Infant victimization in a nationally representative sample

The relationship between childhood emotional abuse and borderline personality disorder: the mediating role of difficulties in emotion regulation among Lebanese adults

OBJECTIVE

The present study investigates the mediating effect of difficulties in emotion regulation in the association between childhood emotional abuse and Borderline Personality Disorder (BPD) among Lebanese adults.

METHOD

This cross-sectional study, involving 411 participants, was conducted between March and August 2022. Lebanese individuals from all governorates of the country were recruited using the Snowball Sampling technique. Three self-report scales were utilized to complete this research; the 'Difficulties in Emotion Regulation Scale-Brief Version (DERS-16)' which evaluates the difficulties in emotion regulation of individuals, the 'Childhood Trauma Questionnaire-Short Form (CTQ-SF)' which grants a subjective evaluation of the general childhood environment of the participants, as well as the 'Borderline Personality Questionnaire (BPQ)' which measures Borderline Personality Disorder traits, that demonstrate significant convergence with the disorder.

RESULTS

The results indicate that DERS-16 played an indirect effect role between childhood emotional abuse scores and Borderline Personality Disorder. Higher emotional abuse scores were significantly associated with higher DERS-16 scores, which in turn was significantly associated with higher BPQ scores. Moreover, childhood emotional abuse was directly associated with higher BPQ scores.

CONCLUSION

This work suggests that, among the different forms of childhood abuse, emotional abuse may have a role in the development of Borderline Personality Disorder. Training on emotion regulation strategies would potentially benefit individuals in preventing BPD development and facilitating therapeutic processes.

Child Neglect and the Broader Context of Child Victimization

Using a pooled data set of two waves of the National Surveys of Children's Exposure to Violence, this study investigates links between indicators of socioeconomic resources and lifetime exposure to two different forms of child neglect (physical and supervisory), examines how neglect is associated with the risk of other types of victimization, and estimates the impact of neglect on trauma symptoms. Findings suggest that physical neglect is directly linked to economic stressors, while low parental education is consequential for both physical and supervisory neglect. Both types of neglect also were strongly associated with risk of other maltreatment and most other forms of victimization. Physical neglect was particularly strongly related to sexual abuse and witnessing sibling abuse, while supervisory neglect was most strongly related to risk for sexual victimization by a nonfamily adult. Although neglect is significantly associated with trauma symptoms, poly-victims had, by far, the highest levels of trauma symptoms.

From Poly-Victimization to Poly-Strengths: Understanding the Web of Violence Can Transform Research on Youth Violence and Illuminate the Path to Prevention and Resilience

For many years, an overly "siloed" approach has hampered efforts to understand violence and minimize the societal burden of violence and victimization. This article discusses the limitations of an overly specialized approach to youth violence research, which has focused too much on violence in particular contexts, such as the family or the school. Instead, a child-centered approach is needed that comprehensively assesses all exposures to violence. This concept of the total cumulative burden of violence is known as poly-victimization. The poly-victimization framework reveals that many youth are entangled in a web of violence, experiencing victimization in multiple settings by multiple perpetrators. This more accurate view of children's exposure to violence has many advantages for advancing our scientific understanding of violence. Perhaps somewhat surprisingly, this more comprehensive view also points to new insights for resilience and prevention. This includes recognizing a parallel concept, "poly-strengths," which captures the number of resources and assets children and their families can use to help insulate youth from violence (prevention) or assist in coping and promoting well-being after victimization (intervention). Reconceptualizing how resilience is defined and understood among youth populations can help alleviate the true societal burden of youth victimization.

Quantifying sources of bias in longitudinal data linkage studies of child abuse and neglect: measuring impact of outcome specification, linkage error, and partial cohort follow-up

Background

Health informatics projects combining statewide birth populations with child welfare records have emerged as a valuable approach to conducting longitudinal research of child maltreatment. The potential bias resulting from linkage misspecification, partial cohort follow-up, and outcome misclassification in these studies has been largely unexplored. This study integrated epidemiological survey and novel administrative data sources to establish the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project. Using these data we evaluated and quantified the impact of non-linkage misspecification and single source maltreatment ascertainment use on reported maltreatment risk and effect estimates.

