Family Violence and Other Potentially Traumatic Interpersonal Events Among 9- to 17-Year-Old Children Attending an Outpatient Psychiatric Clinic

Sexual harassment and patterns of symptoms and functional abilities in a psychiatric sample of adolescents

PURPOSE

To investigate how commonly adolescent psychiatric outpatients with symptoms of depression and anxiety report having been subjected to sexual harassment, and to explore how symptoms and functional abilities differ between adolescent psychiatric outpatients with symptoms of depression and anxiety who do report and those who do not report having been subjected to sexual harassment.

METHODS

Swedish adolescent psychiatric outpatients with symptoms of depression or anxiety (n = 324; 66 boys and 258 girls, aged 12-19 years, M = 15.6, SD = 1.7) answered the PROMIS paediatric measures. Logistic regression analyses were performed to assess differences between the respondents classified as 'Sexually harassed' and 'Not sexually harassed' based on these self-report questionnaires.

RESULTS

About 60% of the adolescents reported having been subjected to sexual harassment, and reported higher levels of suicidal ideation, disturbed sleep, fatigue, anxiety, depression, anger, and pain interference, as well as lower functional ability in terms of school problems, alcohol consumption, and poor family relationships. Logistic regression analyses showed that the strongest associations were with suicidal ideation, disturbed sleep, anger, and alcohol consumption.

CONCLUSIONS

About 60% of the adolescents in the studied psychiatric cohort reported having been subjected to sexual harassment. Reported experiences were high in all three subtypes, with the most reports on having been subjected to verbal harassment. Clinicians should ask about experiences of sexual harassment and give information about the consequences of sexual violence and treatment options. Alcohol consumption should be addressed and tested for. Structured assessment of suicidality should always be done.

Experiences of Online Sexual Violence: Interviews With Swedish Teenage Girls in Psychiatric Care

Research about online sexual violence (OSV) is needed to be able to better meet the needs of girls in psychiatric care. The objectives of this study are to explore experiences of online sexual violence among young female psychiatric service users. Interviews with nine girls with psychiatric care needs were analyzed with thematic analysis. The findings are summarized in four themes which contribute to the notion that online sexual violence is only one, albeit important, part of a more complex picture of violence among young girls in psychiatric care. The girls' narratives are shaped by, as well as reproducing gender norms.

Prevalence of chronic pain in children and adolescents with psychiatric conditions

The prevalence of pain in children and adolescents with psychiatric conditions is rarely investigated. The aims of the current study were to (a) describe the prevalence of headaches and abdominal pain in children and adolescents with psychiatric conditions, (b) compare the prevalence of pain in children and adolescents with psychiatric conditions with that in the general population, and (c) investigate the associations between pain experience and different types of psychiatric diagnoses. Families with a child aged 6-15 years who had been referred to a child and adolescent psychiatry (CAP) clinic completed the Chronic Pain in Psychiatric Conditions questionnaire. Information about the child/adolescent's psychiatric diagnosis(es) was extracted from the CAP clinic's medical records. The children and adolescents included in the study were divided into diagnostic groups and compared. Their data were also compared with data of control subjects collected during a previous study of the general population. Abdominal pain was more common among girls with a psychiatric diagnosis (85%) than in the matched control population (62%, p = 0.031). Children and adolescents with neurodevelopmental diagnoses had a higher prevalence of abdominal pain than children and adolescents with other psychiatric diagnoses. Pain conditions in children and adolescents with a psychiatric diagnosis are common and must be addressed.

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Exposure to adverse childhood experiences is a risk factor for the development of serious psychiatric and somatic illness. Although trauma-focused therapy is effective in reducing symptoms, not all children benefit from it. To improve treatment efficacy, the children's perspective on what they perceive as helpful versus hindering is necessary. This study aimed, retrospectively, to explore how children exposed to family violence experienced treatment at the Child and Adolescent Mental Health Service. Seventeen children and youths were interviewed 4-5 years after treatment. The thematic analysis resulted in five themes: confusion, the need to feel heard, fear of consequences, feelings of pain, and identifying oneself as an agent. The results emphasize the importance of the therapeutic relationship, and that trust, genuine interest, and reciprocity are necessary for the child to engage in treatment. However, neither the child's own agency nor external obstacles such as continuous exposure to abuse should be underestimated in terms of the child's engagement.

Associations Among Age of First Experience of Violence, Type of Victimization, Polyvictimization, and Mental Distress in Nigerian Females

This study explored associations of age of first victimization, sexual violence (SV), physical violence (PV), polyvictimization, and mental distress among females in Nigeria (n = 1,766, 13-24 years old) using the nationally representative 2014 Nigeria Violence Against Children Survey. Multinomial logistic regressions were performed. Nigerian females reporting SV victimization and polyvictimization were more likely to experience higher mental distress. The older the female was at the time of PV victimization, the greater the risk for mental distress. Violence is prevalent in Nigeria and its impact on youth's health is severe. However, evidence-based and data-driven policies and programs can reduce and prevent violence.

