A Cumulative Risk Model of Child Physical Maltreatment Potential: Findings From a Community-Based Study

A roller coaster of emotions. A content analysis of experiences and evaluations of hospitalization after birth

BACKGROUND

Most new parents spend the first few days with their newborns in the hospital.

PROBLEM

Although negative hospital care experiences can have short- and long-term negative consequences (e.g., risk of postnatal depression), only a handful of studies have investigated experiences of maternity care after birth.

AIM OF THE STUDY

The aim was to gather more detailed information on the experiences during the immediate postpartum period at the maternity ward, in order to confirm and complement previous findings with additional data sources.

METHODS

A content analysis was conducted on 524 textual units comprising ratings of maternity care units in Germany provided by mothers or accompanying individuals. These units were sourced from a publicly accessible website.

FINDINGS

The analysis identified three overarching themes that influenced positive or negative experiences: Hospital and Maternity Ward Infrastructure; Midwifery, Medical, and Nursing Care; and Breastfeeding and Establishing a Breastfeeding Relationship.

DISCUSSION

The findings indicate systemic challenges within the medical system, including persistent issues such as staff shortages and overworked personnel. Additionally, critical primary support structures related to early parental mental health care and breastfeeding initiation were found to be lacking in certain hospitals.

CONCLUSION

These results underscore the necessity for structural reforms within hospitals to establish a comprehensive prevention network capable of early problem detection and intervention.

Known groups validity of the SPARK36: To guide nurse-led consultations for the early detection of child developmental and parenting problems

AIM

Early detection of child developmental and parenting problems is important for timely prevention. The SPARK36 (Structured Problem Analysis of Raising Kids aged 36 months) is a novel broad-scope structured interview guide aimed at assessing parenting concerns and needs for support for child developmental and parenting problems, using the parental and professional's (Youth Health Care nurses) perspective. The applicability of the SPARK36 in practice was already demonstrated. Our aim was to evaluate its known groups validity.

DESING/METHODS

SPARK36 data were collected in a cross-sectional study in 2020-2021. The known groups validity was assessed by testing two hypotheses: the SPARK36 risk assessment shows a higher risk of parenting and child developmental problems in children (1) from parents with a lower socioeconomic status and (2) from families with ≥4 risk factors for child maltreatment. To test the hypotheses, Fisher's exact tests were applied.

RESULTS

In total, 29 Youth Health Care nurses from four School Health Services performed SPARK36-led consultations with 599 parent-child pairs to assess the risk for child developmental and parenting problems. Both hypotheses were accepted at a significant p level.

CONCLUSION

The results of the known groups validity support the hypothesis that the SPARK36 risk assessment for child developmental and parenting problems is carried out in a valid way. Future research is needed to assess other aspects of the validity and reliability of the SPARK36.

IMPACT

This is a first step in validating the instrument for use during a nurse-led consultation with parents of 3-year-olds in Flemish School Health Services. Thereby, SPARK36 supports the nurses in accomplishing their assignment, making a risk assessment, and contributes to quality of care.

PATIENT OR PUBLIC CONTRIBUTION

This study aimed to evaluate the known groups validity of the SPARK36. Therefore, it was not conducted using input from the public or the patient population.

Early detection of risk for maltreatment within Dutch preventive child health care: A proxy-based evaluation of the long-term predictive validity of the SPARK method

BACKGROUND

For effective prevention of child maltreatment, it is crucial that risk factors for child maltreatment are identified as early as possible. In the Dutch preventive child healthcare, the SPARK-method is used for this purpose.

OBJECTIVE

The current study investigated the predictive validity of the SPARK-method for predicting child protection activities, as a proxy for child maltreatment, and whether the estimation can be improved with an actuarial module.

PARTICIPANTS AND SETTING

Participants included a community sample of 1582 children of approximately 18-months-old for whom the SPARK was administered during well-child visits at home (51 %) or at the well-baby clinic (49 %).

METHODS

SPARK measurements were linked to data on child protection orders and residential youth care over a 10-year follow-up period. The predictive validity was evaluated using Area Under the receiver operating characteristic Curve (AUC) values.