Methods

The ALCANLink project integrates the 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) sample with multiple administrative databases through 2014, including one novel administrative source to track out-of-state emigration. For this project we limited our analysis to the 2009 PRAMS sample. We report on the impact of linkage quality, cohort follow-up, and multisource outcome ascertainment on the incidence proportion of reported maltreatment before age 6 and hazard ratios of selected characteristics that are often available in birth cohort linkage studies of maltreatment.

Results

Failure to account for out-of-state emigration biased the incidence proportion by 12% (from 28.3%_w to 25.2%_w), and the hazard ratio (HR) by as much as 33% for some risk factors. Overly restrictive linkage parameters biased the incidence proportion downwards by 43% and the HR by as much as 27% for some factors. Multi-source linkages, on the other hand, were of little benefit for improving reported maltreatment ascertainment.

Conclusion

Using the ALCANLink data which included a novel administrative data source, we were able to observe and quantify bias to both the incidence proportion and HR in a birth cohort linkage study of reported child maltreatment. Failure to account for out-of-state emigration and low-quality linkage methods may induce bias in longitudinal data linkage studies of child maltreatment which other researchers should be aware of. In this study multi-agency linkage did not lead to substantial increased detection of reported maltreatment. The ALCANLink methodology may be a practical approach for other states interested in developing longitudinal birth cohort linkage studies of maltreatment that requires limited resources to implement, provides comprehensive data elements, and can facilitate comparability between studies.

Electronic supplementary material

The online version of this article (doi:10.1186/s40621-017-0119-6) contains supplementary material, which is available to authorized users.

The Amsterdam Sexual Abuse Case (ASAC)-study in day care centers: longitudinal effects of sexual abuse on infants and very young children and their parents, and the consequences of the persistence of abusive images on the internet

BACKGROUND

Little research has been done on the signs of child sexual abuse (CSA) in infants and very young children, or on the consequences that such abuse - including the persistence of the abusive pornographic images on the internet - might have for the children and their parents. The effects of CSA can be severe, and a variety of risk- and protective factors, may influence those effects. CSA may affect the psychosocial-, emotional-, cognitive-, and physical development of children, their relationships with their parent(s), and the relations between parents. In the so called 'the Amsterdam sexual abuse case' (ASAC), infants and very young children were victimized by a day-care employee and most of the victims were boys. Research involving the children and their parents would enable recognition of the signs of CSA in very young children and understanding the consequences the abuse might have on the long term.

METHODS/DESIGN

The proposed research project consists of three components: (I) An initial assessment to identify physical- or psychological signs of CSA in infants and very young children who are thought to have been sexually abused (n = 130); (II) A cross-sequential longitudinal study of children who have experienced sexual abuse, or for whom there are strong suspicions; (III) A qualitative study in which interviews are conducted with parents (n = 25) and with therapists treating children from the ASAC. Parents will be interviewed on the perceived condition of their child and family situation, their experiences with the service responses to the abuse, the effects of legal proceedings and media attention, and the impact of knowing that pornographic material has been disseminated on the internet. Therapists will be interviewed on their clinical experiences in treating children and parents. The assessments will extend over a period of several years. The outcome measures will be symptoms of posttraumatic stress disorder (PTSD), dissociative symptoms, age-inappropriate sexual behaviors and knowledge, behavioral problems, attachment disturbances, the quality of parent-child interaction, parental PTSD, parental partner relation, and biological outcomes (BMI and DNA).

DISCUSSION

The ASAC-project would facilitate early detection of symptoms and prompt therapeutic intervention when CSA is suspected in very young children.

Sibling and peer victimization in childhood and adolescence

This study examined how victimizations by either a sibling or peer are linked to each other and to mental health in childhood and adolescence. The data were from the National Survey of Children's Exposure to Violence which includes a sample of children aged 3-9 (N=1,536) and adolescents aged 10-17 (N=1,523) gathered through telephone interviews. An adult caregiver (usually a parent) provided the information for children while self-reports were employed for adolescents. Fifteen percent of each age group reported victimization by both a sibling and peer. Victimization by a sibling alone was more common in childhood than adolescence. Victimization by a sibling was predictive of peer victimization. Children and adolescents victimized by both a sibling and peer reported the greatest mental distress. This work establishes that for some children and adolescents, victimization at the hands of other juveniles happens both at home and school. Programs should consider the role of siblings and target parents and siblings to encourage the development and maintenance of constructive sibling interactions.

