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Han Q, Jocson R, Kunovski I, Raleva M, Juhari R, Okop K, Oppler A, Wilson K, Cirovic T, Sacolo Gwebu H, Alampay L, Eagling-Peche S, Calderon F, Vallance I, Muharam F, Chen Y, Lachman J. The bidirectional temporal relationship between parenting stress and child maltreatment: A cross-lagged study based on intervention and cohort data. J Affect Disord 2024; 354:302-308. [PMID: 38479502 DOI: 10.1016/j.jad.2024.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Parenting stress has long been proposed as a major risk factor for child maltreatment. However, there is a lack of evidence from existing studies on the temporal sequence to establish a causal relationship. This study aims to examine bidirectional temporal relationships between parenting stress and child maltreatment. METHODS Longitudinal data from two different sources were analysed: a pre-post study of an online parenting programme conducted across six countries - the ePLH Evaluation Study, and a prospective cohort study in the United States - LONGSCAN. Cross-lagged panel model on parenting stress and child maltreatment was used in each dataset. RESULTS Based on repeatedly measured data of 484 caregivers in the ePLH study across five time points (every two weeks), we found that parenting stress at an earlier time point predicted later child maltreatment (IRR = 1.14, 95 % CI: 1.10,1.18). In addition, the occurrence of child maltreatment was associated with higher subsequent short-term parenting stress (IRR = 1.04, 95 % CI: 1.01,1.08) and thus could form a vicious circle. In the LONGSCAN analysis with 772 caregivers who were followed up from child age of 6 to child age of 16, we also found parenting stress at an earlier time point predicted later child maltreatment (β = 0.11, 95 % CI: 0.01,0.20), but did not observe an association between child maltreatment and subsequent long-term parenting stress. LIMITATIONS Potential information bias on the measurements. CONCLUSIONS This study provides evidence for a bidirectional temporal relationship between parenting stress and child maltreatment, which should be considered in parenting intervention programmes.
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Affiliation(s)
| | | | | | - Marija Raleva
- St. Cyril and Methodius University Skopje, North Macedonia
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jamie Lachman
- University of Oxford, UK; University of Cape Town, South Africa.
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Felt JM, Chimed-Ochir U, Shores KA, Olson AE, Li Y, Fisher ZF, Ram N, Shenk CE. Contamination bias in the estimation of child maltreatment causal effects on adolescent internalizing and externalizing behavior problems. J Child Psychol Psychiatry 2024. [PMID: 38634466 DOI: 10.1111/jcpp.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual-measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems. METHODS This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self-report assessment at ages 12, 14, and 16 or by a one-time retrospective self-report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self-reports, and when it was controlled for by retrospective self-reports. RESULTS Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used. CONCLUSIONS The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies.
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Affiliation(s)
- John M Felt
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - Ulziimaa Chimed-Ochir
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | | | - Anneke E Olson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Yanling Li
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Zachary F Fisher
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Nilam Ram
- Department of Communications, Stanford University, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Chad E Shenk
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
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Kisely S, Arnautovska U, Siskind D, Warren N, Najman JM. Admissions for psychosis following agency-notified child maltreatment at 40-year-follow-up: Results from the Childhood Adversity and Lifetime Morbidity (CALM) cohort. Schizophr Res 2024; 267:247-253. [PMID: 38581827 DOI: 10.1016/j.schres.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
There is substantial evidence of an association between self-reported child maltreatment (CM) and subsequent psychosis in retrospective data. Such findings may be affected by recall bias. Prospective studies of notifications to statutory agencies address recall bias but are less common and subject to attrition bias. These studies may therefore be underpowered to detect significant associations for some CM types such as sexual abuse. This study therefore linked administrative health data to a large birth cohort that included notifications to child protection agencies. We assessed psychiatric outcomes of CM as measured by inpatient admissions for non-affective psychoses (ICD10 codes F20-F29) to both public and private hospitals in Brisbane, Australia. Follow-up was up to 40 years old. There were 6087 cohort participants whose data could be linked to the administrative health data. Of these, 10.1 % had been the subject of a CM notification. Seventy-two participants (1.2 %) had been admitted for non-affective psychosis by 40-year follow-up. On adjusted analysis, all notified and substantiated types of CM were associated with admissions for non-affective psychosis. This included neglect, physical, sexual or emotional abuse, as well as notifications for multiple CM types. For instance, there was a 2.72-fold increase in admissions following any agency notification (95 % CI = 1.53-4.85). All maltreatment types therefore show a significant association with subsequent admissions for psychosis up to the age of 40. Screening for CM in individuals who present with psychosis is, therefore, indicated, as well as greater awareness that survivors of CM may be at higher risk of developing psychotic symptoms.
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Affiliation(s)
- Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada; Metro South Addiction and Mental Health Service, Brisbane, Australia.