RESULTS

Results showed good predictive validity for the SPARK clinical risk assessment (AUC = 0.723; large effect). The actuarial module led to a significant improvement in predictive validity (AUC = 0.802; large effect), z = 2.05, p = .04.

CONCLUSION

These results show that the SPARK is suitable for estimating the risk of child protection activities and that the actuarial module is a valuable addition. The SPARK can be used to support professionals in preventive child healthcare with their decision on appropriate follow-up actions.

Risk, Emotional Support, Child Abuse Potential, and Parenting During the First Year of the COVID-19 Pandemic

The COVID-19 pandemic and associated mitigation efforts created stress that threatened parent and child well-being. Conditions that increase stress within families heighten the likelihood of child abuse, but social support can mitigate the impact. This short-term investigation considered whether cumulative risk, COVID-19 specific risk, and emotional support (one aspect of social support), were associated with child abuse potential during the pandemic. Additionally, we investigated whether emotional support moderated the association between COVID-19 specific risk and child abuse potential, and associations between child abuse potential and emotionally positive and emotionally negative parenting. Participants included 89 parents, from a metropolitan area with a large number of economically distressed families, who completed online questionnaires. COVID-19 specific risk and emotional support each explained additional variance in child abuse potential beyond cumulative risk, but emotional support did not moderate the association between COVID-19 specific risk and child abuse potential. Consistent with expectations, child abuse potential was negatively associated with emotionally positive parenting and positively associated with emotionally negative parenting practices. Results highlight the importance of addressing both risks and supports at multiple levels for parents during times of stress.

Cumulative vulnerabilities and smoking abstinence: A test from a randomized clinical trial

Smoking cessation is often associated with socioeconomic and intrapersonal vulnerabilities such as psychopathology. Yet, most research that focuses on predicting smoking cessation outcomes tends focus on a small number of possible vulnerabilities. In a secondary data analysis, we developed and empirically evaluated a comprehensive, cumulative vulnerability risk composite reflecting psychologically based transdiagnostic processes, social determinants of health, and psychopathology. Participants were adult smokers who responded to study advertisements (e.g., flyers, newspaper ads, radio announcements) for an in-person delivered 4-session smoking cessation trial (N = 267; 47% female; Mage = 39.4, SD = 13.8). Results indicated that the decline in point prevalence abstinence (PPA) from quit week to 6-month post-quit was statistically significant (p < .001). There were statistically significant effects of cumulative risk score on the intercept (p < .001) and slope (p = .01). These findings were evident in unadjusted and adjusted (controlling for sex, treatment condition, and nicotine dependence) models. The present results indicate smokers with greater cumulative vulnerability demonstrated poorer smoking cessation outcomes. There may be clinical advantages to better understanding cumulative vulnerability among treatment-seeking smokers and other smoking populations to enhance the impact of public health efforts to reduce smoking.

Average treatment effect of maternal prenatal tobacco smoking on offspring developmental vulnerability in early childhood

BACKGROUND

Early childhood developmental vulnerability has been closely related to the predictors of relatively good health, social and educational outcomes later in adulthood. However, the impacts of prenatal tobacco exposure on childhood developmental vulnerability have been rarely examined. Further, a few of the studies that have investigated maternal prenatal tobacco smoking and child developmental vulnerability have reported mixed results and there are currently no published estimates derived from causal epidemiological methods.

METHODS

We conducted a retrospective population-based cohort study on the association between maternal prenatal tobacco smoking and developmental vulnerability in children born in Western Australia (WA). De-identified individual-level maternal, infant and birth records were obtained from the Midwives Notification System (MNS), a statutory record of all births in WA. WA register for Developmental Anomalies (WARDA) were also obtained from the WA Data Linkage. Records on early childhood developmental vulnerability at the median age of 5 years were obtained from the Australian Early Development Census (AEDC). We used a doubly robust estimator to estimate the causal effects.

