Child maltreatment, attachment security, and internal representations of mother and mother-child relationships

Interpersonal Mechanisms Between Child Maltreatment Timing and Young Adult Internalizing and Externalizing Symptomatology

OBJECTIVE

Children who experience maltreatment are prone to exhibit interpersonal deficits and lack secure attachment, which can lead to internalizing and externalizing symptomatology. This study investigated timing and chronicity of maltreatment and its impacts on psychopathology outcomes in young adulthood. Two interpersonal mediators were examined: problems with peers and childhood attachment security.

METHOD

Children with and without maltreatment exposure were recruited to take part in a 1-week research summer camp (N = 697; mean [SD] age = 11.29 [0.97] years; 71.3% Black or African American; 50.5% male). Participants were recontacted in young adulthood to complete a second wave of assessments (n = 427; mean [SD] age = 19.67 [1.16] years; 78.0% Black or African American; 48.9% male). Structural equation modeling was used to estimate indirect effects from child maltreatment timing to young adult internalizing and externalizing symptomatology via childhood attachment security and peer problems.

RESULTS

Findings highlighted the detrimental impact of chronic maltreatment, which was associated with higher levels of peer problems (β = .24, p < .001) and less secure attachment (β = -.13, p < .01) in childhood. Also, lower attachment quality in childhood mediated the association between chronic maltreatment and self-reported internalizing (a × b = 0.02, p < .05) and externalizing symptomatology (a × b = 0.02, p < .05). Additionally, childhood peer problems mediated the association between chronic maltreatment and caregiver-reported internalizing problems (a × b = 0.04, p < .05).

CONCLUSION

Chronic maltreatment is particularly harmful for interpersonal outcomes of children. Mediation findings differed by who reported on psychopathology, showing the importance of considering multireporter measures of psychopathology.

PLAIN LANGUAGE SUMMARY

Child maltreatment is an interpersonal stressor that may impact developmental outcomes throughout a youth's life. In this study of 697 children who participated in a 1-week research summer camp and were contacted in young adulthood, the authors found that chronic maltreatment significantly increased the risk of difficulties in forming secure attachments as well as having problems with peers during childhood. In turn, these challenges were linked to emotional and behavioral symptomology in young adulthood. These findings emphasize the need to support children facing chronic maltreatment to improve their long-term mental health.

Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention

Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.

Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation

Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.

Latent classes in preschoolers' internal working models of attachment and emotional security: Roles of family risk

Children's relationships inform their internal working models (IWMs) of the world around them. Attachment and emotional security theory (EST) emphasize the importance of parent-child and interparental relationships, respectively, for IWM. The current study examined (a) data-driven classes in child attachment and emotional security IWM, (b) associations between IWM classes and demographic variables, maltreatment, intimate partner violence (IPV), and maternal depressive symptoms, and (c) consistency in attachment and emotional security IWM classes, including as a function of maltreatment, IPV, and maternal depressive symptoms. Participants were 234 preschool-aged children (n = 152 experienced maltreatment and n = 82 had not experienced maltreatment) and their mothers. Children participated in a narrative-based assessment of IWM. Mothers reported demographics, IPV, and maternal depressive symptoms. Latent class analyses revealed three attachment IWM classes and three emotional security IWM classes. Maltreatment was associated with lower likelihood of being in the secure attachment class and elevated likelihood of being in the insecure dysregulated attachment class. Inconsistencies in classification across attachment and emotional security IWM classes were related to maltreatment, IPV, and maternal depressive symptoms. The current study juxtaposes attachment and EST and provides insight into impacts of family adversity on children's IWM across different family relationships.

Language skills and interpersonal trust in adolescents with and without mental illness

PURPOSE

The primary aim was to compare adolescents with mental illness and non-clinical adolescents on vocabulary, social problem-solving, trust in parents, attachment and mentalisation. A secondary aim was to investigate whether adolescents' language skills were associated with trust in parents.

METHOD

Seventy-eight adolescents (16-18 years) participated in this cross-sectional quantitative study: a clinical sample (n = 28, M = 16.7 years, 19F) recruited from a mental health service and a non-clinical sample (n = 50, M = 17.0 years, 28F). Standardised language measures and self-report measures of trust in parents; communication quality; attachment; and mentalisation were used. Primary and secondary aims were addressed through independent samples t-tests and Pearson's correlation analyses, respectively.

RESULT

Adolescents experiencing mental illness reported significantly poorer vocabulary, less trust in mother/father, greater attachment anxiety/avoidance, and poorer reflective functioning, than non-clinical adolescents. Expressive vocabulary of clinical (but not non-clinical) adolescents significantly negatively correlated with trust in mother (but not father).

CONCLUSION

Results highlight a role for speech-language pathologists (SLPs) in supporting communication needs of adolescents with mental illness. SLPs should consider trust by: i) understanding adolescents with mental illness may have difficulty trusting them potentially impacting therapeutic engagement; and ii) delivering services in ways that might build trust, such as involving adolescents in treatment planning.

Childhood attachment security mediates the effect of childhood maltreatment chronicity on emotion regulation patterns in emerging adulthood

This study uses a 2-wave, longitudinal design to evaluate mother-child attachment security (child-reported) and emotion regulation capacities (wave 1, age 10-12) as mediators linking childhood maltreatment chronicity and emotion regulation (ER) patterns in emerging adulthood (wave 2; N = 399; 48.1% male; 77.2% Black/African-American, 11.3% White, 7.8% Hispanic, 3.8% other race). Children from families eligible for public assistance with and without maltreatment exposure participated in a summer research camp (wave 1) and were recontacted in emerging adulthood (wave 2). SEM results showed that greater maltreatment chronicity predicted lower childhood attachment security, which in turn predicted membership in ER profiles marked by emotion dysregulation and limited access to ER strategies. Greater attachment security predicted membership in adaptive ER profiles in emerging adulthood. Results suggest that insecure attachment is one process by which childhood maltreatment disrupts adaptive ER across development, whereas greater attachment security in childhood can promote multiple forms of adaptive emotion regulation.

