Early physical abuse and later violent delinquency: a prospective longitudinal study

Gender Differences in Co-developmental Trajectories of Internalizing and Externalizing Problems: A 7-Year Longitudinal Study from Ages 3 to 12

The co-occurrence of externalizing and internalizing problems is acknowledged, but gender differences remain unclear. The present study examines gender differences in the longitudinal relationships between conduct and emotional problems throughout childhood. The sample, drawn from the ELISA project, included 2368 children (48.1% girls; ages 3-12). Latent growth curve models were employed to analyze the trajectories of parent-reported conduct problems and emotional symptoms separately, while parallel process latent growth curve models were utilized to compare joint trajectories. The decrease in conduct problems was consistent for girls, but not for boys. High initial emotional symptoms predicted a slower increase in emotional symptoms over time for girls. Parental positivity was a protective factor for conduct problems in girls. Grandiose-deceitful traits were more related to conduct problems in girls, while callous-unemotional traits were related to emotional symptoms in boys. This study highlights the importance of considering gender in childhood conduct and emotional problems.

Program Evaluation of the radKIDS® Youth Personal Empowerment Safety Education Program

Developing sound evidence of program effectiveness can be difficult for many programs initiated by schools and communities, and impedes many beneficial programs from broader dissemination. This paper shares results of an evaluation approach used with a bullying and victimization prevention program with elementary school children called the radKIDS® Personal Empowerment and Safety Education Program. The purpose of this study was to examine indicators of initial effectiveness of the radKIDS® program for elementary school child safety skill development and instructor training to reduce child victimization and associated trauma and empower healthy psychosocial child development. The study involved 330 active radKIDS® instructors surveyed during two separate two-week periods, resulting in 148 completed questionnaires (45%). Instructors rated their perceptions of what children effectively learned in radKIDS®, the effectiveness of instructor training, and on Social Emotional Learning (SEL) competencies addressed in the program. Evaluation findings confirmed the theoretical model of the program, and that the developmental safety domains impacting children in radKIDS® differs from those in other bullying prevention interventions focused on SEL and other competencies. Recommended areas of improvement for the program included making training less time consuming and more flexible in delivery, provide more practice opportunities and time on skill acquisition during training, and increase supervision and guidance during program implementation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-024-00618-5.

The Profile and Characteristics of Young People Accessing Recently Implemented Community Forensic Child and Adolescent Mental Health Services (F:CAMHS) in Northern Ireland

Children under the age of 18 who are known to forensic child and adolescent mental health services often present with complex psychosocial and behavioural needs that are elevated compared with those in the general youth population. The Forensic Child and Adolescent Mental Health Service for Northern Ireland (FCAMHSNI) was commissioned in 2014 to support these children. Despite almost a decade of implementation, the profile and characteristics in the service remain under-analysed, impeding service improvement and making international comparisons more difficult. The primary aim of the current study was to address the regional gaps in how the needs of those accessing FCAMHSNI are understood. A secondary aim was to capture comparable data. Data on 107 accepted referrals are included in the analyses. The majority of cases within this time period were male (81.1%, n = 86) and the majority of presenting behaviours were related to violence and aggression 62.3% (n = 48). However, some forms of violence, such as harmful sexual behaviour, was relatively low when compared with other jurisdictions. Specific demographic characteristics such as gender and religious background appeared to be significant risk factors for referral to the service. Almost all of the sample are known to have experienced at least one potentially traumatic event (95.2%) and in more than one-third of cases, service users presented with co-morbid issues (35.6%, n = 37). These observations are discussed. This study adds to the growing international literature around the needs of forensically involved youth and helps to inform future service development and provision.

Applying a Racial Lens to the "Cycle of Violence"

One overlooked result in a 1989 Science paper on the "cycle of violence" was a race-specific increase in risk for arrest for violence among Black maltreated children, but not White maltreated children. We examine whether race differences in the cycle of violence are explained by risk factors traditionally associated with violence. Using a prospective design, maltreated and non-maltreated children were matched on age, sex, race, and approximate family social class and interviewed at mean age 28.7 years (N = 1196). Arrest histories were obtained through age 50.5. Regression analyses included maltreatment, race, self-reported violent behavior, and risk factors (e.g., family, school, neighborhood variables). For arrests for violent crime, race was a significant predictor, whereas childhood maltreatment was not significant. For violent arrests, there was a significant race × maltreatment interaction when the total number of risk factors were included controlling for self-reported violent behaviors. For self-reported violent behaviors, childhood maltreatment remained significant for some risk factors. However, race did not predict self-reported violent behaviors. Offending behavior and traditional risk factors did not explain the disproportionate arrests among Black maltreated children. This disparity in the cycle of violence may reflect complex processes influenced by racial bias or structural racism.

The effects of a defendant's childhood physical abuse on lay support for sentencing: The moderating role of essentialism

Research suggests that a defendant's history of experiencing childhood abuse, and its effects on their life and later decision-making, may impact public support for a defendant's sentencing, particularly mitigation. However, no existing research has examined how and why sentencing support may vary based on the time period when the abuse occurs during a defendant's childhood. This experiment, using a sample of the U.S. public (N = 400), examines how the age at which a defendant's childhood physical abuse occurs affects lay support for the goals of their sentencing. We hypothesized that participants with higher levels of social and biological trait essentialism would moderate their increased support for more punitive sentencing goals-particularly when a defendant was abused earlier, rather than later, in childhood. Results suggest that social essentialism is associated with increased support for restoration and rehabilitation toward defendants with histories of childhood physical abuse, potentially indicating that the public views the effects of child abuse as more of a social, versus biological, process which may affect support for utilitarian punishment goals.

Investigating Trauma Symptomology as a Mediator of the Relationships Between Childhood Maltreatment and Sexual and Non-Sexual Delinquency

Maltreatment is a risk factor for both sexual and non-sexual delinquency. Little is known about how specific forms of maltreatment relate to the distinct offending outcomes. Though trauma symptoms have been associated with maltreatment and delinquency, the intervening role of trauma symptoms in pathways from maltreatment to offending is not well understood. The goal of the current study was to test social learning and general strain theory explanations for sexual and non-sexual delinquency in adolescence, exploring trauma symptoms as a mediator between the four major types of maltreatment and offending outcomes. Data were collected via surveys of 136 incarcerated youth at seven residential treatment and community corrections facilities in a Midwestern state. Confirmatory factor analysis (CFA) was used to establish a measurement model, and structural equation modeling was employed to test direct and indirect pathways from maltreatment to offending. Individual forms of maltreatment had differential relationships with offending outcomes, with neglect having a significant association with non-sexual delinquency, and sexual abuse having a significant direct relationship with sexual delinquency. Trauma symptomology did not mediate these relationships. Future research should explore developmentally appropriate proxies for measuring childhood trauma. Practice and policy should consider the role of maltreatment victimization history in the inception of delinquency behaviors, prioritizing therapeutic alternatives to detention and incarceration.

