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Hamel C, Rodrigue C, Clermont C, Hébert M, Paquette L, Dion J. Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence. Sci Rep 2024; 14:6359. [PMID: 38493260 PMCID: PMC10944459 DOI: 10.1038/s41598-024-56909-2] [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: 10/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.
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Affiliation(s)
- Catherine Hamel
- Département de Psychologie, Université de Montréal, Montréal, H2V 2S9, Canada.
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada.
| | - Christopher Rodrigue
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Camille Clermont
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- École de Psychologie, Université Laval, Québec, G1V 0A6, Canada
| | - Martine Hébert
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Sexologie, Université du Québec À Montréal, Montréal, H2L 4Y2, Canada
| | - Linda Paquette
- Département Des Sciences de La Santé, Université du Québec À Chicoutimi, Chicoutimi, G7H 2B1, Canada
| | - Jacinthe Dion
- Research Centre On Intimate Relationship Problems and Sexual Abuse (CRIPCAS), Université de Montréal, Montréal, H2V 2S9, Canada
- Département de Psychologie, Université du Québec À Trois-Rivières, Trois-Rivières, G9A 5H7, Canada
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King WM, Fleischer NL, Operario D, Chatters LM, Gamarel KE. Inequities in the distribution of adverse childhood experiences and their association with health among transgender people of color. CHILD ABUSE & NEGLECT 2024; 149:106654. [PMID: 38350400 DOI: 10.1016/j.chiabu.2024.106654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Racism and cisgenderism expose transgender people of color to adversity across the life course. However, little is known about the prevalence of adverse childhood experiences (ACEs) in this population or their association with health in comparison to other groups. OBJECTIVE Guided by the structural trauma framework, we examined race/ethnicity/gender group differences in the prevalence of ACEs and their association with adult mental and physical health. PARTICIPANTS AND SETTING 2019-2021 Behavioral Risk Factor Surveillance Survey. METHODS Transgender participants (n = 551) were matched with two cisgender men (n = 1102) and two cisgender women (n = 1102) on key covariates. We compared age-adjusted predicted probabilities of nine ACEs by race/ethnicity/gender group. We then fit adjusted logistic regression models predicting poor mental and physical health by each ACE and compared marginal effects between groups. RESULTS Transgender people of color had higher age-adjusted probabilities of six ACEs than at least one other group; for example, household incarceration was 0.16 (95 % CI: 0.11-0.22) compared to 0.09 (95 % CI: 0.06-0.13) for cisgender men of color (p = 0.032). The relationship between five ACEs and poor mental health was greater for transgender people of color than at least one other group. For instance, the marginal effect of household alcoholism on poor mental health was 0.28 (95 % CI: 0.11-0.45) compared to 0.07 (0.01-0.14) for White cisgender men (p = 0.031). There were no statistically significant differences regarding effects on poor physical health. CONCLUSIONS ACEs inequitably impact transgender people of color, reflecting the need to restructure the interlocking systems that drive adversity among transgender children of color and exacerbate ACEs' health effects among adults.
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Affiliation(s)
- Wesley M King
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1525 Clifton Road, Atlanta, GA 30329, United States of America.
| | - Linda M Chatters
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America; University of Michigan School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, United States of America.
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
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Higgins DJ, Lawrence D, Haslam DM, Mathews B, Malacova E, Erskine HE, Finkelhor D, Pacella R, Meinck F, Thomas HJ, Scott JG. Prevalence of Diverse Genders and Sexualities in Australia and Associations With Five Forms of Child Maltreatment and Multi-type Maltreatment. CHILD MALTREATMENT 2024:10775595231226331. [PMID: 38214251 DOI: 10.1177/10775595231226331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data (N = 8503), 9.5% of participants identified with a diverse sexuality and .9% with a diverse gender. Diverse identities were more prevalent in the youth cohort, with 17.7% of 16-24 years olds identifying with a diverse sexuality and 2.3% with a diverse gender. Gender and sexuality diversity also intersect - for example, with women (aged 16-24 and 25-44) more likely than men to identify as bisexual. The prevalence of physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence was very high for those with diverse sexuality and/or gender identities. Maltreatment was most prevalent for participants in the youth cohort with diverse gender identities (90.5% experiencing some form of child maltreatment; 77% multi-type maltreatment) or diverse sexualities (85.3% reporting any child maltreatment; 64.3% multi-type maltreatment). The strong association found between child maltreatment and diverse sexuality and gender identities is critical for understanding the social and mental health vulnerabilities of these groups, and informing services needed to support them.