The Interaction Effects Between Father-Child Relationship Quality and Parent-perpetrated Maltreatment on Adolescent Behavior Problems

Despite ample evidence supporting the positive and important role fathers play in youth well-being, currently little is known about the potential buffering effects of positive father-child relationships on adolescent behavioral functioning, especially within the context of child maltreatment. Clarifying whether positive parent-child relationships are helpful in the presence of maltreatment perpetrated by the same or another parent is critical for designing and implementing successful family-based interventions for positive youth development. Thus, the present study aimed to investigate the unique and combined effects of the perpetrator of child maltreatment (i.e., maltreatment perpetrated by fathers versus mothers alone) and father-child relationship quality on adolescent internalizing and externalizing problems. A series of Ordinary Least Squares multiple regressions were conducted on a sample of 14-year-old high-risk youth (N = 661) drawn from the Longitudinal Studies of Child Abuse and Neglect. The results indicated that both father-perpetrated maltreatment and mother-alone maltreatment were associated with higher levels of internalizing and externalizing problems. Higher quality of father-child relationships was associated with lower levels of internalizing but was not significantly associated with externalizing problems. Higher quality father-child relationships had a buffering impact against adolescent internalizing and externalizing problems when adolescents were maltreated by mothers alone. The findings suggest that policy and practical efforts seeking to build resilience of youth should strive to nurture and leverage positive, non-maltreating father-child relationships. Such efforts may support the positive development of adolescents, even in the face of mother-perpetrated maltreatment.

Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences

This study examines the differential childhood adversities experienced by two samples of Australian adolescents involved in the juvenile justice system: male youth who had been adjudicated for sexual offences and their counterparts who had been adjudicated for nonsexual violence. The sample is comprised of clients referred to a service that explicitly prioritises cases identified to be high risk, high need, and living in rural or remote areas. Male youth who had committed a sexual offence were more likely than their counterparts to have experienced emotional and sexual abuse and neglect in their childhoods. Alternatively, the childhoods of the comparison group were marked by characteristics of more general household dysfunction. Potential explanations for these findings are provided. The onset of sexual offending is presented as a possible consequence of poor attachment and emotional dysregulation and the impact of vicarious violence, and a chaotic family life are considered in the development of subsequent nonsexual violence. The implications of these findings for both clinical practice and future research are discussed.

Desired attachment and breakup distress relate to automatic approach of the ex-partner

BACKGROUND AND OBJECTIVES

Romantic relationship breakups can lead to severe emotional disturbances including major depression. Anxious attachment and desired attachment with the ex-partner are hypothesized to elicit repetitive thought about the breakup and the former partner and attempts to reunite with (i.e. approach) the ex-partner, which fuel breakup distress. Since prior research on this topic has mostly used survey methodology, the study aim was to examine the relations between above-mentioned variables employing a behavioral measure of approach of the ex-partner.

METHODS

Automatic approach-avoidance tendencies toward the former partner were assessed with an Approach Avoidance Task (AAT). Sixty-two students (76% female) moved a manikin towards or away from stimuli pictures (ex-partner, matched stranger, landscape) as fast as possible based on the stimulus frame color (blue, yellow). Participants also completed questionnaires assessing anxious attachment, desired attachment, repetitive thought about the breakup (rumination) and the ex-partner (yearning), and breakup distress (prolonged grief symptoms).

RESULTS

Anxious attachment related positively to rumination and breakup distress. Desired attachment related positively to yearning, automatic approach bias toward the ex-partner, and breakup distress. Both anxious and desired attachment, rumination, yearning, and approach bias related positively to breakup distress.

LIMITATIONS

The use of a student sample may limit generalizability. A correlational design precludes causal conclusions.

CONCLUSIONS

Together with prior work, results suggests anxious attachment hampers psychological adaptation to a breakup by increasing the use of ruminative coping. Desire to retain an attachment bond with the ex-partner, expressed in yearning and approach of the ex-partner, may also worsen breakup distress.

Intergenerational Trauma: Assessment in Biological Mothers and Preschool Children

Childhood trauma can lead to lifelong detrimental outcomes. Intergenerational trauma should be considered when supporting healthy parent-child relationships. Research is needed on intergenerational trauma in relation to children's negative life event exposure, which could compound intergenerational trauma. We examined the prevalence of and relations between mother and child traumas in a sample of 88 biological mothers and their preschool-aged children. We coded child negative life events to examine those related to intergenerational trauma. Results showed that mother traumas and child negative life events were positively associated; subtypes of mothers' traumas (abuse, neglect) and high trauma levels were associated with higher numbers of child negative life events, including those tied to parent trauma. It is necessary to consider how childhood trauma in adults and children is measured, and what analyses can reveal about the intergenerational context, especially considering compounding current, stressful world events.

Adverse childhood experiences in depression and the mediating role of multimorbidity in mid-late life: A nationwide longitudinal study

BACKGROUNDS

Adverse childhood experiences are co-occurring factors of multimorbidity and depression in mid-late life, but the combined effect of ACEs and multimorbidity on depression over life has not been fully studied.

METHODS

We used data from the China Health and Retirement Longitudinal Study which includes 4,440 middle-aged and older adults. Different types of ACEs experienced up to the age of 17 were assessed based on self-reports. We used parallel process Latent Growth Curve modelling to evaluate the longitudinal mediation role of ACEs, multimorbidity and depression.

RESULTS

People who had more ACEs were found to have a higher level of multimorbidity (intercept: 0.057, 95% CI: 0.031 to 0.079) and depression (intercept: 0.047, 95% CI: 0.013 to 0.076) at the baseline and a faster increase in multimorbidity (slope: 0.107, 95%CI: 0.078 to 0.136) and depression (slope: 0.074, 95%CI: 0.035 to 0.153). The mediation analysis indicated that there was a positive indirect association of ACEs via the multimorbidity intercept with the intercept of depression (0.028, 95%CI: 0.012 to 0.043), and a small negative association with the slope of depression (-0.002, 95%CI: -0.003 to -0.001). We also found a positive indirect association of ACEs via the multimorbidity slope with the intercept (0.035, 95%CI: 0.021 to 0.049) and slope (0.008, 95%CI: 0.004 to 0.011) of depression.

CONCLUSIONS

ACEs were related to higher depression partly via elevated multimorbidity. Public health services and behavioural interventions to prevent and reduce the occurrence of ACEs might help to lower the risk of multimorbidity and depression in later life.