RESULTS

Complete data were available for 64,558 mothers-children's pairs. Approximately 16% of children were exposed to maternal prenatal tobacco smoking. Children exposed to maternal prenatal tobacco smoking were more likely to be classified as developmentally vulnerable/at-risk on the physical health and wellbeing (RR = 1.40, 95%CI:1.36-1.45), social competence (RR = 1.42, 95%CI: 1.38-1.47), emotional maturity (RR = 1.34, 95%CI:1.30-1.39), language and cognitive skills (RR = 1.50, 95%CI:1.45-1.54), and communication skills and general knowledge (RR = 1.37, 95%CI:1.33-1.42) domains.

CONCLUSION

Maternal prenatal exposure to tobacco may influence early childhood developmental vulnerability. Early intervention to quit tobacco smoking before becoming pregnant could potentially reduce later childhood developmental vulnerability on multiple domains.

Child abuse and neglect in Brussels during the COVID-19-lockdown

BACKGROUND

It is likely that the circumstances during the COVID-19-lockdown in Belgium increased the incidence and prevalence of child abuse and neglect (CAN) due to exacerbated risk factors and new COVID-19-related stressors. However, traditional reporters had less contact with children which could lead to undetected cases of CAN.

OBJECTIVE

Gain insight into the number and profile of CAN reports filed to the Brussels Confidential Center of Child Abuse and Neglect (CCCAN) during the COVID-19-lockdown.

PARTICIPANTS AND SETTING

A dataset comprising 536 CAN reports from periods before (N = 442) and during the lockdown (N = 94).

METHODS

Characteristics about the report, reporter, victim and his/her family, perpetrator(s) and the trajectory with the CCCAN were registered. The number and characteristics of reports during the lockdown were compared to those of reports before the lockdown.

RESULTS

The number of advisory questions (p = .506, d = .377) and allegations (p = .095, d = 1.206) remained unchanged. During the lockdown, the risk assessment of advisory questions was higher (p = .011, d = .280), they evolved more into social exigency investigations (p < .001, φ = .246) and were referred more often to judicial authorities (p = .010, φ = .163). Allegations were filed more often by the helpline, police and judicial authorities (p < .001, φ = .590) during the lockdown and involved more Dutch-speaking (p = .016, φ = .166) victims.

CONCLUSIONS

The number of CAN reports remained the same during the lockdown but their profile changed.

The more developmental assets, the less internet gaming disorder? Testing the cumulative effect and longitudinal mechanism during the COVID-19 pandemic

The COVID-19 pandemic has triggered the dramatical development and prosperity of online games, while worldwide people are suffering from it. Considering the high prevalence, serious impacts, and huge development potential of internet gaming disorder (IGD), it is extremely necessary to develop a protective model to prevent and intervene with it among young people. Based on the developmental assets theory, the present study adopted a two-wave longitudinal design to evaluate the cumulative effects of developmental assets on IGD, as well as the underlying mechanisms during this specific period. Data were collected from a sample of 1023 adolescents in Hubei province, Central China through self-report questionnaires. The results indicated that (1) developmental assets were negatively associated with adolescents' IGD concurrently and longitudinally; (2) the overall developmental assets had cumulative effects in linear patterns on adolescents' IGD, concurrently and longitudinally; and (3) internal developmental assets mediated the relationship between external developmental assets and adolescents' IGD longitudinally. Theoretically, the present study supports the developmental assets theory and expands the literature about developmental assets and IGD in younger generations. Practically, the present study provides guidance for prevention and intervention of IGD among adolescents during and after the COVID-19 pandemic. Comprehensive measures should be taken to assist in developing positive internal and external resources to promote youth thriving.

[Responding to children's emotional and cognitive needs: Applying the cumulative model to the general population]

OBJECTIVES

Several risk factors are associated with neglectful behaviors. Yet their cumulative effect, which refers to the accumulation of risk regardless of the presence or absence of specific factors, remains unknown. This study aims to determine whether risk accumulation predicts caregivers' responses to children's emotional and cognitive needs in the general population and to examine the presence of clinical thresholds.

METHOD

A total of 1102 maternal figures of children aged 5 to 9 years old living in Quebec were questioned through a telephone survey. The response to children's emotional and cognitive needs was measured using a validated version of the Parent-Report Multidimensional Neglectful Behavior Scale. Ten individual, family and socioeconomic risk factors were combined to compute a cumulative risk index.