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Affiliation(s)
- Daryl J Higgins
- Institute of Child Protection Studies, Australian Catholic University, Melbourne, VIC, Australia
| | - David Lawrence
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Divna M Haslam
- School of Law, Queensland University of Technology, Brisbane, QLD, Australia
- Parenting and Family Support Centre, University of Queensland, Brisbane, QLD, Australia
| | - Ben Mathews
- School of Law, Queensland University of Technology, Brisbane, QLD, Australia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eva Malacova
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
| | - Holly E Erskine
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- School of Public Health, University of Queensland, Saint Lucia, QLD, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - David Finkelhor
- Crimes against Children Research Center, Department of Sociology, University of New Hampshire, Durham, NH, USA
| | - Rosana Pacella
- Institute for Lifecourse Development, University of Greenwich, London, UK
| | - Franziska Meinck
- School of Social & Political Science, University of Edinburgh, Edinburgh, UK
- Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hannah J Thomas
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - James G Scott
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
- Child and Youth Mental Health Service, Children's Health QLD, South Brisbane, QLD, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
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Rancher C, Hanson R, Williams LM, Saunders BE, Smith DW. Longitudinal predictors of children's self-blame appraisals among military families reported for family violence. CHILD ABUSE & NEGLECT 2024; 147:106596. [PMID: 38071942 PMCID: PMC10842802 DOI: 10.1016/j.chiabu.2023.106596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/27/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Although children's self-blame appraisals are recognized as important sequelae of child victimization that contribute to subsequent adjustment problems, little is known about the factors that predict their development and longitudinal course. OBJECTIVE The current study examines the stability and longitudinal predictors of children's self-blame appraisals among a sample of children reported for family violence. PARTICIPANTS AND SETTING Children (N = 195; 63 % female) aged 7 to 17 years (Mage = 12.17) were recruited as part of a longitudinal assessment of families referred to the United States Navy's Family Advocacy Program due to allegations of child physical abuse, sexual abuse, or intimate partner violence. METHODS Children completed assessments on self-blame at 3 time points (baseline, 9-12 months, and 18-24 months) and baseline measures of their victimization experience, caregiver-child conflict, and depression. RESULTS In univariate analyses, victimization that involved injury (r = 0.29, p < .001), the number of perpetrators (r = 0.23, p = .001), the number of victimization types (r = 0.32, p < .001), caregiver-child conflict (r = 0.36, p < .001), and depression (r = 0.39, p < .001) were each positively associated with baseline self-blame. When examined in a single longitudinal multilevel model, results indicated only caregiver-child conflict (b = 0.08, p = .007) and baseline depression (b = 0.06, p = .013) predicted increases in self-blame. CONCLUSION Findings suggest clinicians and researchers may consider assessment of victimization characteristics, caregiver-child relationships, and depression symptoms to identify children most at risk for developing self-blame appraisals.