How a defensive mindset develops from early adverse experiences and guides antisocial outcomes

Dante Cicchetti has had a lasting impact on our understanding of the development of externalizing psychopathology through at least two seminal contributions, including establishment of the field of developmental psychopathology and assertion of the hypothesis that early physical abuse and neglect trigger a cascade of maladaptive outcomes across the life course. These ideas have guided a program of research on children's deviant social information processing and defensive mindset as the psychological mechanisms through which early physical abuse leads to long-term psychopathology. Longitudinal studies following children from early life through mid-adulthood show that physical abuse in the first five years of life leads children to adopt a defensive mindset that, in turn, cascades into long-term outcomes of externalizing psychopathology, incarceration, and dysfunction. Cicchetti's ideas have also guided the development of preventive interventions to interrupt this life course.

Association Between Child Maltreatment and Aggression in Chinese Early Adolescents: The Mediating Role of Irritability

Child maltreatment (CM) is a major global public health issue, and a strong association exists between CM and aggression. However, the underlying mechanism of this association has not been understood to date. The objective of this study was to explore the mediating role of irritability in the association between CM and aggression in Chinese early adolescents. A cross-sectional study was conducted using a self-report questionnaire to evaluate the levels of CM, aggression, and irritability in 5,724 middle school students from the Anhui Province, China. Structural equation modeling was used to test the hypothesis of the mediating effect of irritability on the relationship between CM and aggression. We further investigated gender differences in this association using multiple group analyses. CM was positively related to both irritability and aggression, and irritability was positively associated with aggression (p < .01). The mediating effects of irritability between CM and aggression were significant (β = .107, 95% confidence intervals [CI]: 0.077-0.133, p < .05). Males had a higher indirect effect size of the pathway from CM to aggression via irritability compared with females. Overall, irritability was a crucial mediator in the relationship between CM and aggression in Chinese adolescents, and males were more prone to engage in aggression compared with females through the pathway of irritability. Therefore, early irritability characteristics should be carefully monitored in adolescents, and they should be provided adequate support to acquire critical emotion regulation skills.

Risk and Protective Factors for African American Kinship Caregiving: A Scoping Review

Background

African American children are disproportionately placed in kinship care, specifically with kin caregivers who have pressing service needs given their relatively poor physical and mental health, and low economic status. Kinship caregivers often face challenges, however, they also show resilience when raising relative children. Although the literature has examined risk and protective factors that affect kinship caregiving, no scoping review has been conducted to summarize these factors as they relate to African American kinship caregivers.

Objectives

This study aims to summarize the risk and protective factors that affect African American kinship caregiving.

Methods

Twenty-six studies were identified from this scoping review. A data template was used to extract information on data/sample, research methods, and risk and protective factors.

Results

This review found that the risk and protective factors in the identified studies can be summarized into four types: child, caregiver, relationship, and legal, cultural or social issues. Caregiver factors were examined from the perspective of physical and behavioral health, parenting, and resources. The most common risk factors were caregivers' low social economic status or great financial need, and caregivers' physical health. The most common protective factor was caregivers' spirituality or religion.

Discussion

This review helps to better understand the risk and protective factors for African American kinship caregivers. Policies should be informed by African American kinship caregivers' unique qualities to provide useful cultural solutions. Evidence based interventions should be developed and provided to African American kinship caregivers to improve their parenting abilities and to provide them with additional resources and supports. Implications for child welfare research are also presented.

The Epidemiology of Violence Exposure in Children

Exposure to violence remains a significant issue for children in the United States. The COVID-19 pandemic exacerbated many of these exposures. Violence unequally impacts children of color and lesbian, gay, bisexual, transgender, and questioning youth. Pediatricians can and must continue to advocate and intervene to decrease pediatric violence exposure and its effects.

The impact of child maltreatment on mental health outcome improvements among children and youth accessing community mental health care

BACKGROUND

Although children with histories of maltreatment are more likely to engage with mental healthcare than non-maltreated children, few studies have examined the impact of maltreatment on children's mental health outcome improvement over time.

OBJECTIVE

The current study addresses this gap in the present literature by exploring the ways that histories of physical, sexual, and emotional abuse and exposure to domestic violence can influence children's improvement on mental health outcomes commonly associated with trauma.

PARTICIPANTS AND SETTING

De-identified routine care data from 58 community mental health agencies across Ontario, Canada, representing 16,517 children was obtained. This data represented assessments that occurred between February 2015 and December 2021.

METHODS

General linear models were used to illustrate the effect of each trauma type on change scores computed between baseline and follow-up assessments of externalizing behaviours, risk of harm to others, depressive symptoms, risk of suicide and self-harm, and anxiety, while adjusting for baseline scores, inpatient status, time between assessments, and select demographic variables.

RESULTS

When the effects of each trauma type was considered separately, children without histories of trauma consistently showed greater improvement than those with that trauma across all mental health outcomes (0.07-0.44, p < 0.01). When all trauma types were considered together, sexual abuse was associated with some of the most significant negative impacts on children's mental health improvements.

CONCLUSIONS

Our findings highlight an urgent need for the implementation of standardized, evidence-based assessments that screen trauma histories of children accessing mental health supports and research examining the impact of trauma on children's treatment responsiveness.

The Suitability of the Childhood Trauma Questionnaire in Criminal Offender Samples

Adverse childhood experiences (ACEs) are common in community samples and are associated with various dysfunctional physical, psychological, and behavioral consequences. In this regard, criminal offenders are at specific risk, considering their elevated ACE rates compared with community samples and the associations of ACEs with criminal behaviors. However, assessing ACEs in offender samples by self-reports has been criticized with regard to their validity and reliability. We examined the suitability of ACE-self-reports using the Childhood Trauma Questionnaire (CTQ) in a sample of 231 male offenders involved in the German criminal justice system by comparing self-reported to externally rated ACEs to externally rated ACEs based on the information from the offenders' criminal and health-related files and on interviews conducted by forensically trained psychological/psychiatric experts. The accordance between self-ratings and expert ratings was examined considering mean differences, correlations, inter-rater agreement measures, and regression analyses. Offenders themselves reported a higher ACE burden than the one that was rated externally, but there was a strong relationship between CTQ self-assessments and external assessments. However, associations were stronger in offenders seen for risk assessment than in those evaluated for criminal responsibility. Overall, the CTQ seems suitable for use in forensic samples. However, reporting bias in self-reports of ACEs should be expected. Therefore, the combination of self-assessments and external assessments seems appropriate.

Childhood abuse and anxiety, depression - An interprofessional approach to optimize knowledge and awareness among young adult health professions students of Arunachal Pradesh, India

BACKGROUND

Child abuse is a major public health concern with deep rooted squeal events on adult mental health. The childhood negligence and abusive events is connected invariably with anxiety and depressive disorders in adult life.