Mentoring Children in Foster Care: Examining Relationship Histories as Moderators of Intervention Impact on Children's Mental Health and Trauma Symptoms

Mentoring-based interventions show promise among children in foster care, but previous research suggests that some benefit more than others. Because children in foster care experience relationship disruptions that could affect mentoring effectiveness, we examined whether children's relational histories at baseline (i.e., relationship quality with birth parents, relationship quality with foster parents, caregiver instability, and previous mentoring experience) moderated the impact of a mentoring intervention on children's mental health, trauma symptoms, and quality of life. Participants included 426 racially and ethnically diverse children (age: 9-11; 52% male) who participated in a randomized controlled trial of the Fostering Healthy Futures program (FHF), a 9-month one-to-one mentoring and skills group intervention. Results showed that relationship quality with foster parents and prior mentoring experience did not moderate intervention impact. Relationship quality with birth parents and caregiver instability pre-program, however, moderated the effect on some outcomes. The impact on quality of life was stronger for children with weaker birth parent relationships and fewer caregiver changes. Likewise, the impact on trauma symptoms was stronger for those with fewer caregiver changes. Overall, FHF seems to positively impact children with varied relational histories, yet some may derive more benefits - particularly those with fewer caregiver changes pre-program.

Intergenerational trauma: Parental PTSD and parent-reported child abuse subtypes differentially relate to admission characteristics in the autism inpatient collection

Autistic youth experience high rates of maltreatment. Little research has considered how distinct abuse dimensions differentially relate to meaningful outcomes, nor taken an intergenerational approach to consider how caregiver trauma and child maltreatment are related. This study sought to identify how parent-reported child abuse subtypes and parent posttraumatic stress disorder (PTSD) relate to each other and to admission characteristics upon inpatient service entry. Autistic youth (N = 527; 79% White, 21.3% girls, mean age = 12.94 years) participated in the autism inpatient collection. Parents reported on child abuse subtypes (physical, sexual, emotional) and their own PTSD, child behavior and emergency services, and parenting stress. Youth of parents with PTSD were nearly three times more likely to have parent-reported physical and emotional abuse. Autistic girls were more likely to experience parent-reported sexual abuse and a higher number of subtypes. Lower income related to higher rates of parent-reported child emotional abuse and parent PTSD. Emotional abuse associated with child behavior whereas both child physical and emotional abuse related to emergency services. Reported parent PTSD associated with child behavior and parental distress. When considered jointly, parent PTSD and number of parent-reported child abuse subtypes differentially related to child behavior and interacted to predict psychiatric hospitalizations. Intergenerational continuity of trauma is important to consider among autistic youth, and both parent-reported child abuse and parent PTSD relate to admission characteristics. Critical limitations include reliance on binary parent reports of child abuse and parent PTSD and the low representation of youth of minoritized identities. Implications for trauma-informed care are discussed.

Intergenerational Cycles of Maltreatment: A Scoping Review of Psychosocial Risk and Protective Factors

Child maltreatment tends to show intergenerational continuity. However, a significant proportion of maltreated parents break these cycles. Since several studies have investigated risk and protective factors associated with the intergenerational continuity of child maltreatment over the past decades, and no systematic review of the literature is available, this scoping review aimed to summarize studies documenting associated psychosocial risk and protective factors. A secondary objective was to document the prevalence of this phenomenon. A search in six major databases (PsycINFO, Scopus, Medline, Social Work Abstracts, ProQuest Dissertations/Theses, and Web of Science) was conducted. Studies involving human participants, presenting original findings, written in French or English, and of any type of design were included. There was no limit regarding the date of publication, except for theses/dissertations (5 years). A final sample of 51 papers was retained, 33 providing data on risk and protective factors and 18 providing only prevalence data. Results indicate that parents' individual characteristics (e.g., mental health, age), childhood adversity (e.g., multiple forms of adversity), relational (e.g., couples' adjustment, attachment, social support), and contextual factors (e.g., disadvantage, community violence) are relevant to the intergenerational continuity of child maltreatment. Prevalence rates of continuity ranged from 7% to 88%. Major limitations of reviewed studies are discussed. Continued efforts to uncover the mechanisms associated with the intergenerational continuity of child maltreatment using strong methodological designs are necessary. Knowledge in this area could lead to the development of effective prevention strategies (e.g., mental health services for parents, family/dyadic interventions) to break harmful intergenerational cycles of violence.

Father-child attachment in Black families: Risk and protective processes

Theoretical and empirical work on Black fathering has been grounded in a deficit perspective. Scholarship has focused on absenteeism and incarceration of Black fathers, neglecting their positive roles as well as the structural inequalities and challenges Black fathers face. This paper highlights the significance of positive fathering in Black youth development, with a focus on the protective influences of attachment relationships. Structural and proximal processes that may support or undermine this relationship are delineated, as well as how theory and methods on attachment can be extended to support research on Black families and youth development. Culturally and contextually grounded research on Black fathering may lead to refinement in theory and measurement of attachment. Advancing research on father-child relationships in Black families requires greater attention to processes that promote positive fathering and strengthen father-child attachment bonds, particularly in the context of structural racism.

Development and initial validation of the Odense Child Trauma Screening: a story stem screening tool for preschool and young schoolchildren

Background:

Early identification of young children exposed to trauma who are at risk of developing post-trauma symptomatology such as posttraumatic stress disorder (PTSD) or other emotional or behavioral problems is important for allocating appropriate treatment and preventing long-term consequences. However, assessment of young children exposed to trauma is challenging because children may not be able to talk about their trauma or trauma reactions. Story stem tools combine storytelling and play to access the internal world of young children and can be used in the assessment of children exposed to trauma.

Objective:

To examine reliability and validity of a new story stem tool, the Odense Child Trauma Screening (OCTS). OCTS was developed to screen for play-based behavior and narrative representations indicative of traumatization in preschool and young schoolchildren.

Method:

Forty-nine Danish children aged 4.5–8.9 years (M = 6.6, SD = 1.2) participated in the OCTS. Participants included a risk sample of 31 children exposed to traumas and a community sample of 18 children. Caregivers were interviewed about child symptoms of PTSD, major depressive disorder (MDD), and reactive attachment disorder (RAD) and answered the Strengths and Difficulties Questionnaire (SDQ). The community sample completed OCTS test-retests.

Results:

Interrater reliability proved excellent (ICC = .96-1.00). Test-retest reliability was acceptable (ICC = .66). Significant moderate correlations were found between the OCTS total score and scales of PTSD, MDD and RAD and the SDQ Total Difficulties Scale. The ability of the OCTS to discriminate between children from the risk and community sample was good.

Conclusions:

The study provided preliminary evidence of reliability and validity of the OCTS as a screening tool for young children exposed to trauma. OCTS shows promise as a standardized, age-appropriate informant-based screening measure applicable for clinical assessment.