RESULTS

Results indicate that the cumulative index predicts the response to children's emotional and cognitive needs in the general population. This effect is observed for families exposed to at least two risk factors and it increases considerably when risk exposure reaches 5 factors.

CONCLUSIONS

This study supports the cumulative risk hypothesis, which until now had mainly been examined in vulnerable or clinical samples. It fosters a better statistical understanding of contexts compromising an optimal response to school age children's emotional and cognitive needs in the general population. This breakthrough is particularity important considering the challenges of identifying children at risk of having their needs neglected.

Association between early risk factors and level of functioning at age seven in children at familial risk for schizophrenia or bipolar disorder - The Danish High Risk and Resilience Study VIA 7

Background

Facing multiple risk factors, relative to single risk factor exposure early in life can have great implications for negative child development.

Objective

We aim to examine whether the prevalence of early risk factors is higher among children with familial high risk for schizophrenia or bipolar disorder compared to controls. Further, to investigate the association between number of early risk factors and level of functioning at age seven, and whether this possible association is different in children with familial high risk compared to controls.

Method

The Danish High Risk and Resilience Study VIA 7 is a population-based cohort study of children of parents diagnosed with schizophrenia (N = 202), bipolar disorder (N = 120) and controls (N = 200). We conducted a semi-structured anamnestic interview with the child’s primary caregiver to assess early risk factors from pregnancy to age four. We used the Children’s Global Assessment Scale to measure level of functioning at age seven.

Results

13 out of 17 risk factors were more prevalent in children at familial high risk for schizophrenia and 7 out of 17 risk factors were more prevalent in children at familial high risk for bipolar disorder compared to controls. Level of functioning decreased 2.7 (95% CI, 2.2; 3.3)-points per risk factor, but the association was not significantly different across the three groups (p = 0.09).

Conclusions

Our results showed that children at age seven with familial high risk for schizophrenia or bipolar disorder experience a greater number of early risk factors. A higher number of early risk factors were associated with lower level of functioning at age seven. However, the association is not different for children with familial high risk or controls.

Exploring the Contribution of Proximal Family Risk Factors on SLC6A4 DNA Methylation in Children with a History of Maltreatment: A Preliminary Study

The cumulative effects of proximal family risk factors have been associated with a high number of adverse outcomes in childhood maltreatment, and DNA methylation of the serotonin transporter gene (SLC6A4) has been associated with child maltreatment. However, the relationships between proximal family risk factors and SLC6A4 methylation remains unexplored. We examined the association among cumulative family risk factors, maltreatment experiences and DNA methylation in the SLC6A4 gene in a sample of 33 child victims of maltreatment. We computed a cumulative family risk (CFR) index that included proximal family risk factors, such as drug or alcohol abuse, psychopathology, parents’ experiences of maltreatment/abuse in childhood, criminal history, and domestic violence. The majority of children (90.9%) experienced more than one type of maltreatment. Hierarchical regression models suggested that the higher the CFR index score and the number of maltreatment experiences, and the older the children, the higher the SLC6A4 DNA methylation levels. Although preliminary, our findings suggest that, along with childhood maltreatment experiences per se, cumulative proximal family risk factors are seemingly critically associated with DNA methylation at the SLC6A4 gene.

Validation and further development of a risk assessment instrument for child welfare

BACKGROUND

Although many child maltreatment risk assessment instruments have been implemented in child welfare organizations, thorough studies on their predictive validity are scarce.

OBJECTIVE

To examine (1) the predictive validity of a risk assessment instrument that has been widely implemented in the Netherlands, and to examine (2) whether the actuarial risk estimation could be improved and simplified to widen the instrument's applicability to different organizations serving different populations.

PARTICIPANTS AND SETTING

The sample comprised risk assessments (N = 3,681) performed for families enrolled at one of five child welfare agencies in the Netherlands between January 2015 and December 2017.

METHODS

In a follow-up period of at least one year, child maltreatment was operationalized as whether or not child protection orders, residential care, or hotline reports occurred. Area Under the Curve values were calculated to determine the predictive accuracy of the risk classifications. Chi-square Automatic Interaction Detection was used to develop a new risk classification based on a new cumulative risk variable.