OBJECTIVES

The study focused to determine the prevalence of child abuse, and connection of child abuse with depression and anxiety in course of adulthood, and to evaluate the effect of Interprofessional approach on the knowledge and awareness on child abuse and legal polices among young adult students of health professions in Arunachal Pradesh, India.

PARTICIPANTS AND SETTING

Four hundred sixty-one young adult health professions students from Tomo Riba Institute of Health and Medical Sciences (TRIHMS) and related health sciences institutes in the Itanagar capital complex region of Arunachal Pradesh between age group of 18-25 years.

METHODS

A semi structured self-administered questionnaire was adopted to measure the prevalence of child abuse, Patient Health Questionnaire-9 (PHQ-9) questionnaire to grade the severity of depression and Generalized Anxiety Disorder-7 (GAD-7) questionnaire to grade severity of anxiety. Interprofessional intervention interactive sessions with a psychologist, psychiatrist, and advocate were held after pre-test. Before and after the intervention, the participants' awareness and knowledge on various types of child abuse& negligence and legal policies were assessed.

RESULTS

The overall prevalence of child abuse in any form was 73.42 %. Physical abuse was the most frequent form, accounting for 65.26 %, followed by childhood negligence (62.63 %), emotional abuse (53.15 %), and sexual abuse (23.42 %). Higher incidence of psychological distress with depression (80 %) and anxiety (55.52 %) was observed in participants with previous history of childhood abuse. There was a significant improvement in the knowledge and awareness on various forms of child abuse and negligence (p < 0.05) and legal policies (16.05 % before intervention, 85.90 % after intervention) (p < 0.05) after intervention sessions with interprofessional members.

CONCLUSIONS

The interprofessional interactive sessions exhibited significant improvement in the knowledge and awareness in terms of child abuse and policies in all domains. Utmost need and necessity of including implementation of interprofessional intervention interactive sessions or counselling program in academic institutions specially in developing states where there is a lack of awareness and easy access to services.

General Offending and Intimate Partner Violence Perpetration in Young Adulthood: A Dutch Longitudinal Study

This study examines the relationship between general offending and intimate partner violence (IPV) perpetration in young adulthood, using a Dutch longitudinal study. Young adults were followed over four waves, and self-reported data on general offending, IPV perpetration, and a number of individual characteristics were collected. Results of random effects models demonstrated that young adults involved in more diverse offending behavior reported higher levels of different types of IPV perpetration, even when individual factors were taken into account. Moreover, logistic regression analyses showed that general offending was also related to an increased likelihood of continuity in IPV perpetration. Taken together, the findings indicate that it is useful to view IPV perpetration as part of a broader criminal career.

Trauma Cue-Elicited Alcohol Craving as a Function of Adult Versus Childhood-Onset Interpersonal Traumatic Events in Young Adult Drinkers

OBJECTIVE

Childhood trauma may influence risk for alcohol use disorder and posttraumatic stress disorder through negative and positive reinforcement drinking. Laboratory studies evaluating childhood trauma in relation to these phenotypes are limited.

METHOD

This study examined the influence of childhood index traumas on responses to trauma and alcohol cues among 184 college students (50.0% female) endorsing lifetime interpersonal trauma and current weekly alcohol use. Participants' subjective alcohol craving and distress were measured in response to four narrative (trauma vs. neutral) and beverage (alcohol vs. water) cue combinations.

RESULTS

Forward-fitted linear mixed-effects models indicated main effects of childhood index traumas on distress (β= 6.151, p = .001) and craving (β = 0.656, p = .023), wherein individuals with childhood index traumas showed evidence of elevated levels of distress and craving. Childhood index trauma interacted with the narrative cue to predict distress (β = -10.764, p = .002), wherein individuals with childhood index traumas showed greater levels of distress to the neutral cue, and individuals with adult index traumas showed greater levels of distress to the trauma cue. Childhood index trauma interacted with the beverage cue to predict craving (β = -0.599, p = .011), wherein childhood index traumas were associated with greater levels of craving to neutral cues. Childhood index trauma did not significantly interact with the beverage cue to predict distress or the narrative cue to predict craving (ps > .05).

CONCLUSIONS

Childhood trauma may be more relevant to positive rather than negative reinforcement aspects of alcohol use disorder during young adulthood.

Is Violence, Violence no Matter Where it Strikes? Adjudicated Boys, Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide

This study explores treating violence against others as a precursor to self-directed violence. It tests the utility of including violence against others in the measure of acquired capability to test assumptions from the interpersonal theory of violence. Four theoretical hypotheses are assessed that are consistent with the theory: (1) thwarted belongingness (parental abandonment and rejection) and perceived burdensomeness (exposure to parental interpersonal violence and child abuse) independently increase the likelihood of suicidal ideation; (2) the interaction of thwarted belongingness and perceived burdensomeness increases the likelihood of suicidal ideation controlling for other pertinent variables; (3) the three-way interaction of thwarted belongingness, perceived burdensomeness, and acquired capability (violence against others and prior suicidal attempts) increases the likelihood of suicidal attempts controlling for other pertinent variables; and (4) self-harm responds to the theoretical variables and similarly, to attempts. Subjects are court-adjudicated males (ages 13-18) who were residents for up to 1 year at the Ocean Tides School and rehabilitation center from 1975-2019. The data span 44 years and include 2195 youth. Depression, drug/alcohol use, race, ethnicity, socioeconomic status, and interaction terms between SES and race and SES and ethnicity are also examined. Backward conditional logistic regression analyses find mixed support for the hypotheses, but strong support for including violence against others in the concept of acquired capability. Support is also found for conceptualizing child abuse and exposure to parental interpersonal violence as perceived burdensomeness in tests of this theory as well as measures of depression. Major implications for programming in the treatment and rehabilitation of delinquent boys include conceptualizing and approaching violence against others as a precursor to suicidal attempts and other self-directed harm.

Does Trauma Exacerbate Criminal Behavior? An Exploratory Study of Child Maltreatment and Chronic Offending in a Sample of Chinese Juvenile Offenders

(1) Background: Maltreated children are at increased risk for juvenile delinquency. Extant research has explored the effect of child maltreatment on either the initial risk of juvenile delinquency or general juvenile recidivism. However, little is known regarding the effect of child maltreatment on chronic offending. (2) Methods: Using a sample of 695 male juvenile offenders incarcerated in a centralized juvenile reformatory of the province X located in Southwest China, this study investigates both the prevalence of child maltreatment and the effect of child maltreatment on chronic offending among the juvenile offenders. Descriptive statistical analyses and multinomial logistic regression were utilized to conduct the analyses. (3) Results: A vast majority of the juvenile offenders experienced at least one type of child maltreatment. Moreover, maltreatment was generally found to be more prevalent in chronic offenders than in one-time offenders and recidivists. Results from a series of logistic regression analyses revealed that among five specific maltreatment types, only physical abuse exerted a statistically significant and positive impact on chronic offending. (4) Conclusions: The findings highlight the importance of providing early prevention and intervention programs to juvenile offenders who were physically abused in order to reduce general chronic offending as well as chronic violent offending.