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Affiliation(s)
- Caitlin Rancher
- National Crime Victims Research and Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Rochelle Hanson
- National Crime Victims Research and Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Linda M Williams
- Wellesley Centers for Women, Wellesley College, Wellesley, MA, USA
| | - Benjamin E Saunders
- National Crime Victims Research and Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel W Smith
- National Crime Victims Research and Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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5
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Belloir JA, Fabiano F, Jackman KB, Bockting WO. General self-efficacy as a mediator of the association between adverse childhood experiences and psychological distress in gender-minority individuals. J Nurs Scholarsh 2024; 56:9-17. [PMID: 36935475 DOI: 10.1111/jnu.12889] [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: 09/15/2022] [Revised: 02/04/2023] [Accepted: 02/16/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE To investigate the mediating role of general self-efficacy (i.e., belief in one's competence to cope with a broad range of stressful or challenging demands) in the relationship between adverse childhood experiences (ACEs) and psychological distress (i.e., symptoms of stress, anxiety and depression) in gender minority individuals, which include people with a gender identity that is not aligned with their sex assigned at birth. DESIGN AND METHODS The study sample included gender minority participants who participated in Waves 4 and 5 of Project AFFIRM, a multi-site longitudinal study of gender minority health. ACEs, general self-efficacy, and psychological distress were measured using the Behavior Risk Factor Surveillance System ACE Module at Wave 4, the PROMIS General self-efficacy measure at Wave 4, and the Brief Symptoms Inventory Global Severity Index (GSI) at Wave 5, respectively. After adjustment for covariates, including age, race, sex assigned at birth, and income, multivariable linear regression analyses were conducted to assess each component of the proposed mediation model. Next, mediation analyses were used to determine whether general self-efficacy mediated the association between ACEs and psychological distress. FINDINGS The sample for this study consisted of 166 gender minority adults with a mean age of 38.6 ± 12.2 years. Most were non-Hispanic White (46.4%) and female assigned at birth (59.6%). Mean ACEs score was 3.2 ± 2.1 (range 0-8), mean general self-efficacy score was 13.9 ± 3.6 (range 4-20), and mean raw-score GSI was 17.3 ± 13.7 (range 0-64). Participants who reported experiencing more ACEs had greater psychological distress (B 1.60; 95% CI = 0.66, 2.54) and lower general self-efficacy (B -0.41; 95% CI = -0.67, -0.15). In addition, lower general self-efficacy was associated with higher psychological distress (B -1.06; 95% CI = -1.61, -0.51). Bootstrap estimation of the indirect effect was significant (95% CI = 0.14, 0.90) and explained 27.1% (95% CI = 7.76, 69.76) of the total effect of ACEs on psychological distress in gender minority adults. CONCLUSIONS Our findings suggest that general self-efficacy partially mediated the positive association between ACEs and psychological distress in gender minority adults. Interventions that aim to improve general self-efficacy may be beneficial in alleviating psychological distress in gender minority adults. CLINICAL RELEVANCE Nurses can play an important role in reducing the health risks associated with ACEs by screening gender minority individuals using a trauma-informed approach to care and offering resources and referrals, as appropriate.
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Affiliation(s)
| | - Fredric Fabiano
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, New York, New York, USA
| | - Walter O Bockting
- Columbia University School of Nursing, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
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6
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Blosnich JR. Interpersonal and self-directed violence among sexual and gender minority populations: Moving research from prevalence to prevention. CURR EPIDEMIOL REP 2022; 9:142-160. [PMID: 36845319 PMCID: PMC9957556 DOI: 10.1007/s40471-022-00299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/03/2022]
Abstract
Purpose of review This scoping review of reviews aimed to detail the breadth of violence research about sexual and gender minorities (SGM) in terms of the three generations of health disparities research (i.e., documenting, understanding, and reducing disparities). Recent findings Seventy-three reviews met inclusion criteria. Nearly 70% of the reviews for interpersonal violence and for self-directed violence were classified as first-generation studies. Critical third-generation studies were considerably scant (7% for interpersonal violence and 6% for self-directed violence). Summary Third-generation research to reduce or prevent violence against SGM populations must account for larger scale social environmental dynamics. Sexual orientation and gender identity (SOGI) data collection has increased in population-based health surveys, but administrative datasets (e.g., health care, social services, coroner and medical examiner offices, law enforcement) must begin including SOGI to meet the needs of scaled public health interventions to curb violence among SGM communities.
