Child Maltreatment in Western China: Demographic Differences and Associations with Mental Health

Prevalence and associated factors of adolescent psychological abuse, neglect in Western China a multi-center cross-sectional study

Background: The western region of China has a dense population, relatively underdeveloped economy, and a significant number of left-behind children. Currently, the prevalence of adolescent psychological abuse, neglect, and the factors associated with these issues in the region remain unclear. This study aims to evaluate the current status of adolescent psychological abuse and neglect and its associated factors in this region.Methods: Data were collected from 50 schools in western China through cluster sampling to target adolescents aged 12 to 18. A comprehensive survey form was used to collect socio-demographic characteristics of adolescents. The Child Psychological Abuse and Neglect Scale was employed to assess the current psychological abuse and neglect of adolescents. Independent samples t-tests were used for inter-group comparisons. A Directed Acyclic Graph was constructed for controlling confounding variables. Subsequently, binary logistic regression analysis was performed, and a nomogram risk factors model was developed using R Studio.Results: This study included 12,743 teenagers, with an average age of 15.53(±1.39) years. Among them, 4,965 individuals, accounting for 39.0%, reported experiences of psychological abuse, while 4,167 individuals, accounting for 32.7%, reported experiences of neglect. The rates of psychological abuse and neglect in adolescents are influenced by gender, grade, left-behind experience, parental marital status, and living on campus (P < .05).Conclusion: Adolescents in western China exhibit higher rates of psychological abuse and neglect compared to those in the eastern and northern regions of China. Gender, grade, left-behind experience, and family factors significantly influence the psychological abuse and neglect of adolescents.

The effect of childhood trauma on complex posttraumatic stress disorder: the role of self-esteem

Background: Due to the short time that complex posttraumatic stress disorder (CPTSD) has been an independent diagnosis, few studies have explored the role that self-esteem might play in the relationship between childhood trauma and CPTSD.Objective: The current study aimed to explore the impact of childhood trauma on CPTSD and the role of self-esteem in this relationship.Methods: Study 1 involved a questionnaire survey in which a total of 360 young Chinese adults with childhood trauma participated. Study 2 used experimental research by manipulating short-term self-esteem to explore the effect of self-esteem on CPTSD. A total of 80 young Chinese adults with childhood trauma participated.Results: The results of Study 1 showed that childhood trauma positively predicts adulthood CPTSD, while self-esteem partially mediates the relationship between the two. It also found that self-esteem has a greater mediating effect on the disordered self-organization (DSO) dimension of CPTSD than on the PTSD dimension. In Study 2, participants in the high manipulated-self-esteem group reported fewer CPTSD symptoms than those in the low manipulated-self-esteem group.Conclusion: Overall, this study emphasized the role of self-esteem in CPTSD among individuals with a childhood trauma history. In practice, we provided a potential optimization direction for CPTSD clinical treatment, suggesting a method of self-esteem reconstruction.

Gender-specific associations between types of childhood maltreatment and major depressive disorder: A matched case-control study

INTRODUCTION

Major depressive disorder (MDD) has been found to be nearly twice as prevalent in females as in males. One hypothesis proposed that abused females were particularly prone to MDD. We aim to examine the sex-specific associations between various types of childhood trauma and MDD.

METHODS

In this study, 290 outpatients diagnosed with MDD were recruited from Beijing Anding Hospital, and 290 healthy volunteers were recruited from neighborhoods nearby the hospital, with sex, age, and family history matched. Childhood Trauma Questionnaire-Short Form (CTQ-SF) developed by Bernstein et al. was used to assess the severity of five different types of childhood abuse and neglect. McNemar's test and conditional logistic regression models with potential confounders (i.e., marital status, educational level, and body mass index) controlled were used to explore the sex-specific associations between different types of childhood maltreatment and MDD.

RESULTS

In the full sample, patients with MDD showed a significant higher rate of any childhood maltreatment (i.e., emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect). Among females, all types of childhood abuse were statistically significant. For males, significant differences were only found in emotional abuse and in emotional neglect.

CONCLUSION

It would appear that MDD in the outpatients is associated with any type of childhood trauma in women and emotional abuse or neglect in men.

