. We followed a realist approach to analyse the data and report on the limitations of the studies identified. We identified four mechanisms of change as being triggered by the various intervention activities: (1) awareness and understanding; (2) trust, safety, and security; (3) agency, autonomy, empowerment, and social connections; and (4) self-reflection, self-expression, and self-care. Improving mental health after traumatic events is an ongoing, nonlinear process. Intervention effectiveness and transferability would benefit from more transparent programme theories and well articulated assumptions that identify the pathways to change.
Collapse
Affiliation(s)
- Joelle Mak
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Abigail Bentley
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sharli Paphtis
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Mita Huq
- Institute for Global Health, University College London, London, UK
| | - Cathy Zimmerman
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK
| | - David Osrin
- Institute for Global Health, University College London, London, UK
| | | | - Melanie Abas
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Ligia Kiss
- Institute for Global Health, University College London, London, UK.
| |
Collapse
|
4
|
Greenbaum J, Kaplan D, Young J, Asnes AG, Gavril AR, Gilmartin ABH, Girardet RG, Heavilin ND, Laskey A, Messner SA, Mohr BA, Nienow SM, Rosado N, Forkey H, Keefe R, Keeshin B, Matjasko J, Edward H, Stedt E, Linton J, Gutierrez R, Caballero T, Falusi O“LO, Giri M, Griffin M, Ibrahim A, Mukerjee K, Shah S, Shapiro A, Young J. Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics 2023; 151:190310. [PMID: 36827522 DOI: 10.1542/peds.2022-060416] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Exploitation and labor and sex trafficking of children and adolescents is a major public health problem in the United States and throughout the world. Significant numbers of US and non-US-born children and adolescents (including unaccompanied immigrant minors) are affected by this growing concern and may experience a range of serious physical and mental health problems associated with human trafficking and exploitation (T/E). Despite these considerations, there is limited information available for health care providers regarding the nature and scope of T/E and how providers may help recognize and protect children and adolescents. Knowledge of risk factors, recruitment practices, possible indicators of T/E, and common medical, mental, and emotional health problems experienced by affected individuals will assist health care providers in recognizing vulnerable children and adolescents and responding appropriately. A trauma-informed, rights-based, culturally sensitive approach helps providers identify and treat patients who have experienced or are at risk for T/E. As health care providers, educators, and leaders in child advocacy and development, pediatricians play an important role in addressing the public health issues faced by children and adolescents who experience exploitation and trafficking. Working across disciplines with professionals in the community, health care providers can offer evidence-based medical screening, treatment, and holistic services to individuals who have experienced T/E and assist vulnerable patients and families in recognizing signs of T/E.
Collapse
Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia
| | - Dana Kaplan
- Department of Pediatrics, Staten Island University Hospital, Northwell Health Physician Partners, Staten Island, New York.,The Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Janine Young
- Department of Pediatrics, University of California, San Diego, California
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Supporting emergency department Nurse’s self-Efficacy in victim identification through human trafficking education: A quality improvement project. Int Emerg Nurs 2022; 65:101228. [DOI: 10.1016/j.ienj.2022.101228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/16/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022]
|
6
|
Vujanovic AA, Gordon MR, Coverdale JH, Nguyen PT. Applying Telemental Health Services for Adults Experiencing Trafficking. Public Health Rep 2022; 137:17S-22S. [PMID: 35775909 DOI: 10.1177/00333549221085243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Anka A Vujanovic
- Trauma and Stress Studies Center, Department of Psychology, University of Houston, Houston, TX, USA
| | - Mollie R Gordon
- Anti-Human Trafficking Program, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John H Coverdale
- Anti-Human Trafficking Program, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Phuong T Nguyen
- Anti-Human Trafficking Program, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
7
|
Fraley HE, Subedi G. Confusing Terms: A Concept Analysis of Naming Youth Trafficking. JOURNAL OF FORENSIC NURSING 2022; 18:174-184. [PMID: 35293359 DOI: 10.1097/jfn.0000000000000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human trafficking is a growing population health problem. More than half of all persons experiencing trafficking are youth, with many in the United States unrecognized despite experiencing exploitation. Available peer-reviewed articles report a myriad of descriptions of trafficking, yet the concept and operational definition of youth trafficking, specifically, is lacking and unclear. Youth trafficking is described differently across multidisciplinary researchers and clinicians working with trafficked youth. Furthermore, labor trafficking of youth is largely excluded from the conversation surrounding trafficking. This article presents a concept analysis of naming trafficking of persons under the age of 18 years to clarify the concept specific to youth experiencing all forms of trafficking and approaches professionals can take with this specific subpopulation of trafficked persons and survivors.