RESULTS

The original risk classification and the newly developed and simplified risk classification showed a similar discriminative accuracy for the different outcome measures: Area Under the Curve values were .68 and .69 for child protection orders, .62 and .63 for residential care, and .58 and .60 for hotline reports, respectively.

CONCLUSIONS

The original and new risk classification of the instrument had a medium predictive validity with the latter being simpler, more widely applicable, and based on more valid risk factors.

Stress and parenting during the global COVID-19 pandemic

BACKGROUND

Stress and compromised parenting often place children at risk of abuse and neglect. Child maltreatment has generally been viewed as a highly individualistic problem by focusing on stressors and parenting behaviors that impact individual families. However, because of the global coronavirus disease 2019 (COVID-19), families across the world are experiencing a new range of stressors that threaten their health, safety, and economic well-being.

OBJECTIVE

This study examined the impacts of the COVID-19 pandemic in relation to parental perceived stress and child abuse potential.

PARTICIPANTS AND SETTING

Participants included parents (N = 183) with a child under the age of 18 years in the western United States.

METHOD

Tests of group differences and hierarchical multiple regression analyses were employed to assess the relationships among demographic characteristics, COVID-19 risk factors, mental health risk factors, protective factors, parental perceived stress, and child abuse potential.

RESULTS

Greater COVID-19 related stressors and high anxiety and depressive symptoms are associated with higher parental perceived stress. Receipt of financial assistance and high anxiety and depressive symptoms are associated with higher child abuse potential. Conversely, greater parental support and perceived control during the pandemic are associated with lower perceived stress and child abuse potential. Results also indicate racial and ethnic differences in COVID-19 related stressors, but not in mental health risk, protective factors, perceived stress, or child abuse potential.

CONCLUSION

Findings suggest that although families experience elevated stressors from COVID-19, providing parental support and increasing perceived control may be promising intervention targets.

Stress and parenting during the global COVID-19 pandemic

BACKGROUND

Stress and compromised parenting often place children at risk of abuse and neglect. Child maltreatment has generally been viewed as a highly individualistic problem by focusing on stressors and parenting behaviors that impact individual families. However, because of the global coronavirus disease 2019 (COVID-19), families across the world are experiencing a new range of stressors that threaten their health, safety, and economic well-being.

OBJECTIVE

This study examined the impacts of the COVID-19 pandemic in relation to parental perceived stress and child abuse potential.

PARTICIPANTS AND SETTING

Participants included parents (N = 183) with a child under the age of 18 years in the western United States.

METHOD

Tests of group differences and hierarchical multiple regression analyses were employed to assess the relationships among demographic characteristics, COVID-19 risk factors, mental health risk factors, protective factors, parental perceived stress, and child abuse potential.

RESULTS

Greater COVID-19 related stressors and high anxiety and depressive symptoms are associated with higher parental perceived stress. Receipt of financial assistance and high anxiety and depressive symptoms are associated with higher child abuse potential. Conversely, greater parental support and perceived control during the pandemic are associated with lower perceived stress and child abuse potential. Results also indicate racial and ethnic differences in COVID-19 related stressors, but not in mental health risk, protective factors, perceived stress, or child abuse potential.

CONCLUSION

Findings suggest that although families experience elevated stressors from COVID-19, providing parental support and increasing perceived control may be promising intervention targets.

Stress and parenting during the global COVID-19 pandemic

BACKGROUND

Stress and compromised parenting often place children at risk of abuse and neglect. Child maltreatment has generally been viewed as a highly individualistic problem by focusing on stressors and parenting behaviors that impact individual families. However, because of the global coronavirus disease 2019 (COVID-19), families across the world are experiencing a new range of stressors that threaten their health, safety, and economic well-being.

OBJECTIVE

This study examined the impacts of the COVID-19 pandemic in relation to parental perceived stress and child abuse potential.

PARTICIPANTS AND SETTING

Participants included parents (N = 183) with a child under the age of 18 years in the western United States.

METHOD

Tests of group differences and hierarchical multiple regression analyses were employed to assess the relationships among demographic characteristics, COVID-19 risk factors, mental health risk factors, protective factors, parental perceived stress, and child abuse potential.