Sex Differences in Patterns of Childhood Traumatic Experiences in Chinese Rural-To-Urban Migrant Children

BACKGROUND

Children and adolescents are likely to be exposed to various types of childhood traumatic experiences (CTEs) with gender-specific patterns. Rural-to-urban migrant children have been demonstrated a greater risk of CTE exposure than local children. However, no study has investigated sex differences in the patterns of CTEs and predictive factors among Chinese children.

METHODS

A large-scale questionnaire survey of rural-to-urban migrant children (N = 16,140) was conducted among primary and junior high schools in Beijing. Childhood trauma history, including interpersonal violence, vicarious trauma, accidents and injuries was measured. Demographic variables and social support were also examined. Latent class analysis (LCA) was utilized to examine patterns of childhood trauma, and logistic regression was used to examine predictors.

RESULTS

Four classes of CTEs were found among both boys and girls, labeled low trauma exposure, vicarious trauma exposure, domestic violence exposure, and multiple trauma exposure. The possibility of various CTEs in the four CTE patterns was higher among boys than girls. Sex differences also manifested in predictors of childhood trauma patterns.

CONCLUSIONS

Our findings shed light on sex differences in CTE patterns and predictive factors in Chinese rural-to-urban migrant children, suggesting that trauma history should be considered along with sex, and sex-specific prevention and treatment programs should be developed.

Correlations between childhood maltreatment, anxiety and depressive symptoms, and risk behaviors in adolescent schoolchildren

OBJECTIVE

Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms.

METHODS

We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms.

RESULTS

Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents.

CONCLUSION

The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.

Profiles of family maltreatment and peer victimization: Associations with psychosocial adjustment in Chinese children

BACKGROUND

Although the family and peer systems are both important for children's development, few studies have simultaneously considered the impact of adversity experienced in these systems on children.

OBJECTIVE

The first purpose of this study was using latent profile analysis (LPA) to identify profiles of family maltreatment (i.e., physical abuse, emotional abuse, and neglect) and peer victimization (i.e., physical victimization and relational victimization) among Chinese elementary school children. The second purpose was to examine associations between the identified profiles and short-term psychosocial adjustment (i.e., self-esteem, depression symptoms, prosocial behavior, and externalizing behavior).

PARTICIPANTS AND SETTING

The sample included 4313 children (45.6 % girls) with an average age of 10.9 years (SD = 0.49) from a large city in China.

METHOD

Assessments were conducted on two occasions six months apart. Family maltreatment and peer victimization were assessed at Time 1. Psychosocial adjustment was assessed at Time 2.

RESULTS

The potential complexity of children's adversity experiences was revealed in that six profiles of family maltreatment and peer victimization in children were identified: (a) Low-risk; (b) Slight peer victimization; (c) Severe peer victimization; (d) Serious neglect; (e) Severe maltreatment; (f) Doubly disadvantaged. Children in the low-risk profile showed the best psychosocial adjustment whereas children in the doubly disadvantaged profile showed the worst psychosocial adjustment. The findings revealed additional differences in the subsequent psychosocial adjustment of the children in the six profiles.

CONCLUSIONS

The identification of multiple profiles and differing relations to psychosocial adjustment implies that interventions should be tailored to members of specific profiles.

Life events and parent style for mental health in children: a cross-sectional study

BACKGROUND

Life events and parenting styles might play an important role in children's mental health.

AIMS

This study aims to explore how life events and parenting styles influence children's mental health based on a Chinese sample.

METHODS

A total of 3535 participants had at least one mental disorder (positive group), while a total of 3561 participants had no mental disorders (negative group). The Child Behavior Checklist (CBCL), Adolescent Self-Rating Life Events Check List (ASLEC) and Egna Minnen Beträffande Uppfostran (EMBU) were used for screening these two groups.

RESULTS

CBCL total scores differed significantly by sex in the Positive group according to the Mann-Whitney tests (Z = -5.40, p < 0.001). Multiple regression analyses showed that the dimensions of punishment (p = 0.014) and other (p = 0.048) in the ASLEC scale can significantly predict CBCL total scores in the Positive group. Sex, age and overprotection from the father were risk factors (p < 0.001) according to binary logistic regression.

CONCLUSIONS

Life events and parenting styles may have impacts on mental health. Fathers play a very important role in children's growth. Punitive education and fathers' overprotection might be risk factors for children's mental health.