Rivalidade ou violência? A percepção de estudantes universitários vítimas de violência por parte de irmãos

Este estudo pretende avaliar a percepção das vítimas relativamente a comportamentos de cariz físico, sexual e psicológico, perpetrados por irmãos. Faz parte de uma investigação mais vasta na qual foram avaliados os diferentes tipos de violência e a sua frequência no início da adolescência. Neste estudo, os participantes classificaram os abusos sofridos com recurso ao Self-Labelling of Personally Experienced Violence. Os resultados indicam que os jovens que sofreram todos os tipos de vitimizações (físicas, psicológicas e sexuais) atribuíram os incidentes à "rivalidade entre irmãos", de modo significativo, quando comparados com os jovens que só sofreram um ou dois tipos de vitimização (psicológicas, físicas, psicológicas + físicas ou psicológicas + sexuais). Os resultados são discutidos segundo perspectivas de 'normalização de agressões', as quais explicam a manutenção de comportamentos abusivos contra irmãos.

Prevalence and correlates of sibling victimization types

OBJECTIVE

The goal of this study was to document the prevalence and correlates of any past year sibling victimization, including physical, property, and psychological victimization, by a co-residing juvenile sibling across the spectrum of childhood from one month to 17 years of age.

METHODS

The National Survey of Children's Exposure to Violence data set (N=1,705) was used which includes telephone interviews conducted with an adult caregiver (usually a parent) about one child randomly selected from all eligible children living in a household. If the selected child was 10-17 years old, the main telephone interview was conducted with the child.

RESULTS

Sibling victimization rates were 37.6% for the full sample, peaking at 45% for the 2-5 year olds and 46% for the 6-9 year olds. Rates were higher for males, whites, and those who were closer in age to their sibling. Sibling victimization was also higher in brother-brother pairs and among children who had a parent with some college education.

CONCLUSION

The results add to a growing body of literature on aggressive sibling behavior by demonstrating the importance of taking a comprehensive approach to studying sibling victimization and considering individual, sibling, and family correlates of such behavior. This study's approach to the study of sibling aggression also extends the literature on this generally unrecognized form of family violence.

Kicking the digital dog: a longitudinal investigation of young adults' victimization and cyber-displaced aggression

Using the general strain theory as a theoretical framework, the present longitudinal study investigated both face-to-face and cyber victimization in relation to cyber-displaced aggression. Longitudinal data were collected from 130 (70 women) young adults who completed measures assessing their victimization (face-to-face and cyber), cyber aggression, and both face-to-face and cyber-displaced aggression. Findings indicated that victimization in both social contexts (face-to-face and cyber) contributed to cyber-displaced aggression 6 months later (Time 2), after controlling for gender, cyber aggression, face-to-face displaced aggression, and cyber-displaced aggression at Time 1. A significant two-way interaction revealed that Time 1 cyber victimization was more strongly related to Time 2 cyber-displaced aggression when young adults had higher levels of face-to-face victimization at Time 1. Implications of these findings are discussed as well as a call for more research investigating displaced aggression in the cyber context.

Cumulative prevalence of arrest from ages 8 to 23 in a national sample

OBJECTIVE

To estimate the cumulative proportion of youth who self-report having been arrested or taken into custody for illegal or delinquent offenses (excluding arrests for minor traffic violations) from ages 8 to 23 years.

METHODS

Self-reported arrest history data (excluding arrests for minor traffic violations) from the National Longitudinal Survey of Youth 1997 (N = 7335) were examined from 1997 to 2008.

RESULTS

By age 18, the in-sample cumulative arrest prevalence rate lies between 15.9% and 26.8%; at age 23, it lies between 25.3% and 41.4%. These bounds make no assumptions at all about missing cases. If we assume that the missing cases are at least as likely to have been arrested as the observed cases, the in-sample age-23 prevalence rate must lie between 30.2% and 41.4%. The greatest growth in the cumulative prevalence of arrest occurs during late adolescence and the period of early or emerging adulthood.

CONCLUSIONS

Since the last nationally defensible estimate based on data from 1965, the cumulative prevalence of arrest for American youth (particularly in the period of late adolescence and early adulthood) has increased substantially. At a minimum, being arrested for criminal activity signifies increased risk of unhealthy lifestyle, violence involvement, and violent victimization. Incorporating this insight into regular clinical assessment could yield significant benefits for patients and the larger community.