How Influential are Adverse Childhood Experiences (ACEs) on Youths?: Analyzing the Immediate and Lagged Effect of ACEs on Deviant Behaviors

Although the effect of adverse childhood experiences (ACEs) on antisocial behaviors is well established in the literature, limited research, if any, has analyzed the effect that ACEs have on behaviors at two different times. Limited research also has analyzed the effect that specific ACEs have on deviant behaviors after statistically controlling for respondents' protective factors. This study expands the literature in this area by analyzing in a sample of 555 adolescents the immediate and lagged effect that individual ACEs, and exposure to a number of ACEs, have on three deviant behaviors after controlling for respondents' protective factors not previously examined in ACEs studies. Results obtained from multivariate logistic regression models revealed that stealing things was predicted by being hit hard, being sexually molested, and having lived with a depressed or suicidal individual; and receiving threats over the internet predicted physical fights. Only being hit hard and living with an alcoholic had a lagged effect on smoking marijuana. Results also showed that the protective factors of school connection, anger management skills, and parental supervision reduced the effect of ACEs on the behaviors analyzed. Research, theory, and policy implications are discussed.

A meta-analysis of childhood maltreatment in relation to psychopathic traits

Psychopathy is a personality disorder characterized by a mix of traits belonging to four facets: affective (e.g., callous/lack of empathy), interpersonal (e.g., grandiosity), behavioral instability (e.g., impulsivity, poor behavioral controls), and social deviance (e.g., juvenile delinquency, criminal versatility). Several scholars have argued that early childhood maltreatment impacts the development of psychopathy, although views regarding its role in the four facets differ. We conducted a meta-analysis including 47 studies comprising a total of 389 effect sizes and 12,737 participants, to investigate the association between psychopathy and four types of child maltreatment: physical abuse, emotional abuse, neglect, and sexual abuse. We found support for a moderate link between overall psychopathy and childhood physical abuse, emotional abuse, and neglect, as well as overall childhood maltreatment. The link between psychopathy and childhood sexual abuse was small, but still statistically significant. These associations were stronger for the behavioral and antisocial facets than for the affective and interpersonal facets of psychopathy, but nearly all associations were statistically significant. Our findings are consistent with recently developed theories on the role of complex trauma in the development of severe personality disorders. Trauma-focused preventive and therapeutic interventions can provide further tests of the trauma-psychopathy hypothesis.

Effects of maltreatment during childhood on benign and malicious envy in adulthood: Psychological resilience as a moderator

We explored the effect of two forms of maltreatment of children (emotional and physical) on two kinds of envy in adulthood (benign and malicious), and the moderating role of psychological resilience in these associations. Participants were 676 Chinese undergraduates who completed the Childhood Trauma Questionnaire, the Benign and Malicious Envy Scale, and the Connor-Davidson Resilience Scale. The results indicate that of the two types of childhood maltreatment, only emotional maltreatment negatively predicted benign envy and positively predicted malicious envy. Psychological resilience played a moderating role in the childhood emotional maltreatment–benign/malicious envy link and childhood physical maltreatment–malicious envy link. These results reveal the direct relationships between different types of childhood maltreatment and benign/malicious envy and the moderating effect of psychological resilience in these associations. Our findings have theoretical and practical implications for cultivating psychological resilience to inhibit malicious envy and promote benign envy in adults.

Childhood Adversity Trajectories and Violent Behaviors in Adolescence and Early Adulthood

Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention.

Disparities by Gender and Race/Ethnicity in Child Maltreatment and Memory Performance

Adverse childhood experiences, which include child maltreatment, are a major public health issue nationally. Child maltreatment has been linked to poorer cognitive functioning, which can start in childhood and persist into adulthood. However, studies examining the potential disparities by gender and race/ethnicity are lacking. The aim of this study was to assess the gender and racial/ethnic disparities in the association between child maltreatment and memory performance. Data were obtained from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health (N = 11,624). Weighted multiple linear regression models were used to assess the associations between sexual abuse, physical abuse, neglect, and child maltreatment score and memory. Models were stratified by gender, race, and ethnicity. Men who were exposed to sexual abuse, neglect and two or three child maltreatment types scored one to three points lower (β = -1.44; 95% CI: -2.83, -0.06; β = -2.41; 95% CI: -3.75, -1.08; β = -3.35; 95% CI: -5.33, -1.37; β = -2.31; 95% CI: -3.75, -0.86) in memory performance compared to men who did not report sexual abuse, neglect, or child maltreatment, respectively. Black respondents who were exposed to sexual abuse scored two points lower (β = -1.62; 95% CI: -2.80, -0.44) in memory performance compared to Black respondents who did not report sexual abuse. Among Other race and Hispanic respondents, those who reported neglect scored four points lower (β = -4.06; 95% CI: -6.47, -1.66; β = -4.15; 95% CI: -5.99, -2.30) in memory performance, respectively, compared to their counterparts who did not report neglect. Gender- and racial/ethnic-responsive memory performance interventions addressing child maltreatment may be beneficial for affected populations.

Public policy and parent-child aggression: Considerations for reducing and preventing physical punishment and abuse

Parent-child physical aggression, including both physical punishment and abuse, remains a prevalent problem in the United States. In this paper, we briefly review the prevalence and harms of parent-child aggression and discuss changes in social norms and policies over the past several decades. Then, we discuss broad social policies influencing risk for parent-child physical aggression, policies relevant to reducing and preventing physical abuse, and policies relevant to reducing and preventing physical punishment. We close by considering future directions to strengthen research and evaluation and accelerate progress toward ending parent-child physical aggression.

Childhood Maltreatment, Blood Lead Levels, and Crime and Violence: A Prospective Examination

BACKGROUND

Research has shown that maltreated children are at increased risk for subsequent crime and violence and are more likely to reside in neighborhoods with a high likelihood of lead exposure. Other literature has reported associations between childhood lead exposure and antisocial and criminal behavior. Little is known about the relationships among childhood maltreatment, adult lead exposure, and crime and violence.

METHODS

As part of a prospective longitudinal study of the long-term consequences of childhood maltreatment, children with documented histories of abuse and neglect and demographically matched control children (ages 0-11 years) were followed into adulthood and interviewed. Participants included 556 individuals who had valid blood lead level (BLL) measures at a mean age of 41.2 years. Participants had a mean age of 50.5 (SD = 3.53) years at the time of the last criminal history check used to determine the number of arrests.

RESULTS

Childhood maltreatment predicted a higher number of arrests for any crime and any violence after the blood was collected but not higher BLLs in adulthood. There were significant paths from adult BLLs to arrests after the blood was collected, despite controlling for age, sex, race, and IQ and the inclusion of individual- and neighborhood-level socioeconomic status, and paths from neighborhood socioeconomic status to higher BLLs in models predicting any arrest and any violent arrest after the blood was collected.

