A Novel Screening Tool for Assessing Child Abuse: The Medical Somatic Dissociation Questionnaire-MSDQ

Hyperbaric oxygen therapy vs. pharmacological intervention in adults with fibromyalgia related to childhood sexual abuse: prospective, randomized clinical trial

Fibromyalgia syndrome (FMS) is a chronic pain syndrome characterized by disruptions in pain processing within the central nervous system. It exhibits a high prevalence among patients with a history of traumatic experiences, notably childhood sexual abuse (CSA). This study compared the efficacy of hyperbaric oxygen therapy (HBOT) to the current pharmacological standard of care for individuals suffering from CSA-related FMS. Forty-eight participants diagnosed with FMS and a history of CSA were randomly assigned to either the HBOT group (60 sessions of 100% oxygen at 2 ATA for 90 min, with air breaks every 5 min) or the medication (MED) group (FDA-approved medications, Pregabalin and Duloxetine). The primary endpoint was the Fibromyalgia impact questionnaire (FIQ) score, while secondary endpoints encompassed emotional status and daily functioning questionnaires, as well as pain thresholds and conditioned pain modulation tests. Brain activity was evaluated through single photon emission computed tomography (SPECT). Results revealed a significant group-by-time interaction for the FIQ score favoring HBOT over MED (p < 0.001), with a large effect size (Cohen's d = - 1.27). Similar findings were observed in emotional symptoms and functional measures. SPECT imaging demonstrated an increase in activity in pre-frontal and temporal brain areas, which correlated with symptoms improvement. In conclusion, HBOT exhibited superior benefits over medications in terms of physical, functional, and emotional improvements among FMS patients with a history of CSA. This associated with increased activity in pre-frontal and temporal brain areas, highlighting the neuroplasticity effect of HBOT.

Attachment Anxiety and Dissociation Mediate Associations Between Polytrauma and Somatization in Kenyan Adolescents

The experience of several potentially traumatic events (PTE) is a risk factor for higher somatization symptoms severity among adolescents. Attachment orientations and dissociation may influence the link between exposure to PTE and somatization symptoms severity. We analyzed the associations between direct exposure to PTE and somatization symptoms in Kenyan adolescents and explored the mediating role of attachment orientations and dissociation symptoms in the associations between direct exposure to PTE with somatization symptoms severity. A sample of 475 Kenyan adolescents completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modeling employing Preacher and Hayes' procedures (2008). Attachment anxiety and dissociation symptoms mediate the association between direct exposure to traumatic events and somatization symptoms. Higher exposure to traumatic events was significantly associated with higher attachment anxiety levels, which was associated with higher levels of dissociation symptoms, which was then associated with higher somatization symptoms severity. High levels of attachment anxiety and dissociation might aggravate somatization symptoms differently according to sex, which might be seen as a psychological distress mechanism subsequent to exposure to multiple PTE in African adolescents.

The Medical Somatic Dissociation Questionnaire Assessment For Childhood Sexual Abuse: A Brief Report

Child sexual abuse is a prevalent phenomenon worldwide. However, a gap exists between its incidence and its disclosure rate. Furthermore, assessment tools and techniques capable to identify the source of symptoms are lacking. This study investigates the extent to which the validated Medical Somatic Dissociation Questionnaire (MSDQ) can differentiate between sexually and non-sexually abused children. A total of 794 children and youth between the ages of 8 and 18 (mean age: 12.2 (SD = 2.3); 42% female, 58% male) were recruited from the general population; other participants were residents of boarding schools and children who were referred to medical treatment. The anonymous online questionnaire included queries about demographics, a condensed version of the Traumatic Life Events Questionnaire, and the MSDQ. Findings indicate strong internal consistency, reliability, incremental validity, and predictive validity of the instrument, indicating the superiority of the MSDQ's ability to predict sexual abuse compared to physical abuse or the loss of a family member. It is concluded that the MSDQ can be integrated into the evaluation process performed by healthcare professionals in the diagnosis of minors with unexplained symptomatology.

Use of Self-Figure Drawing as an Assessment Tool for Child Abuse: Differentiating between Sexual, Physical, and Emotional Abuse

Child abuse is a worldwide phenomenon with adverse short- and long-term mental and physical negative consequences, with a huge gap between the prevalence of child abuse and disclosure rates. The study aimed to examine and validate the self-figure drawing as an assessment tool to differentiate between three forms of child abuse, i.e., child sexual abuse (CSA), child physical abuse (CPA), and child emotional abuse (CEA). Following the ethical approval, 1707 Thai children (13–18 years old) from the general population (schools) were asked to complete a self-report anonymous questionnaire consisting of four measures (Demographics, Childhood Trauma Questionnaire (CTQ), The Medical Somatic Dissociation Questionnaire (MSDQ), and The Disclosure of Trauma Questionnaire (DTQ)). After completion, they were asked to draw themselves. There was a significantly positive link between the reluctance to disclose and the experience of abuse, indicating that the more severe the abuse the higher the reluctance to disclose. The findings broaden the knowledge of movement and symbols as representations of inner personal conflictual material. Additionally, it substantiates self-figure drawing as an assessment tool and assists practitioners in early child abuse detection.

Physical Versus Sexual Abuse as Reflected in Adolescents' Self-Figure Drawings: A Preliminary Study

Based on the lack of validated assessment tools to detect past physical or sexual abuse, the current study examines to what extent the experience of either sexual or physical abuse is reflected in self-figure drawings of adolescents at-risk. A convenience sample consists of 93 adolescents at risk between the ages of 12-17 recruited from Welfare institutes divided into three groups: Group 1 included adolescents who experienced sexual abuse, Group 2 included adolescents who experienced physical abuse but not sexual abuse, Group 3 included adolescents who experienced neither sexual abuse nor physical abuse. A self-report anonymous questionnaire that consisted of demographics, traumatic events questionnaire, and the Medical Somatic Dissociation Questionnaire (MSDQ) was administered following Ethical approval and signing of consent forms. Participants were asked to draw themselves on an A4 sheet of paper using a pencil. Five social workers who were unaware of participants' experiences assessed the drawings independently for the level of obviousness of the following indicators: face line, eyes, nose, ears, hair stand, forehead, lower body, arms, and hands. Results yielded differences in pictorial indicators (nose, hair stand, lower body) among the groups. MSDQ score was found significantly higher among sexually abused victims.

Perceptions of Child Abuse as Manifested in Drawings and Narratives by Children and Adolescents

Child abuse is an underreported phenomenon despite its high global prevalence. This study investigated how child abuse is perceived by children and adolescents as manifested in their drawings and narratives, based on the well-established notion that drawings serve as a window into children's mental states. A sample of 97 Israeli children and adolescents aged 6-17 were asked to draw and narrate what child abuse meant to them. The drawings and narratives were coded quantitatively. The results indicated that participants did not perceive a distinction between abuse and violence and referred to them interchangeably. Almost half of the participants focused on emotional abuse. The most frequent type of abuse within the family was between parents and children, and the most frequent abuse outside the family was peer victimization. Most of the drawings were figurative and realistic and half of the drawings included words suggestive of the participants' attempts to be heard and fully understood. The vast majority of drawings did not include the figure of the artist, about a third of the drawings employed dissociative techniques (i.e., included positive objects, were unrelated to abuse, used words alone, or did not follow the instructions), and almost half of the narratives were dissociative or characterized by negative resolution, describing feelings such as sadness, humiliation, and loneliness. These findings suggest the emotional pain associated with the abuse or violence and the use of dissociative mechanisms to bypass the pain. The findings are discussed in light of the literature on children's disclosure.