Multiple Maltreatment and Adverse Childhood Experiences: Exploring Cumulative Threats to Attachment Quality

Child maltreatment and other adverse childhood experiences (ACEs) often cooccur and are related to negative socioemotional outcomes; however, limited research differentiates how maltreatment versus other ACEs predict such outcomes. These efforts are necessary to determine whether cumulative ACE screening efforts best predict those at risk for poor outcomes. We examined cumulative childhood ACEs, cumulative maltreatment subtypes, and adult attachment quality in 379 young and middle-aged adults. This sample enabled comparison between emerging adults and older adults who have navigated additional developmental tasks that may counteract the effects of early ACEs. More ACEs and maltreatment experiences predicted insecure anxious, avoidant, and fearful attachment styles; however, maltreatment failed to predict unique variance in attachment quality beyond other ACEs. Results suggest that maltreatment may be best categorized as part of a general cumulative risk profile predicting poor socioemotional outcomes. Findings support burgeoning trends in medical and social service settings assessing ACEs using simple dichotomous screening tools to identify those requiring intervention and support services.

Pathways from Maternal Adverse Childhood Experiences to Substance Use in Pregnancy: Findings from the All Our Families Cohort

Background: Exposure to adverse childhood experiences (ACEs) is a risk factor for maternal substance use in pregnancy, however, mechanisms by which maternal ACEs may influence substance use in pregnancy have not been fully explored. The current study examines the association between maternal ACEs and substance use in pregnancy (i.e., alcohol, smoking, and drug use) and explores mediating pathways. Methods: A community sample of 1,994 women as part of the All Our Families Cohort were recruited in pregnancy in Calgary, Canada, between 2008 and 2011. Women provided retrospective reports of ACE exposure before age 18 as well as reports of demographic information, substance use (i.e., moderate-to-high alcohol use, any smoking, or any drug use), a previous history of substance use difficulties, and depressive symptoms during pregnancy. Path analyses were used to examine maternal income, education, depression, and previous substance use as mediating variables. Results: There were significant indirect associations between maternal ACEs and maternal substance use in pregnancy via maternal education (β = 0.05, p < 0.001), previous substance use (β = 0.01, p = 0.001), and depression (β = 0.02, p = 0.02). The direct effect of maternal ACEs on maternal substance in pregnancy remained significant after accounting for the indirect effects (β = 0.22, 95% CI = 0.15-0.29, p < 0.001). Conclusions: Exposure to adversity in childhood can lead to socioeconomic and mental health difficulties that increase risk for substance use in pregnancy. Addressing these difficulties before pregnancy may help to reduce the potential for substance use in pregnancy.

Childhood adversity and major depression in later life: A competing-risks regression analysis

OBJECTIVES

This study examined the relationship between childhood adversities and major depression in older adults over 8 years.

METHODS

The study sample consisted of 16 946 participants aged 51 years and older from the US Health and Retirement Study. Major depression was assessed using the Composite International Diagnostic Interview. Competing-risks regression analysis was conducted to examine the impact of each childhood adversity on late-life major depression and the potential moderation effects of sex, race/ethnicity, and adulthood trauma.

RESULTS

After controlling for covariates, childhood adversities including physical abuse by a parent (subdistribution hazard ratio [SHR] = 1.67, 95% confidence interval [CI] = 1.49-1.89, P < .001), trouble with the police (SHR = 1.31, 95% CI = 1.13-1.54, P = .001), receiving help because of financial difficulties (SHR = 1.17, 95% CI = 1.05-1.31, P = .006), and parental substance abuse (SHR = 1.11, 95% CI = 1.01-1.23, P = .037) were associated with a higher rate of major depression in later life. The association of physical abuse and major depression was stronger for men than women (SHR = 1.46, 95% CI = 1.15-1.85, P = .002), despite an overall lower risk of major depression among men. Potential adulthood trauma had a weaker association with late-life major depression in the presence of childhood physical abuse (SHR = 0.91, 95% CI = 0.85-0.98, P = .015). There was a significant dose-response relationship (SHR = 1.20, 95% CI = 1.16-1.24, P < .001).

CONCLUSIONS

Childhood adversities increase the risk of major depression in later life, particularly for those who experienced physical abuse and trouble with the police. Men may be more susceptible to the mental health detriments of childhood adversities.

Sibling relationship pattern in the context of abuse and neglect: Results from a sample of adult siblings

BACKGROUND

Siblings take care of each other and provide comfort and support. However, the sibling relationship is often also characterized by conflict and rivalry. Accordingly, the sibling relationship can be described by four patterns: harmonious, hostile, distanced, and emotional-intense. The sibling relationship pattern (SRP) depends on the sibling constellation, but also to a large extent on the family environment. Surprisingly little research has focused on the effects of child maltreatment on the SRP.

OBJECTIVE

This paper investigates the impact of maltreatment on the SRP during childhood.

PARTICIPANTS AND SETTING

4568 adults provided information about their adverse experiences and SRP while growing up.

METHODS

Multinomial logistic regression analyses were calculated to identify unique predictors for different SRP.

RESULTS

The number of different types of maltreatment predicted a hostile SRP. A low number was associated with a harmonious SRP. Considering the specific influence of types of maltreatment, emotional abuse was predictive for the hostile and the emotional-intense SRP compared to the distanced and the harmonious SRP. Emotional neglect was predictive for either a distanced or a hostile SRP compared to a harmonious or emotional-intense SRP.

CONCLUSIONS

Child maltreatment influences the SRP in childhood. It increases the likelihood of a hostile and less harmonious SRP. However, for some types of maltreatment, especially in the absence of emotional abuse or emotional neglect, exceptions occur. Further research needs to untangle dynamics between siblings throughout childhood. For practice, the findings warrant the need for specific interventions to improve the sibling relationship in cases of child maltreatment.

Tarabulsy. Contacts parent-enfant en contexte de placement : liens entre la sensibilité du parent d’accueil et les réactions des enfants à la suite des contacts

Cadre de la recherche : Au Québec, la Loi sur la protection de la jeunesse encourage le maintien des contacts entre les enfants placés en famille d’accueil et leurs parents biologiques. Or, il n’existe pas de consensus empirique quant aux conséquences de ces contacts sur les enfants placés.

Objectifs : Notre étude vise à examiner les liens entre la sensibilité du parent d’accueil et les réactions des enfants à la suite de ces contacts, en considérant trois facteurs potentiellement confondants soit la sécurité d’attachement, l’âge au moment du premier placement et la fréquence des contacts.

Méthodologie : Il s’agit d’une étude quantitative réalisée auprès de 51 enfants placés âgés de 12 à 45 mois. Une entrevue individuelle auprès du parent biologique nous permet de documenter la fréquence des contacts réalisés auprès de l’enfant. Les réactions de l’enfant, à la suite des contacts, sont rapportées par le parent d’accueil. La sensibilité parentale et la sécurité d’attachement sont observées lors d’une visite au domicile du parent d’accueil. 