Collapse
|
8
|
Perry EW, Osborne MC, Lee N, Kinnish K, Self-Brown SR. Posttraumatic Cognitions and Posttraumatic Stress Symptoms Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking. Public Health Rep 2022; 137:91S-101S. [PMID: 35775917 DOI: 10.1177/00333549211041552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The impact of posttraumatic cognitions on the development and maintenance of posttraumatic stress symptoms (PTSS) is understudied among children and adolescents who have experienced commercial sexual exploitation/trafficking (CSE/T). The objectives of this study were to (1) explore posttraumatic cognitions among help-seeking young people aged 11-19 who have experienced CSE/T; (2) determine whether experiencing direct violence, witnessing violence, polyvictimization (ie, multiple exposures to different categories of potentially traumatic events), or demographic characteristics differentially affect whether these young people meet clinical criteria for posttraumatic cognitions using established cutoffs; and (3) explore associations between posttraumatic cognitions and PTSS among young people who have experienced CSE/T. METHODS This study is a secondary analysis of a baseline cross-sectional survey of 110 young people with substantiated CSE/T experiences who started trauma-focused cognitive behavioral therapy (mean [SD] age = 15.8 [1.5]) from August 1, 2013, through March 31, 2020, in a southeastern US state. We used descriptive statistics, adjusted modified Poisson regression, and adjusted linear regression to test study objectives. RESULTS Fifty-seven of 110 (51.8%) young people aged 11-19 met clinical criteria for posttraumatic cognitions. Increased age and a greater number of trauma categories experienced were significantly associated with meeting clinical criteria for posttraumatic cognitions. On average, higher posttraumatic cognition scores were associated with higher PTSS scores, controlling for demographic characteristics (β = 0.95; 95% CI, 0.64-1.26). CONCLUSIONS These findings underscore the importance of assessing comprehensive trauma history and PTSS of young people who have experienced CSE/T, with added usefulness of measuring cognitive appraisals to inform a therapeutic treatment plan. Measuring cognitive appraisals that may influence PTSS and therapeutic success can ensure an effective public health response for this population.
Collapse
Affiliation(s)
- Elizabeth W Perry
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Melissa C Osborne
- 1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA.,1373 Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - NaeHyung Lee
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Shannon R Self-Brown
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| |
Collapse
|
9
|
Robitz R, Asera A, Nguyen P, Gordon M, Coverdale J, Stoklosa H, Chisolm-Straker M. An Annotated Bibliography on Human Trafficking for the Mental Health Clinician. J Psychiatr Pract 2022; 28:218-226. [PMID: 35511097 DOI: 10.1097/pra.0000000000000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This annotated bibliography provides an overview of sentinel and influential literature about human trafficking for general mental health practitioners. METHODS A modified participatory ranking methodology was used to create the list of articles. RESULTS We identified 25 articles relevant to trafficking and mental health which covered the topics of epidemiology, treatment, identification, policy, and research methodology. CONCLUSIONS The articles presented cover a broad range of trafficking types and topics. However, there is a dearth of literature about labor trafficking and the trafficking of men, boys, transgender, and nonbinary people.