CONCLUSIONS

These findings demonstrate how environmental toxins such as lead can affect outcomes in adulthood, including crime, and provide evidence that links neighborhood disadvantage to higher BLLs in adulthood.

Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters

Posttraumatic stress symptoms (PTSS) are associated with both childhood physical abuse (CPA) and antisocial (AS) traits, yet their potential as mediators of the CPA-AS traits link is understudied and the specific roles of individual symptom clusters in this relation is unknown. The current study aimed to examine the mediational role of PTSS in the relation between CPA and AS traits in a sample of low-income African American women with histories of intimate partner violence (IPV). It was hypothesized that avoidance would emerge as a significant mediator, whereas reexperiencing, numbing, and hyperarousal would not. Participants (N = 150) were recruited from a level-1 trauma public hospital and evaluated as part of a randomized controlled trial of a group therapy intervention for low-income, African American women suicide attempters with histories of IPV. The Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale (PDS), and International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were used to measure variables of interest. Using bootstrapping analyses, a parallel mediation model compared PTSS clusters as potential mediators of the CPA-AS traits relation, controlling for IPV. When reexperiencing, avoidance, numbing, and hyperarousal were entered simultaneously as potential mediators, only avoidance emerged as a significant mediator of the CPA-AS traits link. Avoidance symptoms may play a unique role in the link between early experiences of CPA and later AS traits among multiply traumatized African American women. Findings have implications for understanding AS traits in the context of early life trauma and suggest that targeting specific PTSS clusters (e.g., avoidance) may improve treatment outcomes for women in this population.

An investigation into the association between cannibalism and serial killers

The aim of the current study was to compare and contrast non-cannibalistic and cannibalistic serial killers. Using case study data, the present study assessed common patterns among the life histories of cannibalistic serial killers compared to those of a control sample of serial killers that did not commit cannibalism. These include but are not limited to childhood experiences, socio-economic status, biological abnormalities and life events. Results indicated that factors that may differentiate cannibals from non-cannibals likely result from childhood influences, rather than influences at the time of the kill. Findings may be used to identify potential warning signs or triggers for cannibalistic behaviour.

Violent Victimization and Violence Perpetration Among American Indian Adolescents

In the current study, we propose an integrative approach, which will incorporate elements from the social learning and self-control theories of delinquency and crime to examine violence in an understudied, marginalized, and often discriminated subpopulation group-American Indian youth. The analysis is based on survey data collected between 2009 and 2013 from a sample of American Indian adolescents (N = 3,380) enrolled in 27 school districts located in five regions of the United States (Northern Plains, Southwest, Upper Great Lakes, Southeast/Texas, and the Northeast). The main objective of the analysis is to identify the factors more likely to predict violent offending among American Indian adolescents, a vulnerable group that has an elevated risk of violent victimization. Results of the Tobit regression analysis indicate that in both gender groups a low level of self-control, association with delinquent friends, poor school performance, and underage alcohol consumption significantly predict violence perpetration. Nonetheless, experience with direct violent victimization has the largest effect on male and female adolescents' violent behavior. Although living with both biological parents and childhood exposure to domestic violence do not influence significantly the adolescents' aggressive behavior, parental monitoring does have a significant violence-deterrent effect in both gender groups. Findings suggest that more opportunities should be created for indigenous communities to control their education systems and ensure American Indian students achieve academic success, which is one of the violence protective factors identified in this study. Moreover, measures meant to prevent youth violence in American Indian communities should also focus on parents/caregivers who, directly and indirectly, have the capacity to reduce the adolescents' risk of becoming victims and/or perpetrators of violence.

"An uncomfortable topic": Health professionals' perspectives on child protection capacities, training offers and the potential need for action in Germany

Background

Child maltreatment, due to its high prevalence and often long-lasting (health and/or psycho-social) consequences, is one of the main reasons for global health inequalities. The medical field offers many opportunities to support affected children. This gives physicians and other health professionals the opportunity to provide protective measures and therapies to affected children at an early stage. However, the level of training concerning child protection is often too low among health professionals. This can affect the quality of care as well as providing the appropriate treatment and thus, the long-term (health) burden. The present work aims to survey the state of knowledge and capacities of health professionals regarding child protection in medicine and elicit health professionals' perspectives who absolved a child protection online course on a potential need for action in Germany.

Methods

From June 2016 until February 2021, 3,360 health professionals were interviewed. Using quantitative and qualitative items, the questionnaire assessed demographic and professional background information as well as assessments regarding the awareness of child protection, abilities in child protection among health professionals and training offers in medicine.

Results

The analysis indicates that the topic of child protection in medicine is not as present as the high prevalence of child maltreatment would imply. The majority (94.0%; n = 3.159) of the health professionals stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the health professionals assessed the importance of the issue of child protection as low among health professionals. The reasons cited included child protection as an uncomfortable topic, an unwillingness among managers, and a lack of training on the topic.

Conclusions

There is too little awareness and importance regarding child protection in the medical field in Germany. Hence, it is difficult to ensure adequate care for those affected. Child protection topics should be mandatory in the training curricula of all health professionals, and quality standards for prevention and intervention should be implemented in medical institutions. Furthermore, networking in child protection has to be improved, and medical campaigns should address the topic to sensitize health professionals and society to the issue and to destigmatize the topic.

The interRAI Child and Youth Suite of Mental Health Assessment Instruments: An Integrated Approach to Mental Health Service Delivery

Various biological, social, psychological, and environmental factors impact children and youth living with mental health problems across their lifespan. To meet the wide-ranging challenges of mental illness, service system integration is needed to improve efficiencies and reduce fragmentation. Unfortunately, the mental health system has been plagued by the lack of coordination across services. There is a general consensus that mental health service delivery must ensure a child or youth's needs are addressed in a collaborative, coordinated, and seamless manner. A key element to successful integration is the development of a comprehensive standardized screening and assessment system. Numerous assessments have been developed to assess child mental health and functioning, but they typically have a very narrow focus with limited use and utility. Not only does this reduce the ability to take a life course perspective to mental health, but this uncoordinated approach also results in redundancies in information collected, additional resources, and increased assessor burden for children, youth, and their families. The interRAI child and youth mental health assessment suite was developed in response to the need for an integrated mental health system for young persons. This suite includes screening and assessment instruments for in-patient and community settings, emergency departments, educational settings, and youth justice custodial facilities. The instruments form a mental health information system intentionally designed to work in an integrated fashion beginning in infancy, and incorporate key applications such as care planning, outcome measurement, resource allocation, and quality improvement. The design of these assessment tools and their psychometric properties are reviewed. Data is then presented using examples related to interpersonal trauma, illustrating the use and utility of the integrated suite, along with the various applications of these assessment systems.