Résultats : La plupart des enfants affichent au moins une réaction négative à la suite des contacts. Les réactions négatives rapportées sont associées significativement à l’insensibilité du parent d’accueil. 

Conclusions : Notre étude suggère que la sensibilité du parent d’accueil peut être un facteur favorable à de meilleures transitions à la suite des contacts.

Contribution : Cet article contribue à la réflexion sur la tenue des contacts suivant une mesure de placement et sur les réactions manifestées par les enfants à la suite de ces contacts.

Fuel to the fire: The escalating interplay of attachment and maltreatment in the transgenerational transmission of psychopathology in families living in refugee camps

Maltreatment by parents can be conceptualized as pathogenic escalations of a disturbed parent–child relationship that have devastating consequences for children's development and mental health. Although parental psychopathology has been shown to be a risk factor both for maltreatment and insecure attachment representations, these factors` joint contribution to child psychopathology has not been investigated. In a sample of Burundian refugee families living in refugee camps in Western Tanzania, the associations between attachment representations, maltreatment, and psychopathology were examined by conducting structured interviews with 226 children aged 7 to 15 and both their parents. Structural equation modeling revealed that children's insecure attachment representations and maltreatment by mothers fully mediated the relation between maternal and child psychopathology [model fit: comparative fit index (CFI) = 0.96; root mean square error of approximation (RMSEA) = 0.05]. A direct association between paternal and child psychopathology was observed (model fit: CFI = 0.96; RMSEA = 0.05). The findings suggest a vicious cycle, wherein an insecure attachment to a mother suffering from psychopathology may be linked to children's risk to be maltreated, which may reinforce insecure representations and perpetuate the pathogenic relational experience. Interventions targeting the attachment relationship and parental mental health may prevent negative child outcomes.

When a Head Is about to Burst: Attachment Mediates the Relationship Between Childhood Trauma and Migraine

Background: People exposed to childhood trauma show insecure attachment patterns and are more prone to chronic and pain-related conditions, including migraine. The aim of this study was to explore the mediating role of attachment in the association between childhood trauma and adulthood chronic health conditions, with a focus on migraine. Methods: Respondents from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) were asked to report various chronic and pain-related conditions, childhood trauma (The Childhood Trauma Questionnaire, CTQ), and attachment anxiety and avoidance (The Experience in Close Relationships Revised, ECR-R) in a cross-sectional, questionnaire-based survey conducted in 2016. Structural equation models (SEM) adjusted for sociodemographic variables were used to assess the relationship between childhood trauma, adulthood attachment, and adulthood chronic health conditions (migraine, other pain-related conditions, chronic health conditions other than pain, no chronic health complaints). Results: After adjusting for sociodemographic variables, SEM confirmed a significant mediation of the relationship between childhood trauma and migraine through adulthood attachment. There was no mediation effect of adulthood attachment found in other health complaints. Conclusion: This study highlights the mediation effect of attachment in the link between childhood trauma and migraine. Attachment-based therapeutic interventions can be useful in the treatment of patients with migraine.

"My own flesh and blood": The implications of child maltreatment for the orientation towards the body among dyads of mothers and daughters

BACKGROUND

Orientation to bodily signals reflects the ways in which individuals interpret their bodily sensations. Such orientation is formed within early interpersonal context. Findings reveal that trauma may result in catastrophic and fearful orientation towards bodily signals. However, not much is known regarding the link between trauma and orientation towards the body as manifested within a family intergenerational context.

OBJECTIVE

This study examines the link between child maltreatment, complex posttraumatic stress symptoms (CPTS symptoms), and a posttraumatic orientation to bodily signals among dyads of mothers and their young adult daughters.

PARTICIPANTS AND SETTING

194 mother-daughter dyads (mothers' mean age = 56, SD = 6.3; daughters' mean age = 26, SD = 3.03) completed self-reported questionnaires, assessing child maltreatment (CTQ), CPTS symptoms (ITQ), and orientation to bodily signals (pain catastrophizing, anxiety sensitivity-physical, body vigilance).

RESULTS

Orientation to bodily signals was associated with child maltreatment, through the mediation of CPTS symptoms among mothers (indirect effects between 0.13-0.28; p > 0.021) and daughters (indirect effects between 0.21-0.11; p > 0.032). Mothers' child maltreatment was associated with daughters' child maltreatment (effect = 0.35; p < 0.001), and mothers' orientation to bodily signals was associated with daughters' orientation (effects between 0.19-0.27; p < 0.016). Daughters' orientation to bodily signals was partially associated with mothers' child maltreatment through mothers' CPTS symptoms and orientation to body (indirect effect = 0.064; p = 0.023).

CONCLUSIONS

Child maltreatment is implicated in posttraumatic orientation towards bodily signals. Such secondary processes may be intergenerationally transmitted.

Developmental Differences in the Association of Peer Relationships with Traumatic Stress Symptoms

Although childhood trauma exposure has a high incidence, traumatic stress often goes untreated in children and youth. We investigated peer relationship quality as a prevention strategy for reducing traumatic stress across different developmental periods. We analyzed longitudinal data from the National Survey of Child and Adolescent Wellbeing (NSCAW I) using a time-varying effect model (TVEM) to investigate the association between peer relationship quality and traumatic stress symptoms across ages 8-17 years. We controlled for a robust set of confounders identified through a Directed Acyclic Graph (DAG). The unique association between peer relationship quality and traumatic stress symptoms was negative and significant from ages 8 to 8.5 years, and again from ages 9.4 to 10.9 years and at age 16.4 to 16.8 years, with maximum associations of - 1.45 T score points at age 8.5 years (95% CI = [- 2.87, - 0.40]), - 1.57 at age 9.4 years (95% CI = [- 3.13,- 0.01]), and - 1.89 at 16.7 years (95% CI = [- 3.70, - 0.09]). Peer relationship quality protected against traumatic stress during specific times during adolescent development. Our results suggest that helping youth establish and maintain positive peer relationships may be a useful prevention approach for helping them cope with trauma experiences.

Intergenerational maltreatment and child emotion dysregulation

BACKGROUND

Childhood maltreatment has been related to adverse outcomes on social, cognitive, and biological development with sequelae present throughout the lifespan. As such, caregivers maltreated in childhood may face a different set of challenges and interpersonal stressors in rearing their children. Parental history of maltreatment has the potential to increase the risk of parental depression and exposure to maltreatment in the next generation, both of which can have a negative effect on children's development.