Collapse
|
10
|
Huang T, Li H, Tan S, Xie S, Cheng Q, Xiang Y, Zhou X. The efficacy and acceptability of exposure therapy for the treatment of post-traumatic stress disorder in children and adolescents: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:259. [PMID: 35413848 PMCID: PMC9006570 DOI: 10.1186/s12888-022-03867-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 03/18/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is common among children and adolescents who have experienced traumatic events. Exposure therapy (ET) has been shown to be effective in treating PTSD in adults. However, its efficacy remains uncertain in children and adolescents. AIMS To evaluate the efficacy and acceptability of ET in children and adolescents with PTSD. METHOD We searched PubMed, EMBASE, Cochrane, Web of Science, PsycINFO, CINAHL, ProQuest, LILACS, and international trial registries for randomized controlled trials (RCTs) assessed ET in children and adolescents (aged ≤18 years) with PTSD up to August 31, 2020. The primary outcomes were efficacy (the endpoint score from PTSD symptom severity rating scales) and acceptability (all-cause discontinuation), secondary outcomes included efficacy at follow-up (score from PTSD scales at the longest point of follow-up), depressive symptoms (end-point score on depressive symptom severity rating scales) and quality of life/social functioning (end-point score on quality of life/social functioning rating scales). This study was registered with PROSPERO (CRD42020150859). RESULT A total of 6 RCTs (278 patients) were included. The results showed that ET was statistically more efficacious than control groups (standardized mean differences [SMD]: - 0.47, 95% confidence interval [CI]: - 0.91 to - 0.03). In subgroup analysis, exposure therapy was more efficacious for patients with single type of trauma (SMD: - 1.04, 95%CI: - 1.43 to - 0.65). Patients with an average age of 14 years and older, ET was more effective than the control groups (SMD: - 1.04, 95%CI: - 1.43 to - 0.65), and the intervention using prolonged exposure therapy (PE) (SMD: - 1.04, 95%CI: - 1.43 to - 0.65) was superior than control groups. Results for secondary outcomes of efficacy at follow-up (SMD: - 0.64, 95%CI: - 1.17 to - 0.10) and depressive symptoms (SMD: - 0.58, 95%CI: - 0.93 to - 0.22) were similar to the previous findings for efficacy outcome. No statistically significant effects for acceptability and quality of life/social functioning were found. CONCLUSION ET showed superiority in efficacy at post-treatment/follow-up and depressive symptoms improvement in children and adolescents with PTSD. Patients with single type of trauma may benefit more from ET. And ET is more effective in patients 14 years or older. Moreover, PE could be a better choice.
Collapse
Affiliation(s)
- Tengyue Huang
- grid.203458.80000 0000 8653 0555Chongqing Medical University, Chongqing, China ,grid.452206.70000 0004 1758 417XDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haomiao Li
- grid.203458.80000 0000 8653 0555Chongqing Medical University, Chongqing, China ,grid.452206.70000 0004 1758 417XDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shiyu Tan
- grid.203458.80000 0000 8653 0555Chongqing Medical University, Chongqing, China ,grid.452206.70000 0004 1758 417XDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Siyu Xie
- grid.203458.80000 0000 8653 0555Chongqing Medical University, Chongqing, China ,grid.452206.70000 0004 1758 417XDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qisheng Cheng
- grid.203458.80000 0000 8653 0555Chongqing Medical University, Chongqing, China ,grid.452206.70000 0004 1758 417XDepartment of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yajie Xiang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| |
Collapse
|
11
|
Robitz R, Tasarz J, Chambers R. An integrated approach to providing care for people who have been trafficked. Bull Menninger Clin 2022; 86:34-43. [PMID: 35238609 DOI: 10.1521/bumc.2022.86.suppa.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
People who have been trafficked often have complex medical and psychiatric needs. Integrated care is a treatment approach that may be used to improve the care of this population. The authors describe the integrated care model and how it may be applied to this population. They also describe some of the benefits and challenges of using an integrated care model with this population.