Disability and victimization in a national sample of children and youth

Although past research has found higher rates of violence, crime, and abuse among children with disabilities, most studies combine diverse forms of disability into one measure and assess exposure to only one particular type of victimization. Based on a representative national sample of 4,046 children aged 2-17 from the 2008 National Survey of Children's Exposure to Violence, the present study examines the associations between several different types of disability and past-year exposure to multiple forms of child victimization. Results suggest that attention-deficit disorder/attention-deficit with hyperactivity disorder elevates the risk for peer victimization and property crime, internalizing psychological disorders increase risk for both child maltreatment and sexual victimization, and developmental/learning disorders heighten risk only for property crime. In contrast, physical disability did not increase the risk for any type of victimization once confounding factors and co-occurring disabilities were controlled. It appears that disabilities associated with interpersonal and behavioral difficulties are most strongly associated with victimization risks.

Childhood maltreatment in subjects with male-to-female gender identity disorder

Childhood maltreatment (CM) is quite common and constitutes a nonspecific risk factor for a range of different psychiatric symptoms during lifespan. It has been demonstrated that sexual minorities are at higher risk of maltreatment and abuse, and a high proportion of transsexual subjects report CM. The aim of this study is to evaluate the prevalence of reported CM in a clinical sample of patients with male-to-female Gender Identity Disorder (MtF GID), and to explore the relationship between these early life events, body image and different psychopathological and clinical variables. A consecutive series of 162 patients with male genotype was evaluated from July 2008 to May 2010. A total of 109 subjects (mean age 36 ± 10 years) meeting the criteria for MtF GID and giving their informed consent were considered. The occurrence of CM experiences was evaluated through a face-to-face clinical interview. Patients were asked to complete the Body Uneasiness Test and Symptom Checklist-90 Revised. More than one-fourth of patients reported CM. Maltreated subjects reported a higher body dissatisfaction and display a worse lifetime mental health. The presence of reported CM in these patients has relevant psychopathological implications, and therefore should be carefully investigated.

The impact of clinical child protection programs

PURPOSE

To follow up on child protection children after their discharge from hospital in order to assess efficiency of our child protection team (CPT) and collaboration of family and of Youth Welfare Agencies (YWA) with the clinical CPT.

METHODS

Collaboration of the family considering treatment and controls was documented. Questionnaires were sent to the involved social worker and collaboration with the YWA was analyzed.

RESULTS

From 2004 to 2008 57 children entered our child protection program. Clinical cooperation of the families and outcome was good overall. In 56 cases, an official information was sent to the YWA. In ten cases, the injuries were reported to the police which led to convictions in four cases. YWA installed further supervision and support in 53 patients. Cooperation of the families with the social workers was good in 50% of cases, ambivalent in 15% and not existent in 8%. Cooperation with the YWA was wearing.

CONCLUSION

Measurements initiated to protect children were efficient in 98%. While cooperation with the families and the social workers was good, cooperation with the institution of the YWA was wearing caused by discrepancies in understanding data protection acts and act of information. Here clarification is required to improve and simplify collaboration between all involved groups.

Update on child maltreatment: toward refining the evidence base

PURPOSE OF REVIEW

This review is designed to aid general pediatricians as they assess cases of possible child maltreatment. The authors have selected salient articles that inform the daily practice of any professional involved in assessing child abuse.

RECENT FINDINGS

The incidence of child abuse continues to decline in the United States, although a large number of children still suffer from abuse and neglect, and many are subject to more than one type of maltreatment. Clinicians are encouraged to be vigilant about the subtle indicators of physical abuse, with many authors adding to our understanding about how children present after inflicted abdominal or skeletal trauma. Clinicians are also cautioned to watch for signs of Munchausen syndrome by proxy, which may be elusive and difficult to discern.

SUMMARY

The field of child abuse pediatrics is still young, with the first board certification in 2009. The volume of research in the field is exploding and there is a greater level of awareness and data collection occurring throughout the world. Pediatric clinicians are encouraged to play a role in preventing abuse and neglect, as well as addressing intimate partner violence, and to maintain vigilance about child maltreatment and its subtle clinical presentations.