OBJECTIVE

The purpose of this study is to investigate maternal depression and child experiences of maltreatment as mediators of the relationship between mothers' own maltreatment experiences and child emotion dysregulation in children aged 10-12.

PARTICIPANTS AND SETTING

378 low-income mothers and their children were recruited to participate in a research summer camp from 2004-2007.

METHOD

Mothers self-reported on their experiences of maltreatment in childhood and current depressive symptoms. Current generation child maltreatment information was coded from Child Protective Services records. Child emotion dysregulation (rated by camp counselors) was the outcome measure in this study. Structural equation modeling was employed to test associations between maternal maltreatment and child emotion dysregulation.

RESULTS

Maternal history of maltreatment related to both child maltreatment (β = .24, SE = .052, p < .001) and greater maternal depressive symptoms (β = .28, SE = .049, p < .001). Only child maltreatment mediated the effect of mothers' maltreatment on child emotion dysregulation (95 %CI: .005-.023).

CONCLUSIONS

In this low-income sample, the rate of intergenerational maltreatment is high and represents a pathway of influence that increases risk for maladaptive socioemotional child development.

Exploring Attachment and Internal Representations in Looked-After Children

BACKGROUND

This article explores the Story Stem Assessment Profile (SSAP), a narrative-based measure, for the assessment of internal representations in children between the ages of 4 and 11 years old.

METHODS

The findings draw upon two samples of children comprising of a sample of looked-after children at Five Rivers Child Care (FR) (n = 42) and a community-based population (n = 42). The FR group identified were suggested to have a higher level of need, as defined by scores obtained from the Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ).

RESULTS

Using the SSAP, the findings indicate the instrument's discriminant validity with strong differences being displayed between the two populations. Consistently children in the FR sample displayed more disorganized, avoidant and negative representations, whilst at the same time having significantly fewer representations characteristic of 'secure' attachment.

CONCLUSION

The SSAP is successful in differentiating between 'low' and 'high' cohorts of children aged 4-11 years. The study provides strong support for the measure as a way of capturing internal and attachment representations, with further research to explore possible changes in these representations at follow-up being promising and intriguing. Continued research efforts at FR will allow for improved clinical formulations, increased understanding and therefore positive outcomes relating to the children in their care.

Early Adversity and the Neotenous Human Brain

Human brain development is optimized to learn from environmental cues. The protracted development of the cortex and its connections with subcortical targets has been argued to permit more opportunity for acquiring complex behaviors. This review uses the example of amygdala-medial prefrontal cortex circuitry development to illustrate a principle of human development-namely, that the extension of the brain's developmental timeline allows for the (species-expected) collaboration between child and parent in co-construction of the human brain. The neurobiology underlying affective learning capitalizes on this protracted timeline to develop a rich affective repertoire in adulthood. Humans are afforded this luxuriously slow development in part by the extended period of caregiving provided by parents, and parents aid in scaffolding the process of maturation during childhood. Just as adequate caregiving is a potent effector of brain development, so is adverse caregiving, which is the largest environmental risk factor for adult mental illness. There are large individual differences in neurobiological outcomes following caregiving adversity, indicating that these pathways are probabilistic, rather than deterministic, and prolonged plasticity in human brain development may also allow for subsequent amelioration by positive experiences. The extant research indicates that the development of mental health cannot be considered without consideration of children in the context of their families.

The effect of maternal depression on mental representations and child negative affect

BACKGROUND

Maternal depression is a widely recognized public health concern with significant implications for child functioning, including the development of negative child affect and risk for later depression. Negative mental representations may partially account for the association between maternal depression and child negative affect.

METHODS

The effect of depression on low-income mothers' representations of their child, self, and mother was assessed via Expressed Emotion (EE) during Five-Minute Speech Samples. Direct and indirect pathways between maternal depression, EE, and child negative affect were examined. Mothers (M = 24 years old) who had experienced a major depressive episode (n = 144) since child's birth, non-depressed comparison mothers (n = 62), and their children participated.

RESULTS

Examination of between-group differences revealed that depressed mothers had higher levels of overall self EE. Trend results also suggest depressed mothers may have higher overall EE toward their children and their own mothers. Novel coding systems for EE toward self (Identity and Depressotypic Cognitions) and EE toward mother (Source of Concrete Support and Resolution of Past Adversity) were also developed and tested. A significant indirect relation was found between maternal baseline depression and child negative affect at 26 months via the mother's level of EE-Criticism of her mother.

LIMITATIONS

Certain EE subcodes may need to be adapted for young children and high-risk, low-income participants.

CONCLUSIONS

Findings highlights the importance of relational interventions that focus on maternal representations for women with depression and their children.

Maltreatment experiences and psychopathology in children and adolescents: The intervening role of domain-specific self-representations moderated by age

BACKGROUND

Associations between maltreatment experiences and psychopathology symptoms in children and adolescents are well established. However, the role of domain-specific self-representations (SR) in those associations remains unexplored.

OBJECTIVE

This multi-informant study aimed to explore the indirect associations between maltreatment experiences and children's and adolescents' psychopathology symptoms (i.e., internalizing and externalizing problems), through domain-specific self-representations, and the moderating role of age in those indirect associations.

PARTICIPANTS AND SETTING

Participants were 203 children/adolescents (52.7 % boys), aged 8-16 years old (M = 12.64; SD = 2.47), referred to child/youth protection commissions, their parents, and case workers.

METHOD

Case workers reported on child/adolescent maltreatment, children/adolescents reported on SR, and parents reported on psychopathology symptoms.

RESULTS

Controlling for chronicity of maltreatment and child/adolescent sex effects, multiple mediation path analysis revealed that: 1) higher levels of physical and psychological abuse were associated with less externalizing problems through more negative social SR; 2) higher levels of physical neglect were associated with more externalizing problems through more positive opposition SR; 3) higher levels of psychological neglect were associated with less externalizing problems through more negative physical appearance SR, and 4) associated with more externalizing problems through more negative opposition SR. Moreover, the indirect effects of physical and psychological abuse on internalizing and externalizing problems through instrumental SR were conditional on child/adolescent age.

CONCLUSION

Findings signal the relevance of preventing child/adolescent maltreatment and promoting the construction of positive and, foremost, realistic and adaptive self-representations as protection against maladjustment.