RESULTS

Greater COVID-19 related stressors and high anxiety and depressive symptoms are associated with higher parental perceived stress. Receipt of financial assistance and high anxiety and depressive symptoms are associated with higher child abuse potential. Conversely, greater parental support and perceived control during the pandemic are associated with lower perceived stress and child abuse potential. Results also indicate racial and ethnic differences in COVID-19 related stressors, but not in mental health risk, protective factors, perceived stress, or child abuse potential.

CONCLUSION

Findings suggest that although families experience elevated stressors from COVID-19, providing parental support and increasing perceived control may be promising intervention targets.

Cumulative socio-contextual risk and child abuse potential in parents of young children: Can social support buffer the impact?

Child abuse potential refers to characteristics and practices closely linked to child abuse. Past investigations document that the number of risk factors parents experience is a correlate of child abuse potential. The purpose of this investigation was to test a model with multiple domains of risk including cumulative socio-contextual risk, parenting locus of control, children's externalizing behavior problems, social support, and child abuse potential. Using self-report data from eighty-seven mothers of children between the ages of 1-5 years old, bivariate correlations and linear regression analyses revealed that cumulative socio-contextual risk was positively associated with child abuse potential and that this association remained statistically significant when controlling for parenting locus of control and child externalizing behavior problems. Additionally, social support moderated the association between cumulative risk and child abuse potential.

Establishing clinically and theoretically grounded cross-domain cumulative risk and protection scores in sibling groups exposed prenatally to substances

BACKGROUND

Prenatal substance exposure is associated with neurodevelopmental deficits. Deficits are exacerbated by cumulative risks yet attenuated by cumulative protective factors. Cross-domain relative to intra-domain risk exposure presents more neurodevelopmental challenges. Cumulative risk and protection scores must be clinically and theoretically grounded, with cross-domain considerations.

OBJECTIVES

1) Create clinically and theoretically grounded, cross-domain cumulative risk and protection scores; 2) Describe the benefits of our methodological approach.

PARTICIPANTS & SETTING

This study included three sibling groups (N = 8) at Mothercraft's Breaking the Cycle, a child maltreatment prevention and early intervention program for substance using mothers and their children.

METHOD

We outlined the process of establishing clinically and theoretically grounded, cross-domain cumulative risk and protection scores. Total and cross-domain cumulative risk and protection percentages, and the balance between domains of risk and protection, were explored.

RESULTS

Clinically and theoretically grounded, cross-domain cumulative risk and protection scores were established. Total percentages were reported. Cross-domain profiles of cumulative risk and protection, and the number of significant domains of risk relative to protection, were reported. The cross-domain profiles facilitated consideration of intra- and inter-domain risk and protection within and between sibling groups.

CONCLUSIONS

Emerging patterns indicate the importance of establishing cumulative risk and protection scores that are: 1) clinically and theoretically grounded, 2) cross-domain, and 3) encompass cumulative protection and risk. In understanding profiles of risk and protection, we can inform evidence-based early interventions that address: 1) high-risk children, 2) the full range of risks, 3) vulnerable domains, and 4) protective factors.

Exploring the interrelatedness of risk factors for child maltreatment: A network approach

BACKGROUND

Theories on the etiology of child maltreatment generally focus on the interaction between multiple risk and protective factors. Moreover, the quadratic model of cumulative risk describes a threshold at which the risk of child maltreatment increases exponentially, suggesting a synergistic effect between risk factors.

OBJECTIVE

This study explored the interrelatedness of risk factors for child maltreatment.

PARTICIPANTS AND SETTING

The sample consisted of risk assessments performed for both high-risk families (n = 2,399; child protection services) and lower risk families (n = 1,904; community outreach services).

METHODS

Network analyses were performed on parental risk factors. Three networks were constructed: a cross-sample network, a high-risk network, and a lower risk network. The relations between risk factors were examined, as well as the centrality of each risk factor in these networks. Additionally, the networks of the two samples were compared.