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Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34 St., Los Angeles, CA 90089, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, USA
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7
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Katz-Wise SL, Gordon AR, Sharp KJ, Johnson NP, Hart LM. Developing Parenting Guidelines to Support Transgender and Gender Diverse Children's Well-being. Pediatrics 2022; 150:189276. [PMID: 36045300 DOI: 10.1542/peds.2021-055347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. METHODS We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. RESULTS Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. CONCLUSIONS These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Kendall J Sharp
- Department of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Stith SM, Topham GL, Spencer C, Jones B, Coburn K, Kelly L, Langston Z. Using systemic interventions to reduce intimate partner violence or child maltreatment: A systematic review of publications between 2010 and 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:231-250. [PMID: 34697816 DOI: 10.1111/jmft.12566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
This systematic review seeks to understand the effectiveness of systemic interventions to reduce Intimate Partner Violence (IPV) or child maltreatment published between January 2010 and December 2019. We found nine studies reviewing systemic interventions for IPV and 12 studies reviewing systemic interventions for child maltreatment. In our discussion, we added relevant articles published before 2010 to determine the overall state of the evidence for these interventions. We determined that parent training programs with in vivo coaching components for child maltreatment meet the criteria for well-established interventions. Relationship education approaches are probably efficacious. Parent education and family therapy programs to reduce child maltreatment, and cognitive behavioral couples treatment to reduce IPV are possibly efficacious interventions. Programs based on "naturalistic" couples therapy for IPV are experimental interventions. This review also highlights limitations in this research in addressing the needs of marginalized couples and families.
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Affiliation(s)
| | | | | | | | | | - Lorin Kelly
- Kansas State University, Manhattan, Kansas, USA
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10
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Rafferty J. Childhood Abuse Among Transgender Youth: A Trauma-Informed Approach. Pediatrics 2021; 148:peds.2021-050216. [PMID: 34226248 DOI: 10.1542/peds.2021-050216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jason Rafferty
- Hasbro Children's Hospital, Providence, Rhode Island .,Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Thundermist Health Center, Woonsocket, Rhode Island.,Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
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11
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Suarez NA, Peitzmeier SM, Potter J, Samandur A, Reisner SL. Preliminary findings for adverse childhood experiences and associations with negative physical and mental health and victimization in transmasculine adults. CHILD ABUSE & NEGLECT 2021; 118:105161. [PMID: 34146966 DOI: 10.1016/j.chiabu.2021.105161] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Studies highlight the impact of adverse childhood experiences (ACEs) on risk for negative health outcomes in adulthood, including cancer, cardiovascular disease, substance use, and mental health. Lesbian, gay, bisexual, and transgender (LGBT) people report higher rates of ACEs than non-LGBT people, with transgender people at greatest risk. OBJECTIVE This study aims to comprehensively assess the prevalence of ACEs and association with health outcomes among transmasculine individuals. PARTICIPANTS AND SETTING A sample of 131 transmasculine individuals enrolled in a clinical trial on preventive cervical cancer screening between March 2015 and September 2016 in the United States were surveyed about ACEs and health outcomes. METHODS Pearson's chi-squared tests and logistic regression models were used to examine associations between self-reported ACEs prior to age 18 and the risk of various negative health outcomes in adulthood. ACEs were categorized as 0-1 ACEs, 2-3 ACEs, and 4+ ACEs. RESULTS Over 90% of the sample (120/131) reported at least 1 ACE; 45% (59/131) reported 4+ ACEs. Report of 4 or more ACEs increased risk for negative health outcomes and risk factors compared to 0-1 ACEs, including: depression (AOR = 5.3, 95%CI = 1.7, 16.2), suicidality (AOR = 5.2, 95%CI = 1.4, 18.8), post-traumatic stress disorder (AOR = 6.0, 95%CI (1.6, 22.8)), intimate partner violence (AOR = 5.3, 95%CI = 1.4, 18.8), and obesity (AOR = 8.2, 95%CI = 1.8, 37.2). Report of 2-3 ACEs was also significantly associated with obesity (AOR = 5.9, 95%CI = 1.3, 26.2). CONCLUSIONS ACEs are highly prevalent in this sample, and more attention is needed for research and intervention. This exploratory study is the first to comprehensively highlight patterns of physical and mental health risk and victimization associated with report of ACEs among transmasculine individuals. Trauma-informed screening and intervention efforts tailored to the unique needs of this population are needed to provide appropriate and effective care. Clinicians should consider routinely screening for ACEs among transmasculine youth and engage in prevention strategies to reduce health disparities. Further research is warranted to validate these findings among larger, more representative samples to better reflect the diversity of experiences and identities of transmasculine individuals and produce more reliable findings.