Using a Developmental-Relational Approach to Understand the Impact of Interpersonal Violence in Women Who Struggle with Substance Use

Substance use among women is a major public health concern. This review article takes a developmental-relational approach to examine processes through which early relational trauma and violence in relationships may lead to substance use. We examine how early exposure to violence in relationships can impact neurological development, specifically through interference with physiological mechanisms (e.g., the hypothalamic-pituitary-adrenal axis), brain structure and functioning (e.g., the hippocampus and prefrontal cortex), and neuropsychological development (e.g., executive functioning and emotion regulation) across the lifespan. Further, we discuss the impact of exposure to violence on the development of relational capacity, including attachment, internal working models, and subsequent interpersonal relationships across the lifespan, and how these developmental pathways can lead to continued problematic substance use in women.

Childhood Maltreatment Disrupts Brain-Mediated Pathways Between Adolescent Maternal Relationship Quality and Positive Adult Outcomes

The quality of early caregiving may partially shape brain structure and circuits involved in regulating emotions, including the frontal cortex, affecting vulnerability to the development of psychopathology and maladaptation. Given the profound impact of child maltreatment (CM) on psychological and neural development, we tested whether CM alters the pathways linking mother-adolescent relationship, frontal cortex, and adult outcomes. We used structural equation modeling to investigate whether CM history affected the association between mother-child relationship quality during early adolescence, frontal lobe volume in adulthood, and adult internalizing and externalizing symptomatology and competence. Participants from a longitudinal high-risk, low-income sample included 48 adults with a history of CM and 40 adults without such history (M = 30.0 years). Results showed that greater frontal lobe volume predicted higher levels of adult adaptive functioning and fewer adult internalizing symptoms but showed no relation to adult externalizing symptoms. Frontal lobe volume significantly mediated the effect of adolescent maternal relationship quality on both adult internalizing symptoms and adult adaptive functioning, but only for individuals with no maltreatment history. Given the observed relationship between frontal lobe volume and healthy adult functioning across the full sample, it will be important to identify protective factors in maltreated individuals that foster frontal lobe development.

Re-examining the "cycle of abuse": Parenting determinants among previously maltreated, low-income mothers

Multidomain approaches toward understanding the transmission of harsh caregiving across generations have been largely overlooked in the literature. To address this, the current study examined how maternal and child factors may operate as mediating mechanisms in the association between maternal history of child maltreatment and maternal caregiving behaviors. In particular, we tested the relative roles of maternal depression, maternal efficacy beliefs, and child behavioral difficulties as explanatory variables in these associations. Participants (N = 127) were drawn from a community sample of mother-child dyads from socioeconomically disadvantaged, ethnically diverse backgrounds. Mother-child dyads were assessed at baseline, when the children were approximately 12 months old, with follow-up visits occurring when children were 26 and 37 months of age. Findings did not support a significant direct effect of childhood maltreatment on mothers' subsequent harsh or responsive parenting behavior. However, analyses demonstrated a significant indirect effect of childhood maltreatment history on later responsive parenting behaviors via maternal depression. Results also supported a significant indirect effect of childhood maltreatment history on later harsh parenting behavior through child behavior problems. Although mothers' childhood maltreatment history significantly predicted lower levels of maternal efficacy, results did not support a mediating role of maternal efficacy beliefs in the association between maltreatment history and subsequent parenting behaviors. Identifying specific factors that potentially disrupt the intergenerational pattern of maladaptive parenting can serve to guide prevention and intervention efforts aimed at facilitating more positive, responsive parenting strategies within high-risk families. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Spirituality and its Relation to Mental Health Outcomes: An Examination of Youth in Foster Care

The effects of spirituality and youth relationships with others on internalizing, externalizing, and adaptive outcomes were examined in a sample of 159 youth between the ages of 8 and 21 in foster or residential care. Indirect effects of direct coping and perceived social support on the relations between these factors and youth outcomes were examined. Preliminary analyses indicated a significant relation between youth spirituality and adaptive outcomes, with a significant indirect effect of perceived social support on these relations. However, these relations were nonsignificant when accounting for youth relationships with others. Final results indicated that youth relationships with others significantly affected youth adaptive functioning through both coping and perceived social support. Youth relationships also significantly affected youth internalizing symptoms, albeit only through youths' perceived levels of social support. These findings suggest that, while spiritual beliefs are potentially an important factor in affecting outcomes for foster youth, the strongest effects likely occur through youths' relationships with others, social support, and coping in relation to adaptive outcomes for these youth.

Assessment of Trauma Symptoms in Toddlers and Preschoolers Living in Poverty

A first-line screening instrument, the Preschool Inventory of Trauma Symptoms (PITS), was developed to assess trauma symptoms with a diverse sample of 150 toddlers and preschoolers (M = 2.49 years; SD = 1.12). Items reflected the current trauma literature, assessment measures, and diagnostic criteria for very young children. A principal component analysis produced a 34-item, four-factor model: Arousal and Hyper-Reactivity, Fearful Attachment, Intrusion and Re-Experiencing, and Avoidance and Negative Cognition and Mood. One validity scale, Response Style, was also developed. All scales significantly correlated (r = .45 to .81; p < .01) with preestablished trauma measures and demonstrated adequate internal consistency (α = .68 - .87). A receiver operating characteristics curve analysis identified a cut-score with good discrimination ability (.88), sensitivity (.81), and specificity (.81). In a preliminary pilot study, PITS also was found to be sensitive to trauma symptom change following participation in an evidence-based trauma informed treatment program. A copy of the PITS is included in the Appendix for free use by qualified professionals.

Parental presence switches avoidance to attraction learning in children

Attachment-related learning (that is, forming preferences for cues associated with the parent) defies the traditional rules of learning in that it seems to occur independently of apparent reinforcement¹-young children prefer cues associated with their parent, regardless of valence (rewarding or aversive), despite the diversity of parenting styles². This obligatory attraction for parental cues keeps the child nearby and safe to explore the environment; thus, it is critical for survival and sets the foundation for normal human cognitive-emotional behaviour. Here we examined the learning underlying this attraction in preschool-age children. Young children underwent an aversive conditioning procedure either in the parent's presence or alone. We showed that despite disliking the aversive unconditioned stimulus, children exhibited a behavioural approach for conditioned stimuli that were acquired in the parent's presence and an avoidance for stimuli acquired in the parent's absence, an effect that was strongest among those with the lowest cortisol levels. The results suggest that learning systems during early childhood are constructed to permit modification by parental presence.