Association of aggressivity at adolescence and criminality to severe assault exposure among former adolescent psychiatric inpatients

This study investigated the associations of adolescent aggression, and criminality, to severe hospital-treated assault exposures among young adults (n = 508) with a history of adolescent psychiatric inpatient treatment between 2001-2006. Participants were interviewed during hospitalization using K-SADS-PL to assess psychiatric disorders, and to obtain information on aggressivity. Data on crimes committed were obtained from the Finnish Legal Register Centre, and the treatment episodes for assault exposures from the Finnish National Care Register for Health Care, up to end of 2016. Predictors for severe assault exposure were male sex (OR = 2.1), short temperedness (OR = 2.4), non-violent offending (OR = 2.6), and violent offending (OR = 4.8). These results indicate that the participants most vulnerable to severe assaults were those suffering from a continuum of aggressivity across their lifetime. Our findings can be utilized to identify adolescents at risk of severe assault exposure, and to reduce this risk by focusing on appropriate treatments for these vulnerable adolescents.

Risk of Injury to Others: The Development of an Algorithm to Identify Children and Youth at High-Risk of Aggressive Behaviours

Youth violence is considered one of the most preventable causes of morbidity and premature mortality. Various risk factors have previously been identified, however, there is presently a crucial need to develop effective decision-support tools in order to identify children and youth at increased risk for violence. The current study utilised data collected from the interRAI Child and Youth Mental Health Screener (ChYMH-S), within the province of Ontario, to develop and validate a methodology for the purpose of identifying young persons who were at greater risk of harm to others. Additional data from 59 mental health agencies validated the algorithm, and it was found to be a strong predictor of harmful behaviour toward others. The RIO algorithm provides a valuable decision-support tool with strong psychometric properties that may be used to identify young persons who exhibit signs or symptoms associated with increased likelihood of harm toward others, in order to provide early intervention efforts for these vulnerable youth, thereby reducing the likelihood of future aggressive behaviours.

Neighborhood influences on early childhood behavioral problems: Child maltreatment as a mediator

BACKGROUND

A sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King et al., 2004; Vaillancourt et al., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing and externalizing symptoms via adverse childhood experiences.

OBJECTIVE

This study aims to capture the specific pathways from neighborhood structural factors and process factors to early childhood internalizing and externalizing symptoms.

PARTICIPANTS AND SETTING

The restricted version of the Fragile Family Child Wellbeing Study (FFCWS) dataset at ages 3 and 5 were used, and 2722 children were included in the final model.

METHODS

The Structural Equation Model was used to estimate the pathways from neighborhood structural and process factors to early childhood internalizing (INT) and externalizing (EXT) symptoms. Neighborhood structural factors were measured at the census tract level. Neighborhood collective efficacy, child maltreatment experiences, and early childhood internalizing, and externalizing symptoms were reported by the focal child's mother.

RESULTS

Neighborhood process factors and structural factors showed both direct and indirect effects on early childhood EXT and INT differently. Emotional assault and neglect worked as mediators in this relationship.

CONCLUSIONS

Findings emphasize the importance for researchers and practitioners to involve neighborhood context when assisting children with early childhood behavior problems. Implications for research and interventions are further discussed.

Different forms of childhood maltreatment have different impacts on the neural systems involved in the representation of reinforcement value

Background

The current study aimed to address two gaps in the literature on child maltreatment, reinforcement processing and psychopathology. First, the extent to which compromised reinforcement processing might be particularly associated with either neglect or abuse. Second, the extent to which maltreatment-related compromised reinforcement processing might be associated with particular symptom sets (depression, conduct problems, anxiety) or symptomatology more generally.

Methods

A sample of adolescents (N = 142) aged between 14 and 18 years with varying levels of prior maltreatment participated in this fMRI study. They were scanned while performing a passive avoidance learning task, where the participant learns to respond to stimuli that engender reward and avoid responding to stimuli that engender punishment. Maltreatment (abuse and neglect) levels were assessed with the Childhood Trauma Questionnaire (CTQ).

Results

We found that: (i) level of neglect, but not abuse, was negatively associated with differential BOLD responses to reward-punishment within the striatum and medial frontal cortex; and (ii) differential reward-punishment responses within these neglect-associated regions were particularly negatively associated with level of conduct problems.

Conclusion

Our findings demonstrate the adverse neurodevelopmental impact of childhood maltreatment, particularly neglect, on reinforcement processing. Moreover, they suggest a neurodevelopmental route by which neglect might increase the risk for conduct problems.

Developing Health Lifestyle Pathways and Social Inequalities across Early Childhood

Lifestyles are a long-theorized aspect of social inequalities that root individual behaviors in social group differences. Although the health lifestyle construct is an important advance for understanding social inequalities and health behaviors, research has not theorized or investigated the longitudinal development of health lifestyles from infancy through the transition to school. This study documented children's longitudinal health lifestyle pathways, articulated and tested a theoretical framework of health lifestyle development in early life, and assessed associations with kindergarten cognition, socioemotional behavior, and health. Latent class analyses identified health lifestyle pathways using the US Early Childhood Longitudinal Study - Birth Cohort (ECLS-B; N≈6,550). Children's health lifestyle pathways were complex, combining healthier and unhealthier behaviors and changing with age. Social background prior to birth was associated with health lifestyle pathways, as were parents' resources, health behaviors, and non-health-focused parenting. Developing health lifestyle pathways were related to kindergarten cognition, behavior, and health net of social background and other parent influences. Thus, family context is important for the development of complex health lifestyle pathways across early childhood, which have implications for school preparedness and thus for social inequalities and well-being throughout life. Developing health lifestyles both reflect and reproduce social inequalities across generations.

Trajectories of Psychopathology According to Continuation or Discontinuation of Child Abuse: A Longitudinal Observational Study

Long-term exposure to childhood abuse and occurrence of mental illness are positively correlated. Using long-term tracking data in Korea, we identified the characteristics of children and adolescents who experienced abuse and impact thereof on their psychopathology. Using the Korea Welfare Panel data, 354 teenagers in grades 4–6 of elementary school participated, were assessed at baseline, and monitored 3 years later. They were categorized into Never, Occurrence, Continuation, and Discontinuation groups according to changes in the abuse experienced. Psychopathology was evaluated using K-CBCL. Childhood abuse experience significantly affected psychopathology. At the baseline, the Continuation and Discontinuation groups had a higher severity of psychopathology than the Never group. Psychopathology at the baseline was associated with whether the patient experienced abuse that year. In the follow-up observation, the risk of psychopathology in the Occurrence and Continuation groups was higher than that in the Never group. The Discontinuation group had decreased psychopathology, which was not clinically significant in the follow-up observation (INT aRR = 2.09; 95% CI 0.61–7.13, EXT aRR = 4.23; 95% CI 1.12–16.07). Stopping abuse in late childhood reduces adolescents’ psychopathology in the long term, meaning they can recover their normal developmental trajectory according to risk groups and provide effective interventions including discontinuation of abuse.