IMPACT

It is a large sample (3535) study of Chinese children and adolescents It provides evidence that life events and parenting styles have impacts on mental health and that fathers play a very important role in children's growth. It is conducive to the development of interventions for the mental health of children and adolescents.

Contribution of brain network connectivity in predicting effects of polygenic risk and childhood trauma on state-trait anxiety

BACKGROUND

Anxiety is usually attributed to adverse environmental factors, but it is known as a polygenic inheritance disease. Gene-environment interactions on the occurrence and severity of anxiety are still unclear. The role of brain network connectivity in the gene-environment effects on anxiety has not been explored and may be key to understanding neuropathogenesis and guiding treatment.

METHODS

This study recruited 177 young adults from the community that completed functional magnetic resonance imaging, Childhood Trauma Questionnaire (CTQ), state-trait anxiety scores, and whole exome sequencing. We calculated polygenic risk score (PRS) for anxiety and the sum score of CTQ, which are genetic and environmental factors that may affect anxiety, respectively. Abnormal brain network connectivity determined by the gene-environment effects and its associations with anxiety scores were then explored.

RESULTS

Except for the main effect of PRS or CTQ on intra-network connectivity, significant interactions were found in intra-network connectivity of visual network, default mode network, self-reference network, and sensorimotor network. Moreover, altered network connectivity was related to anxious tendency. In particular, the effect of CTQ on trait anxiety was mediated by the disrupted sensorimotor network, accompanied by a significant direct effect. However, the PRS influence on anxiety was mainly mediated through sensorimotor network paths, which exceeded the direct influence and was moderated by childhood trauma levels.

CONCLUSIONS

These network-specific functional changes related to individual gene-environment risks advance our understanding of psychiatric pathogenesis of anxiety and provide new insights for clinical intervention.

How do physical and emotional abuse affect depression and problematic behaviors in adolescents? The roles of emotional regulation and anger

BACKGROUND

Rates of physical and emotional abuse are high among Chinese adolescents and elicit distinct psychopathologies. However, it remains unclear whether physical and emotional abuse relate to depression and behavior problems similarly or differently. In addition, few studies have examined if they share underlying mechanisms in adolescents.

OBJECTIVE

This study used longitudinal data to examine the mechanisms underlying the effect of physical and emotional abuse on depression and problematic behaviors through emotional regulation and anger in Chinese adolescents.

PARTICIPANTS AND SETTINGS

Participants were 1689 adolescents (with age ranging from 12 to 17 years) from junior and senior high schools in Zhejiang Province, China.

METHODS

Participants completed a childhood trauma questionnaire and an emotion regulation strategies questionnaire at time 1 (T1), and they completed an anger scale, a depression scale, and a problematic behaviors questionnaire one year later (T2). Structural equation modeling was used to examine the research hypotheses.

RESULTS

Physical abuse had direct positive effects on problematic behaviors but not on depression. However, emotional abuse had direct effects on depression and problematic behaviors, and indirect effects on both psychopathologies through expressive suppression and anger.

CONCLUSIONS

Physical and emotional abuse had distinct effects and influencing mechanisms on adolescents' externalizing and internalizing problems. Compared with physical abuse, emotional abuse elicited more harms and subsequent psychopathologies.

Higher exposure to childhood adversity associates with lower adult flourishing

BACKGROUND

Adverse childhood experiences (ACEs) are prevalent and associated with negative health and social outcomes. However, our understanding of how patterns of ACEs exposure relate to positive outcomes in adulthood remains limited. This study aims to identify patterns of ACEs and examine associations with flourishing in a sample of Chinese young adults.

METHODS

This cross-sectional study was conducted from August to November 2020. Young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China were recruited through convenience and snowball sampling to participate in a survey. The exposure to ACEs was measured by the twelve-item Chinese version of the ACE-International Questionnaire. Additional measures included six domains of flourishing assessed using the Chinese version of the Flourishing Measure, and demographic covariates (i.e., gender, age, year in university, marital status). Descriptive statistical analysis and latent class analysis (LCA) were performed using SPSS 27 and Mplus 8.5.