RESULTS

The networks revealed that risk factors for child maltreatment were highly interrelated, which is consistent with Belsky's multi-dimensional perspective on child maltreatment. As expected, risk factors were generally stronger related to each other in the high-risk sample than in the lower risk sample. Centrality analyses showed that the following risk factors play an important role in the development of child maltreatment: "Caregiver was maltreated as a child", "History of domestic violence", and "Caregiver is emotionally absent".

CONCLUSIONS

We conclude that studying the interrelatedness of risk factors contributes to knowledge on the etiology of child maltreatment and the improvement of both risk assessment procedures and interventions for child maltreatment.

Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample

BACKGROUND

Adverse childhood experiences (ACE) are associated with an array of health consequences in later life, but few studies have examined the effects of ACEs on women's birth outcomes.

METHODS

We analyzed data gathered from a sample of 1848 low-income women who received services from home visiting programs in Wisconsin. Archival program records from a public health database were used to create three birth outcomes reflecting each participant's reproductive health history: any pregnancy loss; any preterm birth; any low birthweight. Multivariate logistic regressions were performed to test the linear and non-linear effects of ACEs on birth outcomes, controlling for age, race/ethnicity, and education.

RESULTS

Descriptive analyses showed that 84.4% of women had at least one ACE, and that 68.2% reported multiple ACEs. Multivariate logistic regression analyses showed that cumulative ACE scores were associated with an increased likelihood of pregnancy loss (OR = 1.12; 95% CI = 1.08-1.17), preterm birth (OR = 1.07; 95% CI = 1.01-1.12), and low birthweight (OR = 1.08; 95% CI = 1.03-1.15). Additional analyses revealed that the ACE-birthweight association deviated from a linear, dose-response pattern.

CONCLUSIONS

Findings confirmed that high levels of childhood adversity are associated with poor birth outcomes. Alongside additive risk models, future ACE research should test interactive risk models and causal mechanisms through which childhood adversity compromises reproductive health.

Unpacking the Associations Among Maltreatment, Disengagement Coping, and Behavioral Functioning in High-Risk Youth

Given the association between child maltreatment and a host of negative behavioral consequences, there remains a need to continue to identify mechanisms underlying this association as a means of improving intervention efforts. The present study examined one potential mechanism, namely, disengagement coping. We asked 6- to 17-year-old maltreated ( n = 249) and comparison ( n = 133) youth questions about emotional experiences that induced sadness and anger, strategies they used to cope with those emotions, and behavioral functioning (i.e., behavioral problems and aggression). Maltreated adolescents reported higher levels of behavioral problems and aggression relative to comparison adolescents, and adolescents who disengaged from emotional situations reported more behavioral problems relative to those who did not disengage. Tests of mediation suggested that, for adolescent-age youth, part of the association between maltreatment status and behavioral problems was explained by disengagement. In children, maltreatment was not associated with disengagement or behavioral problems. Results have implications for understanding age-related differences in the emotional and behavioral consequences of maltreatment.

Typologies of intimate partner violence-maternal parenting and children's externalizing problems: The moderating effect of the exposure to other forms of family violence

Typologies of IPV and parenting practices in mothers who experienced police-reported IPV remain surprisingly unexplored, in addition to how those typologies are linked with children's externalizing problems. Using data from 162 Portuguese mother-child dyads with a police or child protection services referral of IPV, this study aimed to: (a) identify IPV-parenting typologies; (b) test the associations between typologies and children's externalizing problems, and (c) examine the moderating effect of children's exposure to other forms of family violence in those associations. Using a person-centered approach, two IPV-parenting typologies were found: a spillover typology, with high levels of physical, psychological, and sexual violence and high levels of harsh and inconsistent parenting practices; and a compartmentalized typology, with high levels of physical, psychological, and sexual violence and lower ineffective parenting practices. Results also showed that externalizing symptoms (reported by mothers and teachers) were significantly lower in children of mothers in the compartmentalized typology compared to those in the spillover typology. Children's direct exposure to other forms of family violence moderated this association. Findings suggested that children with a high exposure to other forms of family violence showed the highest levels of externalizing problems when their mothers were classified into the spillover typology, and they exhibited the lowest levels of externalizing problems when their mothers were classified in the compartmentalized typology.

