Mother's IPV, Child Maltreatment Type and the Presence of PTSD in Children and Adolescents

Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

Complex post-traumatic stress disorder (CPTSD) of ICD-11 in youths with childhood maltreatment: Associations with age of exposure and clinical outcomes

BACKGROUND

Exposure to childhood maltreatment (CM) increases the risk of psychiatric morbidity in youths. The new Complex Post-Traumatic Stress Disorder (CPTSD) diagnosis captures the heterogeneity and complexity of clinical outcomes observed in youths exposed to CM. This study explores CPTSD symptomatology and its association with clinical outcomes, considering the impact of CM subtypes and age of exposure.

METHODS

Exposure to CM and clinical outcomes were evaluated in 187 youths aged 7-17 (116 with psychiatric disorder; 71 healthy controls) following the Tools for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV) structured interview criteria. CPTSD symptomatology was explored by confirmatory factor analysis, considering four subdomains: post-traumatic stress symptoms, emotion dysregulation, negative self-concept and interpersonal problems.

RESULTS

Youths exposed to CM (with or without psychiatric disorders) showed greater internalizing, externalizing and other symptomatology, worse premorbid adjustment and poorer overall functioning. Youth with psychiatric disorder and exposed to CM reported more CPTSD symptomatology, psychiatric comorbidity and polypharmacy and earlier onset of cannabis use. Different subtypes of CM and the developmental stage of exposure differentially impact CPTSD subdomains.

LIMITATIONS

Small percentage of resilient youths was studied. It was not possible to explore specific interactions between diagnostic categories and CM. Direct inference cannot be assumed.

CONCLUSIONS

Gathering information on type and age of exposure to CM is clinically useful to understand the complexity of psychiatric symptoms observed in youths. Inclusion of the CPTSD diagnosis should increase the implementation of early specific interventions, improving youths' functioning and reducing the severity of clinical outcomes.

On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age

BACKGROUND

Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age.

METHODS

This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27 months), and child outcomes when children were school-age (age mean = 83.2 months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age.

RESULTS

Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization.

CONCLUSIONS

sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature-both for mothers as well as children-of the intergenerational transmission of violence and associated psychopathology.

Prevalence, factors, and impact of exposure to parental intimate partner violence: A scoping review

Exposure of children to their parents' intimate partner violence (IPV) is recognized as an adverse childhood experience that has a significant impact on the overall healthy development of the children and this research summarizes all relevant literature to determine the prevalence, impacts, risks, and protective factors of adolescents subjected to parental IPV since childhood. The literature in this scoping was scrutinized based on both inclusion, exclusion criteria. Almost 15 articles were reviewed out of 118 related literature sourced from electronic databases such as PubMed, Scopus, Research Gate, and Google Scholar published in the year 2016-2021. The search method followed Mays, Roberts, and Popay's process of gathering relevant literature and mapping important ideas to capture the available data in a study topic, especially the one which lacked proper evaluation. The results of this review of the literature indicate that parental IPV is a pervasive problem that impairs the adolescent's overall well-being. It also highlights a range of protective factors that can mitigate the impact of parental IPV. The findings of this scoping review have implications for practice and policy. Given the enormous scope and burden of children's parental IPV exposure, intervention techniques to safeguard this vulnerable population and enhance well-being are urgently needed.

Tunisian maltreating mothers characteristics

Introduction

the aim of our cross-sectional study was to compare the sociodemographic and clinical characteristics, the social support, the personal history of abuse, and the parental bonding style of maltreating Tunisian mothers to those of nonmaltreating mothers.

Methods

this was a cross-sectional study carried out on the child psychiatry department of Mongi Slim Hospital in Tunisia. A data-collection sheet was designed to collect sociodemographic and clinical data about the child and the maltreatment (type, frequency, and duration), the mother of the child (sociodemographic and clinical data) and the family (socioeconomic situation and conjugal violence).

Results

the sample was composed of 167 mothers. Children were significantly more maltreated when their ages were between 6 and 12 years (p=0.004) and less maltreated when they had been born prematurely (p=0.007). Also, the higher the level of the mother´s education, the less the child was maltreated (p=0.007). In addition, maltreated mothers more frequently had a history of physical abuse, emotional abuse, or emotional neglect during their childhood (p values were respectively 0.002, 0.05, and 0.007). Thus, when mothers maltreated their children, a perception of optimal grandmother-mother parenting was significantly less frequent, and a perception of an affectionless-bonding grandmother-mother was significantly frequent (p = 0.019).