RESULTS

Participants included 9468 young adults (mean age = 20.1 years). Majority of participants were female (75.3%), undergraduate students (96.4%), and single (79.8%). Approximately 56% of participants reported at least one ACE; 7.0% reported four or more ACEs. Emotional neglect (33.2%), household violence (20.6%), and parental separation/divorce (13.9%) were the most frequently reported ACEs. LCA identified three ACEs classes: multiple maltreatment and household violence (4.7%), emotional neglect and household violence (16.2%), and low ACEs (79.1%). Individuals in the low ACEs class had the highest level of flourishing whereas individuals in multiple maltreatment and household violence had the lowest level of flourishing in all six domains. There were no significant differences in flourishing between the multiple maltreatment and household violence and the emotional neglect and household violence classes except in the physical and mental health (means = 6.17 vs 6.51, p = 0.02) and the financial and material stability domains (means = 5.25 vs 5.66, p = 0.04).

CONCLUSIONS

Patterns of multiple ACEs exposures were associated with lower levels of flourishing. Our findings have implications for efforts to prevent ACEs exposure through monitoring and promoting family well-being and routine screening to identify those with ACEs exposure to prevent negative social and health sequelae.

Childhood Psychological Maltreatment and Depression among Chinese Adolescents: Multiple Mediating Roles of Perceived Ostracism and Core Self-Evaluation

Previous studies have primarily focused on the separate mediating role of interpersonal context or personal characteristics in the relationship between childhood psychological maltreatment and depression, neglecting the combined effects, which have limited ecological validity. Therefore, this study investigated the multiple mediating roles of perceived ostracism and core self-evaluation in the relationship between childhood psychological maltreatment and depression. A total of 1592 Chinese adolescents (51.1% boys), ranging in age from 11 to 15 years (M = 13.23, SD = 0.96), completed a self-report questionnaire regarding demographics, psychological maltreatment, perceived ostracism, core self-evaluation and depression. A multiple mediation model was tested using Model 6 of the PROCESS macro. After controlling for the variables of gender and age, the results indicated that perceived ostracism and core self-evaluation parallelly and sequentially mediated the link between psychological maltreatment and depression. The multiple mediation model could account for 55% of the total effect. In conclusion, the current study helps us better understand the mechanisms of depression caused by psychological maltreatment, and contributes to preventing and intervening in depression among Chinese adolescents.

Perceived Child Abuse and Neglect in Hospitalized Children with Special Health Care Needs in Iran

BACKGROUND

Child Abuse and Neglect (CAN) is an important public health concern. Nurses play a key role in caring for the children and keeping them safe from abuse and neglect. The aim of this study was to determine the rate of perceived CAN in Hospitalized Children with Special Health Care Needs (CSHCN) as well as the relationship between the rate and some effective factors.

MATERIALS AND METHODS

This is a descriptive cross-sectional study on 199 CSHCN aged 6-18 years old, admitted to the pediatric wards in an educational hospital, in Isfahan, Iran, in 2018. Children were selected through convenience sampling method and assessed for CAN through a child abuse questionnaire. The Pearson correlation coefficient and Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. The p values smaller than 0.05 were regarded as significant.

RESULTS

According to the findings, 173 children (86.93%) had perceived CAN, the average total score of which was 9.36 contributing commonly to malnutrition 3.01 (2.36) followed by psycho-emotional abuse 2.71 (1.76), neglect 1.62 (1.23), and physical 1.52 (1.08) and sexual 0.54 (0.31) abuse based on mean (SD). Statistical analysis indicated a significant effect of child's age, economic situation of the family, mother's education and occupation, and parents' illness on the total score of perceived CAN (p < 0.05).

CONCLUSIONS

Malnutrition was found to be the most common type of perceived CAN. Therefore, parents and the health system are advised to prioritize nutritional needs when planning their nutrition.

The association of child neglect with lifestyles, depression, and self-esteem: Cross-lagged analyses in Chinese primary schoolchildren