Childhood physical maltreatment with physical injuries is associated with higher adult psychopathology symptoms

BACKGROUND

Previous research has neglected the distinction between childhood physical maltreatment (CPM) behaviors and the physical sequelae resulting from CPM. Prior empirical work has combined CPM behaviors (e.g., beat, hit with a belt) and CPM physical sequelae (e.g., bruises, fractures) into a single conceptual category to predict adverse psychological consequences in adults. This is preventing the examination whether specific subgroups of CPM exposure may report a higher risk of psychopathology symptoms in adulthood. The aim of this study was to examine whether distinct experiences of CPM histories (no physical maltreatment, physical maltreatment only, and physical maltreatment with physical sequelae) would be differentially associated with specific psychopathology dimensions in adulthood. symptoms METHOD: Data were drawn from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect (N = 941). Participants completed the Childhood History Questionnaire and the Brief Symptom Inventory.

RESULTS

Three groups were created based on participants' experience of CPM assessed by the Childhood History Questionnaire. Participants who reported that suffered physical sequelae of the CPM exhibited significantly higher symptoms in all psychopathology dimensions than participants with no history of CPM and participants that were exposed to physical maltreatment without sequelae.

CONCLUSIONS

These findings suggest that clinicians should discriminate CPM behavior from CPM physical sequelae in order to increase effectiveness of mental health treatment with adults with history of CPM. Our findings are discussed in light of the evolutionary-developmental frameworks of adaptative development and cumulative risk hypothesis.

Cognitive-affective depression and somatic symptoms clusters are differentially associated with maternal parenting and coparenting

BACKGROUND

Both depressive and somatic symptoms are significant predictors of parenting and coparenting problems. However, despite clear evidence of their co-occurrence, no study to date has examined the association between depressive-somatic symptoms clusters and parenting and coparenting. The current research sought to identify and cross-validate clusters of cognitive-affective depressive symptoms and nonspecific somatic symptoms, as well as to test whether clusters would differ on parenting and coparenting problems across three independent samples of mothers.

METHOD

Participants in Studies 1 and 3 consisted of 409 and 652 community mothers, respectively. Participants in Study 2 consisted of 162 mothers exposed to intimate partner violence. All participants prospectively completed self-report measures of depressive and nonspecific somatic symptoms and parenting (Studies 1 and 2) or coparenting (Study 3).

RESULTS

Across studies, three depression-somatic symptoms clusters were identified: no symptoms, high depression and low nonspecific somatic symptoms, and high depression and nonspecific somatic symptoms. The high depression-somatic symptoms cluster was associated with the highest levels of child physical maltreatment risk (Study 1) and overt-conflict coparenting (Study 3). No differences in perceived maternal competence (Study 2) and cooperative and undermining coparenting (Study 3) were found between the high depression and low somatic symptoms cluster and the high depression-somatic symptoms cluster.

CONCLUSIONS

The results provide novel evidence for the strong associations between clusters of depression and nonspecific somatic symptoms and specific parenting and coparenting problems. Cluster stability across three independent samples suggest that they may be generalizable. The results inform preventive approaches and evidence-based psychotherapeutic treatments.

Developmental delay and emotion dysregulation: Predicting parent-child conflict across early to middle childhood

Cumulative risk research has increased understanding of how multiple risk factors impact various socioemotional and interpersonal outcomes across the life span. However, little is known about risk factors for parent-child conflict early in development, where identifying predictors of change could be highly salient for intervention. Given their established association with parent-child conflict, child developmental delay (DD) and emotion dysregulation were examined as predictors of change in conflict across early to middle childhood (ages 3 to 7 years). Participants (n = 211) were part of a longitudinal study examining the development of psychopathology in children with or without DD. Level of parent-child conflict was derived from naturalistic home observations, whereas child dysregulation was measured using an adapted CBCL-Emotion Dysregulation Index. PROCESS was used to examine the conditional interactive effects of delay status (typically developing, DD) and dysregulation on change in conflict from child ages 3 to 5 and 5 to 7 years. Across both of these timeframes, parent-child conflict increased only for families of children with both DD and high dysregulation, providing support for an interactive risk model of parent-child conflict. Findings are considered in the context of developmental transitions, and implications for intervention are discussed. (PsycINFO Database Record