Conclusion

we conclude that it is important to consider individual, relational, communal, and social factors to elaborate efficient strategies for preventing children maltreatment.

Does time heal all wounds? How is children’s exposure to intimate partner violence related to their current internalizing symptoms?

The effects of time and the longitudinal course of the children’s internalizing symptoms following Intimate Partner Violence Exposure (IPVE) are still of great interest today. This study aimed to analyze the effect of the frequency of IPVE, adverse experiences after the cessation of the IPVE and the time elapsed since the termination of the violent relation on the prevalence of anxiety and depression among children. Participants were 107 children and their mothers who had been victims of IPV and had existing judicial protection and restraining orders. Hierarchical logistic regression models were estimated to analyze children’s adjustment, considering the effect of the time elapsed since the termination, frequency of IPVE, experiences of revictimization, maternal pathology, and anxious anticipation of the mother at the prospect of future harm. Exposure to multiple events of violence at the hands of multiple ex-partners and higher scores in the mother’s anxious anticipation were significant predictors of children’s pathological depression and anxiety. Our results emphasize the need for early psychological evaluation of women and children’s victims of IPV to provide timely interventions that avoid symptoms from becoming chronic. Strategies to bring support and emotional security to the victims after the end of the violent relationship are desirable.

Children Exposed to Intimate Partner Violence During Confinement: Characteristics by Age and Sex

The COVID-19 pandemic and restrictions imposed to stop its advance have affected the entire population. Children living with difficulties or in vulnerable situations prior to the pandemic might have suffered an even greater impact. This present study examines the psychological impact of quarantine on children and adolescents exposed to intimate partner violence against their mothers. Participants were 185 mothers who reported 269 children, as well as 108 children who self-reported. An emotional and behavioral checklist was administered to both mothers and children throughout confinement. Results show mothers observed changes in their children's psychological state. Children, in turn, reported an increase in different variables. Mothers reported a higher percentage of overall increase for both general and severe symptoms than their children. Differences were found by sex and age. Future research with similar population groups is necessary to establish the support and intervention children require in similar contexts, as well as to clarify possible causes of differences found by age and sex.

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

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

Change of pace: How developmental tempo varies to accommodate failed provision of early needs

The interplay of genes and environments (GxE) is a fundamental source of variation in behavioral and developmental outcomes. Although the role of developmental time (T) in the unfolding of such interactions has yet to be fully considered, GxE operates within a temporal frame of reference across multiple timescales and degrees of biological complexity. Here, we consider GxExT interactions to understand adversity-induced developmental acceleration or deceleration whereby environmental conditions hasten or hinder children's development. To date, developmental pace changes have been largely explained through a focus on the individual: for example, how adversity "wears down" aging biological systems or how adversity accelerates or decelerates maturation to optimize reproductive fitness. We broaden such theories by positing shifts in developmental pace in response to the parent-child dyad's capacity or incapacity for meeting children's early, physiological and safety needs. We describe empirical evidence and potential neurobiological mechanisms supporting this new conceptualization of developmental acceleration and deceleration. We conclude with suggestions for future research on the developmental consequences of early adverse exposures.

The Role of Acculturation and Intimate Partner Violence on Post-Traumatic Stress Symptoms Among Hispanic Youth With Child Welfare Contact

Research suggests that Hispanic youth with intimate partner violence (IPV) exposure report fewer trauma symptoms compared with youth from other racial/ethnic groups. However, no study has examined possible explanations for this finding. Our objective was to study the association between acculturation, IPV, and post-traumatic stress (PTS) symptoms among Hispanic youth and to test whether acculturation moderates the relationship between IPV and PTS symptoms. This analysis used data from 271 Hispanic youth aged 8 years or older participating in the second cohort of the National Survey of Child and Adolescent Well-being (NSCAW II). We conducted multiple linear regression analyses to achieve our study aims. We did not find a statistically significant relationship between IPV exposure and PTS symptoms among Hispanic youth (B = 0.21, 95% confidence interval [CI] = [-0.09, 0.52]), or that acculturation moderated this relationship (B = 0.04, 95% CI = [-0.23, 0.32]). However, we found a significant relationship between PTS symptoms and acculturation level. Specifically, higher levels of acculturation were associated with more reports of PTS symptoms (B = 1.03, 95% CI = [0.13, 1.93]). These study results highlight the need to consider the role of acculturation when working with Hispanic youth involved with child welfare.