Child neglect robustly predicts many behavioral problems and adulthood mental disorders, but little is known about its association with daily lifestyles and psychological development during childhood, particularly in the longitudinal study. We aimed to examine the association of child neglect with physical activity (PA), screen time (ST), eating habits (EHs), and depression/self-esteem using a two-wave follow-up study of primary schoolchildren in Wuhan, China. Data of 1085 schoolchildren aged 8-10 years (boys: 53.5%) were analyzed. Child neglect, lifestyles, and depression/self-esteem were collected in 2018 (T1) and 2019 (T2). Autoregressive cross-lagged models (ARCLMs) were fitted to explore the interrelationships among these variables. In ARCLM including child neglect and lifestyles, higher child neglect at T1 was significantly associated with higher ST and more risky EHs at T2, while insignificantly associated with PA. In ARCLM including child neglect and depression/self-esteem, lower T1 child neglect significantly predicted a higher T2 depression, but insignificantly for T2 self-esteem. In ARCLM including all variables, child neglect still significantly predicted later ST and depression, but insignificantly predicted EHs. Our study underscores that child neglect is strongly intertwined with ST, EHs, and depression during childhood. The prevention of child neglect may promote some healthy lifestyles and depression in children.

Validation of posttraumatic stress disorder (PTSD) and complex PTSD in Chinese children as per the ICD-11 proposals using the International trauma questionnaire

Background: Given that the validity of applying complex posttraumatic stress disorder (CPTSD) in nonclinical children remains unclear. Objectives: The current study aimed to explore the factor structure, discriminant validity, and risk factors of ICD-11 posttraumatic stress disorder (PTSD) and CPTSD using the International Trauma Questionnaire. Methods: A total of 3478 trauma-exposed Chinese children aged 9-12 years were included in this study. All participants were assessed for PTSD and CPTSD using the International Trauma Questionnaire (ITQ). Confirmatory factor analysis (CFA) was conducted to explore the factor structure of CPTSD in a sample of Chinese children. Latent class analysis (LCA) was employed to evaluate the discriminant validity of CPTSD symptoms. Multinomial logistic regression analyses determined associations between the different classes and traumatic events. Results: The CFA results showed that the first-order six-factor model was identified as the best-fitting model in Chinese children aged 9-12 years. Four different classes, CPTSD symptoms, PTSD symptoms, disturbances in self-organization (DSO) symptoms, and a low symptom class were found by LCA. Both prolonged interpersonal trauma and other types of trauma were risk factors for the CPTSD class and the PTSD class. Conclusions: The results of this study partially support the factorial validity and strongly support the discriminant validity of the ICD-11 proposals for PTSD and CPTSD in Chinese children, supporting the conceptualization of PTSD and CPTSD as sibling diagnoses based on the ICD-11. However, findings suggest the need for careful consideration of identified trauma types in the ICD-11 proposals.

The Effects of Childhood Maltreatment on Non-Suicidal Self-Injury in Male Adolescents: The Moderating Roles of the Monoamine Oxidase A (MAOA) Gene and the Catechol-O-Methyltransferase (COMT) Gene

(1) Background: Numerous studies suggest strong associations between childhood maltreatment and nonsuicidal self-injury (NSSI); this is also true for the roles of dopaminergic genes in the etiology of some psychopathologies related to NSSI. Investigating the interactions of environments and genes is important in order to better understand the etiology of NSSI. (2) Methods: Within a sample of 269 Chinese male adolescents (Mage = 14.72, SD = 0.92), childhood maltreatment and NSSI were evaluated, and saliva samples were collected for MAOA T941G and COMT Val158Met polymorphism analyses. (3) Results: The results revealed no primary effects attributable to MAOA T941G and COMT Val158Met polymorphism on NSSI. However, there was a significant three-way interaction between MAOA, COMT, and child abuse (β = −0.34, p < 0.01) in adolescent NSSI. Except for carriers of the T allele of MAOA and the Met allele of COMT, all studied male adolescents displayed higher NSSI scores when exposed to a higher level of child abuse. A similar three-way interaction was not observed in the case of child neglect. (4) Conclusions: The results indicate that the MAOA gene and COMT gene play moderating roles in the association between child abuse and NSSI of male adolescents and suggest the polygenic underpinnings of NSSI.