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Affiliation(s)
- Nicolas A Suarez
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America..
| | - Sarah M Peitzmeier
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States of America.; Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States of America
| | - Jennifer Potter
- The Fenway Institute, Fenway Health Boston, MA, United States of America.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
| | - Avani Samandur
- University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Sari L Reisner
- The Fenway Institute, Fenway Health Boston, MA, United States of America.; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, United States of America.; Department of Medicine, Harvard Medical School, Boston, MA, United States of America.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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12
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Thoma BC, Rezeppa TL, Choukas-Bradley S, Salk RH, Marshal MP. Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents. Pediatrics 2021; 148:peds.2020-016907. [PMID: 34226247 PMCID: PMC8344346 DOI: 10.1542/peds.2020-016907] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Transgender adolescents (TGAs) exhibit disproportionate levels of mental health problems compared with cisgender adolescents (CGAs), but psychosocial processes underlying mental health disparities among TGAs remain understudied. We examined self-reported childhood abuse among TGAs compared with CGAs and risk for abuse within subgroups of TGAs in a nationwide sample of US adolescents. METHODS Adolescents aged 14 to 18 completed a cross-sectional online survey (n = 1836, including 1055 TGAs, 340 heterosexual CGAs, and 433 sexual minority CGAs). Participants reported gender assigned at birth and current gender identity (categorized as the following: cisgender males, cisgender females, transgender males, transgender females, nonbinary adolescents assigned female at birth, nonbinary adolescents assigned male at birth, and questioning gender identity). Lifetime reports of psychological, physical, and sexual abuse were measured. RESULTS Seventy-three percent of TGAs reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. Compared with heterosexual CGAs, TGAs had higher odds of psychological abuse (odds ratio [OR] = 1.84), physical abuse (OR = 1.61), and sexual abuse (OR = 2.04). Within separate subgroup analyses, transgender males and nonbinary adolescents assigned female at birth had higher odds of reporting psychological abuse than CGAs. CONCLUSIONS In a nationwide online sample of US adolescents, TGAs had elevated rates of psychological, physical, and sexual abuse compared with heterosexual CGAs. Risk for psychological abuse was highest among TGAs assigned female at birth. In the future, researchers should examine how more frequent experiences of abuse during childhood could contribute to disproportionate mental health problems observed within this population.
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Affiliation(s)
- Brian C. Thoma
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Taylor L. Rezeppa
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sophia Choukas-Bradley
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | - Rachel H. Salk
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael P. Marshal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Prior K, Carvalheiro M, Lawler S, Stapinski LA, Newton NC, Mooney-Somers J, Basto-Pereira M, Barrett E. Early trauma and associations with altruistic attitudes and behaviours among young adults. CHILD ABUSE & NEGLECT 2021; 117:105091. [PMID: 33991899 DOI: 10.1016/j.chiabu.2021.105091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/20/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Childhood and adolescent traumas are exceptionally prevalent worldwide. Despite their high prevalence and substantial impact, little research has investigated the rates and specific types of early trauma by gender. It is also unknown whether the types of early trauma are differentially associated with heightened or hindered prosocial attitudes and behaviours. OBJECTIVE To address this gap, this study aims to explore the rates of different types of early trauma (i.e., abuse: sexual, physical, and emotional; neglect: physical and emotional) among young Australian adults and investigate whether these differ according to participant gender (female, male and transgender/gender diverse). The study will also examine the associations between the different types of early trauma and current altruistic attitudes and behaviours (including the affective, behavioural and cognitive altruism domains), among a young adult Australian cohort. METHODS Cross-sectional data was collected from 511 young Australians aged 18-20 years using an online self-report survey. RESULTS Multiple regression analyses revealed that transgender/gender diverse individuals were over 3-times more likely to experience all types of maltreatment than females and over 3-times more likely to experience emotional and sexual abuse and emotional neglect than males. Experiencing one or more trauma types was negatively associated with the cognitive domain of altruism, experiencing physical neglect was associated with the affective domain, and having a family member involved in domestic violence was associated with the behavioural domain, after controlling for gender. CONCLUSIONS Findings show how early traumatic experiences can influence individuals' attitudes and behaviours during the pivotal developmental period of young adulthood.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Monica Carvalheiro
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia; The University of Melbourne, Melbourne, Australia.
| | - Siobhan Lawler
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
| | | | - Miguel Basto-Pereira
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal.