Feasibility of Screening Programs for Domestic Violence in Pediatric and Child and Adolescent Mental Health Services: A Literature Review

Each year, 275 million children worldwide are exposed to domestic violence (DV) and suffer negative mental and physical health consequences; however, only a small proportion receive assistance. Pediatricians and child psychiatrists can play a central role in identifying threatened children. We reviewed experiences of DV screening in pediatric and child and adolescent mental health services (CAMHS) to understand its feasibility and provide clues for its implementation. We performed bibliographic research using the Sapienza Library System, PubMed, and the following databases: MEDLINE, American Psychological Association PsycArticles, American Psychological Association PsycInfo, ScienceDirect, and Scopus. We considered a 20-year interval when selecting the articles and we included studies published in English between January 2000 and March 2021. A total of 23 out of 2335 studies satisfied the inclusion criteria. We found that the prevalence of disclosed DV ranged from 4.2% to 48%, with most prevalence estimates between 10% and 20%. Disclosure increases with a detection plan, which is mostly welcomed by mothers (70–80% acceptance rates). Written tools were used in 55% of studies, oral interviews in 40%, and computer instruments in 20%. Mixed forms were used in three studies (15%). The most used and effective tool appeared to be the Conflict Tactics Scale (CTS) (30% of studies). For young children, parental reports are advisable and written instruments are the first preference; interviews can be conducted with older children. Our research pointed out that the current literature does not provide practical clinical clues on facilitating the disclosure in pediatric clinics and CAMHS. Further studies are needed on the inpatient population and in the field of children psychiatry.

Child Psychiatric Patients Exposed to Intimate Partner Violence and/or Abuse: The Impact of Double Exposure

Children's exposure to intimate partner violence (IPV) and child abuse (CA) is strongly related to later psychological problems. Few studies exist on patients in child and adolescent mental health services (CAMHS) who have been singly or doubly exposed to IPV and/or CA. The overall aim of the current study was to compare self-reported psychiatric symptoms, post-trauma impact, and post-traumatic stress disorder (PTSD) diagnoses among CAMHS patients who had been singly or doubly exposed or had reported no family violence (NoFV). We expected to find more severe symptoms in both singly and doubly exposed patients than in the NoFV group and that double exposure was associated with more severe symptoms than single exposure (to IPV or CA). Finally, we expected to find that higher frequencies of exposure to IPV or CA were related to more psychiatric symptoms, greater post-trauma impact, and a higher likelihood of PTSD diagnosis. We compared psychiatric symptoms, post-trauma impact, and PTSD diagnosis in 578 patients aged 9-17 years with NoFV (n = 287), single exposure (n = 162), and double exposure (n = 129). The influence of gender, age, age of onset, frequency, and traumatic interpersonal events outside the family (IPE) were regressed on psychiatric symptoms, post-trauma impact, and PTSD diagnoses. Patients with double exposure had more severe symptoms than the NoFV group, and patients with single exposure had more trauma-related symptoms than the NoFV group. Double exposure was associated with more severe symptoms than single exposure, and frequency (of exposure to IPV and/or CA) and IPE influenced trauma symptoms and psychiatric symptoms, respectively. Exposure to more than one type of violence is associated with more severe symptoms, but other factors such as frequency of violent acts and IPE are important factors to focus on in future studies and clinical assessment.

Violent Discipline Behaviors in Mothers of Preschool Children in Malatya, East Anatolia

Violent parenting behavior, whether physical or psychological, give harms to child well-being. This study was conducted to describe and compare the prevalence of discipline methods used by mothers of 2- to 5-year-old children in Malatya, Turkey. This is a cross sectional study and 552 mothers were administered a face-to-face questionnaire describe the methods they use to discipline their children in the year previous the survey. It was observed that nine of 10 women used violence on their children physically and psychologically. The study showed that nine of 10 mothers used physical and/or psychological punishment toward their children in the previous year. Nonviolent discipline was less prevalent than punitive discipline, such as psychological and physical punishment. The most commonly used method was psychological punishment. Significant sociodemographic associations with discipline methods were found. Mother's educational level, family income, child gender, and child age were the independent predictors that explained discipline methods used by mothers. Starting parenting classes and strengthening the child protection systems at national level were suggested.

Adverse childhood experiences and mental health in adulthood: Evidence from North Carolina

BACKGROUND

About 1.4 million adults in North Carolina (NC) have mental illnesses. Many get no treatment because of mental health care provider shortages. Necessary prevention requires identification of covariates of mental illness.

STUDY OBJECTIVE

We tested the hypotheses: There is no difference in adulthood mental health of the ACE-affected and the unaffected; ACEs do not significantly predict adulthood mental health.

METHODS

ACEs studied were: living with a mentally ill person, an alcoholic, or drug abuser; witnessing violence; having divorced or unmarried parents; and being physically, mentally or sexually abused. We used data from 2012 and 2014 NC Behavioral Risk Factor Surveillance System. We had 19,187 observations with about 13,900 including ACE data. We conducted t- and χ2 tests of mental health differences between ACE-affected and unaffected and regression analysis to determine mental health predictors.

RESULTS

ACE distribution was: 26.2% had parents or adults swearing at- or insulting them; 25% had divorced or unmarried parents; 22.6% lived with an alcoholic; 15.7% witnessed their parents beat each other; 13.8% lived with a mentally ill person; and 13.6% were hit or beaten by an adult in the home. Respondents also reported being touched sexually (9.4%); living with an adult who abused drugs (7.9%); and 4.1% were forced to have sex. The ACE-affected experienced significantly (p < 0.001) more days of poor mental health and had a higher likelihood of depression diagnosis than the unaffected. ACEs are statistically significant predictors of poor mental health in adulthood.