Validation and Adaptation of the Slovak Version of the Childhood Trauma Questionnaire (CTQ)

Background: Previous research has shown a strong relationship between childhood trauma and worsened physical and mental health. The Childhood Trauma Questionnaire (CTQ) is a commonly used tool assessing early traumatic experiences. The aim of this study was to verify the psychometric properties of the Slovak version of the CTQ. Methods: Data were collected on a representative Slovak sample (N = 1018, mean age 46.24 years, 48.7% of men). The dimensional structure of the CTQ was tested by confirmatory factor analysis (CFA); convergent validity was assessed using the Adverse Childhood Questionnaire (ACE-IQ). Results: CFA confirmed the standard 5-factor CTQ model. The subscales of the CTQ and the ACE-IQ questionnaires showed moderate to high correlations. The internal consistency of the scale was found to be acceptable. Emotional neglect (EN) was reported in 48.1%, physical neglect (PN) in 35.8%, emotional abuse in 15.8%, physical abuse (PA) in 11.0%, and sexual abuse (SA) in 9.1% of the Slovak population, according to the scoring, when even low abuse or neglect is assessed as trauma. Conclusion: The CTQ questionnaire fulfilled the validation criteria and appeared to be a suitable method for assessing retrospectively reported childhood trauma experiences in the Slovak population.

Depression in Children and Adolescents on the Qinghai-Tibet Plateau: Associations with Resilience and Prosocial Behavior

Depression in children and adolescents has become a serious public health problem worldwide. The objectives of this study were twofold: first, to investigate the status of depression among children and adolescents on the Qinghai-Tibet Plateau, the highest plateau in the world, with an average altitude of more than 4200 m (13,776 feet), and second, to examine the associations among prosocial behavior, resilience, and depression. A cross-sectional study was conducted among children and adolescents from Yushu Prefecture on the Qinghai-Tibet Plateau. A total of 11,160 participants aged 10–17 years (M_age = 14.34 years, SD = 1.77; 51.4% girls) were included. Self-reported depression, resilience, and prosocial behavior were assessed. The prevalence of depression was 29.2% in the current study. Higher levels of prosocial behavior were significantly associated with lower levels of depression (β = −0.25, p < 0.001). Furthermore, resilience significantly moderated the relationship between prosocial behavior and depression (β = −0.08, p < 0.001); that is, resilience enhanced the protective role of prosocial behavior in depression. These findings indicate that resilience may play an important role in the associations between prosocial behavior and depression, which suggests that improving resilience is essential for the prevention and intervention of depression among children and adolescents on the Qinghai-Tibet Plateau.

Patterns of childhood trauma and psychopathology among Chinese rural-to-urban migrant children

BACKGROUND

Exposure to childhood trauma can cause psychopathology and negative psychosocial outcomes across the lifespan. Rural-to-urban migrant children are commonly exposed to traumatic experiences (TEs). However, no study has comprehensively examined patterns of childhood trauma in Chinese culture. The current study aimed to examine patterns of childhood trauma exposure among Chinese rural-to-urban migrant children.

METHODS

A large-scale (N = 15,890) cross-sectional survey of rural-to-urban migrant workers' children in grades 4 to 9 was conducted in Beijing. Childhood TEs, including accidents and injuries, interpersonal violence, and vicarious trauma, as well as demographics and internalizing and externalizing behaviors, were measured.

RESULTS

Four patterns of childhood trauma were found: low trauma exposure (60.4%), vicarious trauma exposure (23.9%), domestic violence exposure (10.5%), and multiple trauma exposure (5.3%). Age, gender, parents' marital status, father's education level, family support and peer support differentiated the four TE patterns. Both internalizing and externalizing behaviors were more severe in patterns with more types of TEs.

CONCLUSIONS

Our findings provide a better understanding of childhood trauma in Chinese culture and the relationship between TEs and mental health. Clinicians and policy makers should tailor prevention and treatment programs according to different patterns of victimization.

Child Sexual Abuse and Suicidal Ideation: The Differential Role of Attachment and Emotional Security in the Family System

The objective of this study was to analyze the effects of attachment style and emotional security in the family system on suicidal ideation in a sample of young adult female victims of child sexual abuse (CSA). The possible effects of CSA characteristics and other types of child abuse on suicidal ideation were controlled for. The sample consisted of 188 female college students who had been victims of sexual abuse before the age of 18, as well as 188 randomly selected participants who had not experienced CSA. The results showed that both attachment and emotional security were associated with suicidal ideation, even when controlling for both the characteristics of abuse and the existence of other abuses. The strong relationships of emotional security and attachment style with suicidal ideation suggest the importance of early intervention with children who have been sexually abused and their families, in an effort to optimize their attachment style, as well as to decrease emotional insecurity to prevent the onset of symptomatology related to suicidal ideation.