Children being Reared by their Grandparents in Rural Appalachia: A Pilot Study of Relations Between Psychosocial Stress and Changes in Salivary Markers of Inflammation Over Time

Grandparents in rural Appalachia with primary caregiving responsibilities for their grandchildren often struggle with high levels of stress, inadequate resources, and poor physical and mental health. However, implications for children of being raised by grandparents rarely have been examined, particularly in terms of stress biomarkers. The present study investigated salivary C-reactive protein, interleukin-6, and tumor necrosis factor alpha in a small sample of children (N = 20) aged 5 to 18 years being reared by grandparents in two rural counties in Kentucky, a region well known for its resource scarcity. Saliva samples were collected from children 30 min after waking at two time points spaced one year apart. Grandparents and children completed a series of questionnaires via interview. Children's internalizing symptoms were related to greater markers of inflammation over time. Grandparent stress and poor mental health were also related to greater inflammation, while grandparent positive parenting and religiosity were associated with lower inflammation.

Examination of Child Placement, Emotional, Behavioral and Attachment Problems Among Children with Caregiver-Perpetrated Trauma Histories

Caregiver-perpetrated trauma (CPT) is associated with adverse consequences for youth, including out-of-home placement. Although promotion of kinship care placement has recently increased, effects on youth remain unclear. Psychosocial functioning of 1107 CPT-exposed youth ages 2 to 18 was compared across placement types using generalized mixed models. Youth remaining at home had increased Somatization symptoms compared to kinship (OR = .25, CI = 0.07-.88) and foster care (OR = .32, CI = 0.11-.98) youth. Both out-of-home placement types had higher odds of Attachment Problems (OR = 3.61, CI = 2.22-5.87 and 4.41, CI = 2.71-7.18 respectively). PTSD symptoms varied, youth in kinship care had increased self-reported re-experiencing symptoms (OR = 2.66, CI = 1.04-6.8), while youth in foster care had elevated clinician-rated PTSD (OR = 2.07, CI = 1.1.3-3.80). Given the limited differences between kinship and foster care, studies should continue to delineate the impact of child placement type to inform child welfare policy.

Identifying maltreatment subgroups with patterns of maltreatment subtype and chronicity: A latent class analysis approach

Maltreatment experiences are complex, and it is difficult to characterize the heterogeneity in types of maltreatment. Subtypes, such as emotional maltreatment, sexual abuse, physical abuse, and neglect commonly co-occur and may persist across development. Therefore, treating individual maltreatment subtypes as independently occurring is not representative of the nature of maltreatment as it occurs in children's lives. Latent class analysis (LCA) is employed herein to identify subgroups of maltreated children based on commonalities in maltreatment subtype and chronicity. In a sample of 674 low-income urban children, 51.6% of whom experienced officially documented maltreatment, our analyses identified four classes of children, with three distinct classes based on maltreatment subtypes and chronicity, and one group of children who did not experience maltreatment. The largest class of maltreated children identified was the chronic, multi-subtype maltreatment class (57% of maltreated children); a second class was characterized by only neglect in a single developmental period (31% of maltreated children), and the smallest class was characterized by a single subtype of maltreatment (emotional maltreatment, physical, or sexual abuse) occurring in a single developmental period (12% of maltreated children). Characterization of these groups confirms the overlapping nature of maltreatment subtypes. There were notable differences between latent classes on child behavioral and socio-emotional outcomes measured by child self-report and camp counselors report during a one-week summer camp. The largest differences were between the non-maltreated class and the chronic maltreatment class. Children who experienced chronic, multi-subtype maltreatment showed higher levels of externalizing behavior, emotion dysregulation, depression, and anxiety.

Does the Type of Abuse Matter? Study on the Quality of Child Attachment Narratives in a Sample of Abused Children

Child abuse has been associated with the development of insecure-disorganized patterns of attachment. However, the way in which different types of abuse relate to variations in attachment representations is not entirely clear. Thus, the objective of this study was to determine the relationship between three types of abuse (sexual abuse, physical abuse, and neglect) and the quality of child attachment representation, as assessed through attachment narratives. The results indicate that abuse in general, as well as each of its typologies in particular, is associated with insecure-disorganized attachment narratives. No differences were observed in the association between each individual type of abuse and the quality of attachment narratives, as well as between the number of abuse experiences and the quality of attachment. The findings are discussed from attachment theory and the literature on child development and maltreatment.

Children and Caregivers' Exposure to Adverse Childhood Experiences (ACES): Association with Children's and Caregivers' Psychological Outcomes in a Therapeutic Preschool Program

Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver’s and the child’s exposure to ACE and multiple child and caregiver’s outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP). Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control) and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver’s exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes.

A role for epistemic trust in speech-language pathology: A tutorial paper

This paper provides an introduction to epistemic trust for speech-language pathologists (SLPs). 'Epistemic trust' describes a specific form of trust that an individual places in others when learning about the world, particularly the social world. To date, the relevance of epistemic trust to SLP clinical practice has received little theoretical or empirical attention. The aim of this paper is to define epistemic trust and explain its relationship with parent-child attachment and mentalization which have, in turn, been linked with language development and use. Suggestions are made for ways in which SLPs may encourage epistemic trust in clients, emphasizing the need to establish strong therapeutic alliances. The authors conclude that epistemic trust is an important consideration for SLPs and that further research exploring the relationship between epistemic trust and language skills is needed to better understand the interplay of these variables and inform clinical practice.

Children's disclosures of sexual abuse in a population-based sample

Most previous studies on disclosing child sexual abuse (CSA) have either been retrospective or focused on children who already have disclosed. The present study aimed to explore the overall CSA disclosure rate and factors associated with disclosing to adults in a large population-based sample. A representative sample of 11,364 sixth and ninth graders participated in the Finnish Child Victim Survey concerning experiences of violence, including CSA. CSA was defined as having sexual experiences with a person at least five years older at the time of the experience. Within this sample, the CSA prevalence was 2.4%. Children reporting CSA experiences also answered questions regarding disclosure, the disclosure recipient, and potential reasons for not disclosing. The results indicate that most of the children (80%) had disclosed to someone, usually a friend (48%). However, only 26% had disclosed to adults, and even fewer had reported their experiences to authorities (12%). The most common reason for non-disclosing was that the experience was not considered serious enough for reporting (41%), and half of the children having CSA experiences did not self-label their experiences as sexual abuse. Relatively few children reported lacking the courage to disclose (14%). Logistic regression analyses showed that the perpetrator's age, the age of the victim at the time of abuse, and having no experiences of emotional abuse by the mother were associated with disclosing to an adult. The results contribute to understanding the factors underlying children's disclosure patterns in a population-based sample and highlight the need for age-appropriate safety education for children and adolescents.