The Associations of Polygenic Scores for Risky Behaviors and Parenting Behaviors with Adolescent Externalizing Problems

The current study focused on longitudinal effects of genetics and parental behaviors and their interplay on externalizing behaviors in a panel study following individuals from adolescence to young adulthood. The nationally representative sample of Add Health participants of European ancestry included N = 4142 individuals, measured on three occasions. Parenting was operationalized as experiences with child maltreatment and maternal closeness. Externalizing problems were operationalized as alcohol use, cannabis use, and antisocial behaviors. Genetic effects were operationalized as a polygenic score (PGS) of risky behaviors. The results showed significant effects for child maltreatment, maternal closeness, and PGS, above and beyond other factors and previous levels of externalizing behaviors. Furthermore, maternal closeness was found to negatively correlate with PGS. No significant interaction effects of parenting and PGS were found. The results underscore the joint independent effects of parenting and genetics on the change in externalizing behaviors from adolescence to young adulthood.

Child Maltreatment, School Bonds, and Adult Violence: A Serial Mediation Model

Physically abused youth are vulnerable to experiencing difficulties across multiple domains of school functioning. Most of the literature examining the relationship between child physical abuse (CPA) and adult violence has focused narrowly on academic outcomes rather than taking a broader view that explores the processes undergirding school engagement and connections. The present study adopted Connell's model of school engagement, connectedness and outcomes within a social bond framework to examine (a) the link between CPA and school social bonds, (b) the link between CPA and adult violence persistence, and (c) the mediational (parallel, serial) effects of school bonds (engagement, connection, and achievement) on violence perpetration in adulthood. Consistent with previous research, results indicated that children who experience physical abuse have poorer academic performance, which, in turn, is related to future violent trajectories. We further found that the relationship between CPA and violence persistence is mediated by a process of bonding to school that begins with being actively engaged in school activities and ends with higher levels of academic achievement. In particular, some of the "school achievement" effect found in previous research operates through behavioral and emotional manifestations and may be partly explained through physically abused children's lessened ability to be engaged with and connected to school activities. We conclude with a discussion of the policy implications stemming from our findings.

Assessing Violence Risk in Adolescents in the Pediatric Emergency Department: Systematic Review and Clinical Guidance

Introduction

Violence risk assessment is one of the most frequent reasons for child and adolescent psychiatry consultation with adolescents in the pediatric emergency department (ED). Here we provide a systematic review of risk factors for violence in adolescents using the risk factor categories from the MacArthur Violence Risk Assessment study. Further, we provide clinical guidance for assessing adolescent violence risk in the pediatric ED.

Methods

For this systematic review, we used the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2009 checklist. We searched PubMed and PsycINFO databases (1966–July 1, 2020) for studies that reported risk factors for violence in adolescents.

Results

Risk factors for adolescent violence can be organized by MacArthur risk factor categories. Personal characteristics include male gender, younger age, no religious affiliation, lower IQ, and Black, Hispanic, or multiracial race. Historical characteristics include a younger age at first offense, higher number of previous criminal offenses, criminal history in one parent, physical abuse, experiencing poor child-rearing, and low parental education level. Among contextual characteristics, high peer delinquency or violent peer-group membership, low grade point average and poor academic performance, low connectedness to school, truancy, and school failure, along with victimization, are risk factors. Also, firearm access is a risk factor for violence in children and adolescents. Clinical characteristics include substance use, depressive mood, attention deficit hyperactivity disorder, antisocial traits, callous/unemotional traits, grandiosity, and justification of violence.

Conclusion

Using MacArthur risk factor categories as organizing principles, this systematic review recommends the Structured Assessment of Violence Risk in Youth (SAVRY) risk- assessment tool for assessing adolescent violence risk in the pediatric ED.

The comparative and cumulative impact of different forms of violence exposure during childhood and adolescence on long-term adult outcomes

Violence exposure during childhood and adolescence is associated with a range of negative psychosocial outcomes. Research examining the impact of violence exposure has been limited by the compartmentalization into separate bodies of research (e.g., community violence, domestic violence). There is also a paucity of research examining long-term adult outcomes. Using a large and racially diverse sample (n = 754; male = 58%; Black = 46%), the current longitudinal study aimed to elucidate the comparative and cumulative effect of different types of violence exposure (witnessing vs. victimization) across different locations (home, school, neighborhood) in childhood and adolescence (lifetime through Grade 8) on long-term internalizing, externalizing, and attention problems; substance use; and intimate partner violence in adulthood (age 25). Victimization, but not witnessing violence, predicted all five adult outcomes. Specifically, being victimized at home was associated with the widest range of negative outcomes (internalizing, externalizing, and attention problems), while school victimization was associated with substance use. Further, when youth experienced multiple types of violence across multiple locations (cumulative violence exposure), they experienced a more diverse range of negative outcomes in adulthood (composite score). The current study highlights the stronger effects of violence exposure in more proximal contexts, and how these locations are important for emotional and behavioral development.

The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.

Mediating the Maltreatment-Delinquency Relationship: The Role of Triad Gang Membership

The primary aim of this article is to examine the role of triad affiliation in mediating the relationship between child maltreatment (neglect, punishment, emotional abuse, and sexual abuse) and delinquency among active young gang members in Hong Kong. A sample of 177 gang members aged 12 to 24 was recruited to complete a questionnaire with the assistance of a youth outreach social work team. Neglect was identified as the most common form of maltreatment, followed by emotional abuse, punishment, and sexual abuse. Mediation analyses confirmed that triad affiliation acts as a mediating variable in the child maltreatment-delinquency relationship, except in cases of sexual abuse. Only the relationship between punishment and delinquency was found to be fully mediated by triad affiliation; partial mediation effects were found for neglect and emotional abuse. Recommendations for child protection and youth workers are provided.

Cumulative early childhood adversity and later antisocial behavior: The mediating role of passive avoidance

Twenty-six percent of children experience a traumatic event by the age of 4. Negative events during childhood have deleterious correlates later in life, including antisocial behavior. However, the mechanisms that play into this relation are unclear. We explored deficits in neurocognitive functioning, specifically problems in passive avoidance, a construct with elements of inhibitory control and learning as a potential acquired mediator for the pathway between cumulative early childhood adversity from birth to age 7 and later antisocial behavior through age 18, using prospective longitudinal data from 585 participants. Path analyses showed that cumulative early childhood adversity predicted impaired passive avoidance during adolescence and increased antisocial behavior during late adolescence. Furthermore, poor neurocognition, namely, passive avoidance, predicted later antisocial behavior and significantly mediated the relation between cumulative early childhood adversity and later antisocial behavior. This research has implications for understanding the development of later antisocial behavior and points to a potential target for neurocognitive intervention within the pathway from cumulative early childhood adversity to later antisocial behavior.