Collapse
Affiliation(s)
- Rachel Robitz
- Department of Psychiatry and Behavioral Sciences, University of California Davis
| | | | - Ron Chambers
- Dignity Health Medical Safe Haven Clinic, Sacramento, California
| |
Collapse
|
12
|
Bechtel K, Passmore S, Kondis J, Walker Descartes I, Adewusi A, Greenbaum V. Training Experiences of Emergency Department Providers in the Recognition of Child Trafficking. Pediatr Emerg Care 2022; 38:e988-e992. [PMID: 35100788 DOI: 10.1097/pec.0000000000002511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Trafficked children face challenges to obtaining appropriate health care that may be addressed by clinician training. We evaluated emergency department (ED) staff's training experiences regarding child trafficking and attitudes toward educational efforts to provide informed recommendations for improvement in the recognition and evaluation of trafficked children in the ED setting. METHODS In this cross-sectional study of general and pediatric ED staff across 6 cities in the United States, participants completed a 25-question, online anonymous survey. Differences in proportions between categorical data were examined using χ2/Fisher exact tests. Differences in means were evaluated using Student t test and 1-way analysis of variance. RESULTS The 484 participants included physicians (33.0%), nurses (27.4%), resident physicians (12.2%), and social workers (10.1%). Only 12.4% reported being very confident in recognizing child trafficking. Barriers to recognition included lack of awareness and training on child sex trafficking (37.4%, 58.3%) and labor trafficking (38.4%, 50.6%), sensitivity of the topic (44.4%), lack of institutional guidelines (29.8%) and social work coverage (26.0%), and the assumption that children will not disclose victimization (16.5%). Although 62.2% of the respondents had prior training in child sex trafficking, only 13.3% reported that it was adequate. Barriers to training included lack of easy access (82.5%), belief that prior training was adequate (13.3%), poor-quality curricula (5.1%), and low priority of topic (4.1%). Recommendations for training included a 1-hour module/webinar/lecture (43.1%), rounds (40.5%), written guidelines (9.8%), and individualized, case-based learning (6.6%). CONCLUSIONS We found that although most ED providers stated that they had prior training in the recognition of child trafficking, few expressed confidence in their ability to recognize and evaluate trafficked children. Barriers to education included a lack of awareness of and access to available curricula. Providers supported a variety of formats for further education. Strategies for improving educational access are discussed.
Collapse
Affiliation(s)
| | - Sarah Passmore
- School of Community Medicine, College of Medicine, University of Oklahoma, Tulsa, OK
| | - Jamie Kondis
- Washington University School of Medicine, St Louis, MO
| | | | | | | |
Collapse
|
13
|
Greenbaum J. Child Labor and Sex Trafficking. Pediatr Rev 2021; 42:639-654. [PMID: 34850175 DOI: 10.1542/pir.2020-001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Regardless of their practice setting or subspecialty, pediatricians are likely to encounter children who have experienced sex or labor trafficking or who are at risk for exploitation. Only 24.1% of health professionals in one study reported receiving previous training on human trafficking; after a brief presentation on the topic, 39.6% indicated that they knew or suspected they had cared for a trafficked person in the past 3 months. Trafficked and exploited children can present with myriad physical or mental health conditions; most have experienced repeated, significant trauma; and few are likely to spontaneously disclose their exploitative situation. As a result, clinicians face challenges in recognizing and appropriately responding to potential human trafficking. Knowledge of common risk factors and potential indicators of exploitation can assist the pediatrician in recognizing affected and at-risk youth. However, health professionals report that existing training tends to focus on general information about trafficking, with relatively little time spent discussing the specifics of the trauma-informed approach to patient interactions. Given the critical importance of building patient trust, empowering patients to share their concerns, and engaging them in their own care and safety planning, this article focuses on the practical aspects of working with trafficked and exploited children. A brief overview of human trafficking is followed by an extensive discussion of rights-based, culturally sensitive, trauma-informed strategies for interacting with vulnerable patients.
Collapse
Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA.,Institute on Healthcare and Human Trafficking, Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA
| |
Collapse
|
14
|
Jowett S, Argyriou A, Scherrer O, Karatzias T, Katona C. Complex post-traumatic stress disorder in asylum seekers and victims of trafficking: treatment considerations. BJPsych Open 2021; 7:e181. [PMID: 34593084 PMCID: PMC8503916 DOI: 10.1192/bjo.2021.1007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Asylum-seekers experience high levels of traumatic events pre-, post- and during migration. Poly-traumatisation is associated with complex post-traumatic stress disorder (CPTSD), which has not yet been extensively explored in this population. CPTSD is a prevalent and highly disabling disorder in the present population requiring culturally sensitive diagnostic and treatment approaches. In this service evaluation, we evidence the high prevalence of CPTSD in an asylum-seeking sample and its association with greater distress compared with PTSD. We outline the treatment needs of asylum seekers with CPTSD.