Associations Between Maternal Post-traumatic Stress Disorder and Traumatic Events With Child Psychopathology: Results From a Prospective Longitudinal Study

Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children. Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0-3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7-10)]. Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; β = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD (β = 0.48, p < 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety (β = 0.37, p = 0.006), major depressive (β = 0.24, p = 0.039), ADHD (β = 0.27, p = 0.040), PTSD (β = 0.52, p < 0.001), conduct (β = 0.58, p = 0.003) and oppositional defiant (β = 0.34, p = 0.032) disorders. Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.

Unique Risk Factors of the Co-Occurrence Between Child Maltreatment and Intimate Partner Violence Perpetration

Abstract. Recent studies found that there is considerable overlap between perpetrators of intimate partner violence (IPV) and child maltreatment (CM), suggesting that both types of domestic violence can co-occur. However, there is a lack of consistency about the prevalence of co-occurrence, what unique risk factors and outcomes of co-occurrence are, and whether co-occurrence differs between Europe and other world regions. The aim is thus to review existing evidence and provide a framework for the study of IPV and CM co-occurrence by identifying unique risk factors and outcomes. In total, 12 European studies were identified that examined risk factors of co-occurrence between IPV and CM. Risk factors were distinguished at the individual, dyadic, and broader contextual levels, and compared between Europe and other regions of the world. Despite significant variation between studies, several general patterns were discerned, both globally and region-specific. These insights were used to develop a framework for the explanation of IPV and CM co-occurrence, which has implications for prevention and treatment. Importantly, more awareness and early signaling of risk for co-occurrence may counteract the spill-over from one type of domestic violence into the other to the benefit of children’s safety and well-being.

The Relationship between Childhood Maltreatment and Risky Sexual Behaviors: A Meta-Analysis

Childhood maltreatment is associated with risky sexual behaviors (RSBs). Previous systematic reviews and meta-analysis focused only on the relationship between childhood sexual abuse and RSBs, thus the association between childhood maltreatment and RSBs has yet to be systematically and quantitatively reviewed. We aimed to provide a systematic meta-analysis exploring the effect of childhood maltreatment and its subtypes on subsequent RSBs in adolescence and adulthood. PubMed, Google Scholar, EMBASE, Medline were searched for qualified articles up to April 2019. We calculated the pooled risk estimates using either the random-effect model or fixed-effect model. The potential heterogeneity moderators were identified by subgroup and sensitivity analysis. Overall, childhood maltreatment was significantly associated with an early sexual debut (odds ratio (OR) = 2.22; 95% confidence interval (CI): 1.64–3.00), multiple sexual partners (OR = 2.22; 95% CI: 1.78–2.76), transactional sex (OR = 3.05; 95% CI: 1.92–4.86) and unprotected sex (OR = 1.59; 95% CI: 1.22-2.09). Additionally, different types of childhood maltreatment were also significantly associated with higher risk of RSBs. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. Childhood maltreatment is significantly associated with risky sexual behaviors. The current meta-analysis indicates it is vital to protect children from any types of maltreatment and provide health education and support for maltreated individuals.

Measuring the Prevalence of Adverse Childhood Experiences by Survey Research Methods

Background: Child maltreatment has been firmly established as a fundamental risk factor for adult health. However, its quantification poses many questions methodologically, psychologically, and culturally alike. We carried out the first nationally representative survey research in Hungary and in Central⁻Eastern Europe to assess the prevalence of adverse childhood experiences (ACEs) among adults. Methods: Data were collected by an opinion research company using a screening tool of the Adverse Childhood Experiences study. Results: 25% (n = 293) of adults reported any childhood adversity; 5% (n = 59) of them had four or more ACEs. The most prevalent forms of child maltreatment were emotional (5%, n = 59) and physical abuse (5%, n = 59), sexual abuse (1%, n = 12) being the least prevalent. The most frequent dysfunctional household condition was parental divorce or separation (13%, n = 153), followed by household substance abuse (11%, n = 129). Conclusions: Nationally representative surveys on ACEs found a range of overall prevalence of various forms of child maltreatment between 14.1 and 35.2% into which our results fall. Nevertheless, our survey most likely underestimates the prevalence of child maltreatment in Hungary, reflecting the impact of a host of factors influencing awareness. Survey research methods are appropriate to obtain nationally representative data on child maltreatment that not only contribute to designing interventions but can also be used to monitor the effectiveness of interventions to improve child and adult health in the long run.