Maternal adverse childhood experiences and postpartum depressive symptoms in young, low-income women

OBJECTIVES

Exposure to adverse childhood experiences (ACEs), such as child maltreatment and family dysfunction, is highly prevalent. Previous research has shown an association between ACEs and adult depression. The aim of the current study was to expand the existing literature by testing the association between ACEs and postpartum depression (PPD) symptoms in an urban, ethnically diverse sample of women.

METHODS

Participants (N = 746; ages 18-47; mean age = 27.3) were recruited at a large, urban university medical center as part of the Longitudinal Infant and Family Environment (LIFE) study. The association between ACEs and PPD symptoms were tested via hierarchical linear regression models.

RESULTS

The majority of the participants (61%) reported experiencing at least one type of ACEs prior to age 18. ACEs were positively associated with PPD symptoms (β = .29, p < .001), controlling for maternal race/ethnicity, age, educational attainment, marital status, household income, and infant gender and birth order.

CONCLUSIONS

The results showed that exposure to ACEs was related to PPD symptoms among low-income women. Screenings for ACEs during prenatal checkups may help identify women at risk of depression and facilitate timely prevention and treatment efforts.

Risk and Protective Factors of Child-to-Parent Violence: A Comparison Between Physical and Verbal Aggression

Child-to-parent violence (CPV) is a social problem that remains vastly understudied compared with other forms of family violence. The aim of this study is to identify family and child risk and protective factors of CPV, and to investigate whether they differentially predict physical and verbal parent-directed violence among boys and girls. Predictors include parenting behavior during childhood (physical and verbal violence, warmth, monitoring) and respondents' individual characteristics (suicidal ideation, self-control, problematic substance use). Data were examined from a large representative sample of ninth graders (N = 6,444) in Lower Saxony, Germany. Bivariate analyses showed that female adolescents were more likely to aggress verbally, while no gender differences were found for physical CPV. Multilevel logistic regression models revealed that direct experiences of parental physical and verbal violence during childhood were among the strongest predictors of physical and verbal CPV, both among males and females. While parental monitoring was not significantly associated with CPV, parental warmth protected girls from physical parent-directed aggression. Furthermore, high self-control was protective against verbal CPV as well as boys' physical CPV, while problematic substance use predicted physical violence toward parents in both sexes but only boys' verbal CPV. Suicidal ideation was a risk factor of aggression in males only. Except for parental warmth, the importance of risk and protective factors did not substantially vary across child gender. These findings broaden our understanding of different family and child-related factors that either promote or prevent CPV. Specifically, they point to the importance of the parenting context and especially harsh discipline practices for the occurrence of both physical and verbal CPV.

Child maltreatment and adolescent externalizing behavior: Examining the indirect and cross-lagged pathways of prosocial peer activities

BACKGROUND

There is a well-established relation between child maltreatment and externalizing behaviors in adolescence. A gap in this scientific literature is the identification of pathways, particularly protective pathways, explaining this relation prior to the transition to adulthood.

OBJECTIVE

This study examined the indirect and cross-lagged pathways of peer engagement in prosocial activities to explain the relation between child maltreatment and adolescent externalizing behaviors.

PARTICIPANTS AND SETTINGS

Children and their caregivers (N = 1354) participated in a multi-site, multi-wave, prospective cohort study of child maltreatment in the U.S.

METHODS

Child maltreatment, peer engagement in prosocial activities, and externalizing behaviors were assessed at ages twelve, fourteen, and sixteen. A cross-lagged path model evaluated whether peer engagement in prosocial activities was an indirect pathway of the relation between prior child maltreatment and subsequent externalizing behaviors. Cross-lagged relations were examined to determine directionality of risk among these variables during adolescence.

RESULTS

The path model did not support peer engagement in prosocial activities as an indirect or cross-lagged pathway to externalizing behaviors in adolescence. Instead, prior child maltreatment had a direct relation with greater externalizing behaviors, which had indirect and cross-lagged effects with less peer engagement in prosocial activities at multiple points later in adolescence.

CONCLUSIONS

The degree of peer engagement in prosocial activities may not be a risk or protective pathway to externalizing behaviors in adolescence for those exposed to child maltreatment. In fact, externalizing behaviors appear to limit subsequent engagement with peers in prosocial activities, providing an opportunity for future research and intervention.

Early Physical Abuse and Adult Outcomes

BACKGROUND

Because most physical abuse goes unreported and researchers largely rely on retrospective reports of childhood abuse or prospective samples with substantiated maltreatment, long-term outcomes of physical abuse in US community samples are unknown. We hypothesized that early childhood physical abuse would prospectively predict adult outcomes in education and economic stability, physical health, mental health, substance use, and criminal behavior.

METHODS

Researchers in two multisite studies recruited children at kindergarten entry and followed them into adulthood. Parents completed interviews about responses to the child's problem behaviors during the kindergarten interview. Interviewers rated the probability that the child was physically abused in the first 5 years of life. Adult outcomes were measured by using 23 indicators of education and economic stability, physical health, mental health, substance use, and criminal convictions reported by participants and their peers and in school and court records.

RESULTS

Controlling for potential confounds, relative to participants who were not physically abused, adults who had been abused were more likely to have received special education services, repeated a grade, be receiving government assistance, score in the clinical range on externalizing or internalizing disorders, and have been convicted of a crime in the past year (3.20, 2.14, 2.00, 2.42, 2.10, and 2.61 times more likely, respectively) and reported levels of physical health that were 0.10 SDs lower. No differences were found in substance use.

CONCLUSIONS

Unreported physical abuse in community samples has long-term detrimental effects into adulthood. Pediatricians should talk with parents about using only nonviolent discipline and support early interventions to prevent child abuse.

Family Violence Pathways and Externalizing Behavior in Youth

While studies suggest that youth who experience violence in the home are more likely to engage in externalizing behaviors (e.g., aggression, substance use, rule breaking), research is needed to understand factors that may explain how family violence is linked to externalizing, and whether there may be gender-specific trajectories to this outcome. The present study used a cross-sectional design and multigroup, path analytic modeling to test the degree to which personality traits (negative emotionality, constraint) in boys and girls (Model 1), as well as status offending primarily in girls (Model 2), may help explain relationships between exposure to familial adversity (witnessing family violence and child abuse) and adolescent externalizing behaviors in a mixed-gender, community sample with both caregiver and youth reports (N = 237, 57% female, 10-17 years old). Results indicated that personality traits fully explained the relationship between witnessing family violence and externalizing and partially explained the relationship between child abuse and externalizing among youth. Despite theory suggesting a female-specific trajectory involving status offenses, both models were similarly relevant for boys and girls. These findings have implications for understanding processes by which adverse family circumstances may relate to externalizing behavior in youth. Preliminary suggestions are provided for future longitudinal research, policy changes, and clinical techniques that may be essential in preventing the progression to long-term adverse outcomes among youth.