Collapse
Affiliation(s)
- Sally Jowett
- Edinburgh Napier University, School of Health and Social Care, UK
| | | | | | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, UK; and Rivers Centre for Traumatic Stress, NHS Lothian, UK
| | - Cornelius Katona
- Therapy, Helen Bamber Foundation, UK; and Division of Psychiatry, University College London, UK
| |
Collapse
|
15
|
Walker S, Barnett P, Srinivasan R, Abrol E, Johnson S. Clinical and social factors associated with involuntary psychiatric hospitalisation in children and adolescents: a systematic review, meta-analysis, and narrative synthesis. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:501-512. [PMID: 33930330 PMCID: PMC8205858 DOI: 10.1016/s2352-4642(21)00089-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Disparities in involuntary psychiatric hospitalisation between population subgroups have been identified in adults, but little is known about the factors associated with involuntary hospitalisation in children or adolescents. We did a systematic review, meta-analysis, and narrative synthesis to investigate the social and clinical factors associated with involuntary psychiatric hospitalisation among children and adolescents. METHODS We searched MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials for studies of any type up to July 22, 2020, that compared the characteristics of voluntary and involuntary psychiatric inpatients (mean age of sample ≤18 years). We synthesised results using random effects meta-analysis on unadjusted data and by narrative synthesis. Heterogeneity between studies was calculated using I2. This study is registered on PROSPERO, CRD42020099892. FINDINGS 23 studies from 11 countries were included in the systematic review and narrative synthesis, of which 19 studies (n=31 212) were included in the meta-analysis. On meta-analysis, involuntary rather than voluntary hospitalisation of minors was associated with a diagnosis of psychosis (eight studies; odds ratio 3·63, 95% CI 2·43-5·44, p<0·0001), substance misuse (five studies; 1·87, 1·05-3·30, p=0·032), or intellectual disability (four studies; 3·33, 1·33-8·34, p=0·010), as well as presenting with a perceived risk of harm to self (eight studies; 2·05, 1·15-3·64, p=0·015) or to others (five studies; 2·37, 1·39-4·03, p=0·0015). Involuntary hospitalisation was also found to be associated with being aged 12 years or older (three studies; 3·57, 1·46-8·73, p=0·0052) and being from a Black rather than a White ethnic group (three studies; 2·72, 1·88-3·95, p<0·0001). There was substantial between-study heterogeneity for most factors included in the meta-analysis (I2 from 51·3% to 92·3%). Narrative synthesis found that more severe illness and poorer global functioning was associated with involuntary hospitalisation. INTERPRETATION Over-representation of involuntary psychiatric hospitalisation in certain groups might begin in childhood, potentially establishing a cycle of inequality that continues into adulthood. Further research into the systemic factors underlying these health-care inequalities and the barriers to accessing less coercive psychiatric treatment is urgently required, with specific consideration of racial and ethnic factors. FUNDING UK National Institute for Health Research and Wellcome Trust.