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
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Diamond LM, Dehlin AJ, Alley J. Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals. Psychoneuroendocrinology 2021; 129:105215. [PMID: 34090051 DOI: 10.1016/j.psyneuen.2021.105215] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex/gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body's primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing "minority stress" in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
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15
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Linde-Krieger LB, Moon CM, Yates TM. The Implications of Self-Definitions of Child Sexual Abuse for Understanding Socioemotional Adaptation in Young Adulthood. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:80-101. [PMID: 33206584 DOI: 10.1080/10538712.2020.1841352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/30/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
This study examined associations between child sexual abuse (CSA) survivors' self-definition status (i.e., whether or not survivors self-identified as sexually abused) and multiple measures of psychopathology, self-system functioning, and risk behaviors. We evaluated the hypothesis that survivors with concordant abuse perceptions (i.e., individuals who reported objective CSA and self-defined as sexually abused) would evidence more pronounced adjustment difficulties in young adulthood than survivors with discordant perceptions (i.e., individuals who reported objective CSA but did not self-define as sexually abused). In this large and ethnically diverse college student sample (N = 2,195; 63.8% female, 36.2% male; 83.3% nonwhite), objective experiences of CSA were associated with increased psychopathology, decreased self-system functioning, and increased risk behaviors, but the magnitude of these effects varied by survivors' self-definition status. Relative to their nonmaltreated peers, survivors with concordant abuse perceptions evidenced the largest elevations in psychopathology and risk behaviors, whereas survivors with discordant abuse perceptions evidenced the largest deficits in self-system functioning. These findings indicate that standard screening criteria may misidentify a sizable group of CSA survivors because these individuals do not perceive their experiences as "abuse." Efforts to understand the meaning ascribed to CSA experiences may profitably guide clinical interventions to enhance specific domains of functioning.
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Bounds DT, Winiarski DA, Otwell CH, Tobin V, Glover AC, Melendez A, Karnik NS. Considerations for working with youth with socially complex needs. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 33:209-220. [PMID: 32691491 PMCID: PMC7970826 DOI: 10.1111/jcap.12288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/26/2020] [Accepted: 07/05/2020] [Indexed: 12/01/2022]
Abstract
TOPIC The presence of adverse childhood experiences offers a glimpse into the social complexity in the lives of youth. Thus far, youth have been categorized as "at-risk" or "vulnerable,"-identifiers which highlight a deficits-based framework and continue to stigmatize youth. To combat this systemic marginalization, we propose using the term youth with socially complex needs. These youth, often minority ethnic/racial and/or sexual/gender minorities, experience repeated adversity and discrimination. PURPOSE The purpose of this paper is to conceptualize the unique considerations of working with youth with socially complex needs-who have an increased vulnerability for social marginalization. SOURCES USED Given the adversity experienced and challenges inherent in working with youth with socially complex needs, ethical principles, and relevant care delivery models were explored. CONCLUSIONS Delivering mental health care and/or conducting research in collaboration with youth with socially complex needs requires thoughtful consideration of ethical principles and models of care. In conclusion, we propose a strengths-based, individualized approach to working with youth with socially complex needs that requires a dynamic, fluid, multisystemic approach to care and research.
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Affiliation(s)
- Dawn T. Bounds
- Rush University College of Nursing, Chicago, IL, USA
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Dominka A. Winiarski
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Caitlin H. Otwell
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Valerie Tobin
- Rush University College of Nursing, Chicago, IL, USA
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Angela C. Glover
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Adrian Melendez
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Niranjan S. Karnik
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
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