Collapse
Affiliation(s)
- Susan Walker
- Division of Psychiatry, University College London, London, UK; Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Phoebe Barnett
- Department of Clinical Educational and Health Psychology, Centre for Outcomes Research and Effectiveness, University College London, London, UK; National Institute of Health Research Mental Health Policy Research Unit, University College London, London, UK
| | | | - Esha Abrol
- Division of Psychiatry, University College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK; National Institute of Health Research Mental Health Policy Research Unit, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| |
Collapse
|
16
|
Fernández-Fillol C, Pitsiakou C, Perez-Garcia M, Teva I, Hidalgo-Ruzzante N. Complex PTSD in survivors of intimate partner violence: risk factors related to symptoms and diagnoses. Eur J Psychotraumatol 2021; 12:2003616. [PMID: 34925711 PMCID: PMC8682852 DOI: 10.1080/20008198.2021.2003616] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In 2018, the World Health Organization proposed a new diagnosis entitled Complex Posttraumatic Stress Disorder (CPTSD) in the ICD-11. It is a diagnosis that encompasses the classic symptoms of PTSD, along with symptoms of disturbances in self-organization (DSO). Although this disorder has been studied in several countries and populations, research on the population of women survivors of intimate partner violence (IPV) is scarce. OBJECTIVES 1) To analyse the prevalence of CPTSD and PTSD according to ICD-11 criteria; 2) To analyse the associations between CPTSD symptomatology and severity of violence, level of fear, resilience and strategies of emotion regulation; 3) To analyse which risk factors (severity of violence, level of fear, resilience and strategies of emotion regulation) may differ between female survivors with CPTSD or PTSD. METHOD 162 women IPV survivors who completed a socio-demographic and violence-related interview, as well as questionnaires to assess PTSD and CPTSD, severity of violence, resilience and emotion regulation strategies. RESULTS The results showed a higher prevalence of CPTSD (39.50%), compared to PTSD (17.90%). Moreover, a high level of fear was related to re-experiencing in the here and now, avoidance, current sense of threat and disturbances in relationships. Low levels of resilience and maladaptive emotion regulation strategies such as expressive suppression were related to affective dysregulation, negative self-concept and disturbances in relationships. Finally, the results showed that maladaptive emotion regulation strategies differentiated between meeting CPTSD and PTSD criteria in women survivors of IPV. CONCLUSION The findings of this study indicated that CPTSD was twice as prevalent as PTSD within the sample. Moreover, maladaptive emotion regulation strategy as expressive suppression was the main variable related to experiencing CPTSD, in contrast to PTSD. These findings may have important implications for the design of specific treatments aimed at women survivors of IPV, who also suffer CPTSD.
Collapse
Affiliation(s)
- C Fernández-Fillol
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - C Pitsiakou
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - M Perez-Garcia
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - I Teva
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Education, Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
| | - N Hidalgo-Ruzzante
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Education, Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
| |
Collapse
|
17
|
Albright K, Greenbaum J, Edwards SA, Tsai C. Systematic review of facilitators of, barriers to, and recommendations for healthcare services for child survivors of human trafficking globally. CHILD ABUSE & NEGLECT 2020; 100:104289. [PMID: 31787336 DOI: 10.1016/j.chiabu.2019.104289] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Child trafficking is associated with multiple physical and mental health problems, yet relatively little is known about the factors that facilitate or hamper delivery of high-quality health care services to trafficked children. OBJECTIVE To summarize information about identified facilitators of, barriers to, and recommendations for medical and mental health service provision to trafficked children. PARTICIPANTS AND SETTING A systematic review was conducted of the English-language, peer-reviewed literature on medical and mental healthcare of trafficked children published since 2010. METHODS Inclusion criteria were: (1) the study population or focus included, wholly or in part, individuals under the age of 18 years; (2) the study focus was clearly defined as human trafficking or commercial sexual exploitation; (3) a main focus included health services or barriers to care, and (4) the article contained original data. RESULTS Of the 29 articles meeting inclusion criteria, 19 included facilitators of health service provision to trafficked populations, 22 included barriers to that provision, and 25 included explicit recommendations for service improvement. 45 distinct facilitators were identified a total of 140 times, 118 distinct barriers were identified a total of 174 times, and 52 distinct recommendations were identified a total of 100 times. The majority of facilitators, barriers, and recommendations fell under the locus of the healthcare provider and healthcare organization. CONCLUSIONS Existing research reveals abundant areas of opportunity for healthcare professionals and healthcare administrators to improve access to, and quality of, medical and mental health care for trafficked children.
Collapse
Affiliation(s)
- Karen Albright
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA; Institute on Healthcare and Human Trafficking, SVB Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | | | - Carmelle Tsai
- Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| |
Collapse
|
18
|
Hodes M, Vostanis P. Practitioner Review: Mental health problems of refugee children and adolescents and their management. J Child Psychol Psychiatry 2019; 60:716-731. [PMID: 30548855 DOI: 10.1111/jcpp.13002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. METHODS We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. RESULTS Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD, and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high-income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder-specific therapies will be required. CONCLUSIONS Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.
Collapse
Affiliation(s)
- Matthew Hodes
- Centre for Psychiatry, Imperial College London, London, UK
| | - Panos Vostanis
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| |
Collapse
|