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston 4006, Queensland, Australia; School of Social Sciences, The University of Queensland, St Lucia 4072, Queensland, Australia
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Tanis JM, Klein SM, Boyke H. State paid family leave policies and infant maltreatment. Child Abuse Negl 2024; 152:106758. [PMID: 38574603 DOI: 10.1016/j.chiabu.2024.106758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Growing research points to economic policies as protective mechanisms for vulnerable families. Research on pediatric abusive head trauma suggests that paid family leave (PFL) may protect infants in the general population from physical abuse. OBJECTIVE To examine the association of state-level paid family leave policies with infant (ages 0-1) maltreatment rates. PARTICIPANTS AND SETTING A state-level panel dataset was constructed from the National Child Abuse and Neglect Data System (2002-2019) data on infant maltreatment investigations among four states with PFL (California, New Jersey, New York, and Rhode Island) and 36 states without PFL. METHODS A piecewise longitudinal model and a nested model comparison were conducted to estimate the treatment effect of PFL on the population rate of infant maltreatment investigations. Supplementary analyses examined the moderating effect of three covariates. RESULT PFL reduced the linear rate of change in infant maltreatment rates in the states where it was enacted by a factor of 0.979 for each year post-policy implementation compared to states without such policies, B = -0.021, SE = 0.008, 95 % CI = [-0.036,-0.005]. Examining treatment states only, the slope of infant maltreatment became significantly shallower post-policy implementation, χ2(1) = 3.178, p = .075. Interactions testing the moderating effects of family poverty and adults with less than high school education were significant, B = -0.304, 95 % CI = [-0.564,-0.052]; B = -0.511, 95 % CI = [-0.799,-0.249], respectively. CONCLUSION Results suggest that PFL has a beneficial effect on infant maltreatment rates and add to growing evidence that policies aimed to support household economic stability could be a vital child maltreatment prevention policy tool.
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Affiliation(s)
- Jennifer M Tanis
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America; Hope College, Department of Sociology and Social Work, 41 Graves Place, PO Box 9000, Holland, MI 49422, United States of America.
| | - Sacha M Klein
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America.
| | - Hannah Boyke
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America.
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Kawata NYS, Nishitani S, Yao A, Takiguchi S, Mizuno Y, Mizushima S, Makita K, Hamamura S, Saito DN, Okazawa H, Fujisawa TX, Tomoda A. Brain structures and functional connectivity in neglected children with no other types of maltreatment. Neuroimage 2024; 292:120589. [PMID: 38575041 DOI: 10.1016/j.neuroimage.2024.120589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
Child maltreatment can adversely affect brain development, leading to vulnerabilities in brain structure and function and various psychiatric disorders. Among the various types of child maltreatment, neglect has the highest incidence rate (76.0%); however, data on its sole adverse influence on the brain remain limited. This case-control brain magnetic resonance imaging (MRI) study identified the changes in gray matter structure and function that distinguish neglected children with no other type of maltreatment (Neglect group, n = 23) from typically developing children (TD group, n = 140), and investigated the association between these structural and functional differences and specific psychosocial phenotypes observed in neglected children. Our results showed that the Neglect group had a larger right and left anterior cingulate cortex (R/L.ACC) and smaller left angular gyrus (L.AG) gray matter volume. The larger R/L.ACC was associated with hyperactivity and inattention. Resting-state functional analysis showed increased functional connectivity (FC) between the left supramarginal gyrus (L.SMG) in the salience network (SN) and the right middle frontal gyrus (R.MFG) simultaneously with a decrease in FC with the L.ACC for the same seed. The increased FC for the R.MFG was associated with difficulty in peer problems and depressive symptoms; a mediating effect was evident for depressive symptoms. These results suggest that the structural atypicality of the R/L.ACC indirectly contributes to the disturbed FCs within the SN, thereby exacerbating depressive symptoms in neglected children. In conclusion, exposure to neglect in childhood may lead to maladaptive brain development, particularly neural changes associated with depressive symptoms.
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Affiliation(s)
- Natasha Y S Kawata
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Shota Nishitani
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Life Science Innovation Center, University of Fukui, Fukui 910-8507, Japan.
| | - Akiko Yao
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Shinichiro Takiguchi
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Life Science Innovation Center, University of Fukui, Fukui 910-8507, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui 910-1193, Japan
| | - Yoshifumi Mizuno
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui 910-1193, Japan
| | - Sakae Mizushima
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Shoko Hamamura
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui 910-1193, Japan
| | - Daisuke N Saito
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan
| | - Hidehiko Okazawa
- Life Science Innovation Center, University of Fukui, Fukui 910-8507, Japan; Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Life Science Innovation Center, University of Fukui, Fukui 910-8507, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui 910-1193, Japan; Life Science Innovation Center, University of Fukui, Fukui 910-8507, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui 910-1193, Japan.
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Giordano F, Salimbeni CT, Jefferies P. The Tutor of Resilience Program with Children Who Have Experienced Maltreatment: Mothers' Involvement Matters. Child Psychiatry Hum Dev 2024; 55:295-307. [PMID: 35916984 PMCID: PMC10891266 DOI: 10.1007/s10578-022-01393-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/03/2022]
Abstract
Resilience is a dynamic process involving the presence and interaction of personal and environmental factors that modify the impact of adversity. Resilience-building interventions are therefore important for improving trauma-related outcomes in children and caregivers exposed to adversity. This study examines the impact of the Tutor of Resilience (TOR) program on beneficiaries' trauma-related symptoms and on mother-child interactions in a group of children exposed to maltreatment (N = 186; mean age = 11.95; SD = 2.50). Assessments were completed at baseline and post-intervention. RM-ANOVAs indicated significant improvements for most trauma symptoms (anxiety, anger, post-traumatic stress, and disassociation, but not depression) in the intervention group relative to a control group (N = 88; mean age = 10.76; SD = 2.57), and indicated further improvements to anxiety and dissociation for the intervention group when mothers were involved. Mother-child interactions also improved over time, as did their overall trauma symptoms and distress. Findings support the effectiveness of the ToR, especially when involving mothers.
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Affiliation(s)
- F Giordano
- Department of Psychology - Resilience Research Unit, Università Cattolica del Sacro Cuore Largo Gemelli 1, Milan, MI, 20121, Italy.
| | - C Taurelli Salimbeni
- Department of Psychology - Resilience Research Unit, Università Cattolica del Sacro Cuore Largo Gemelli 1, Milan, MI, 20121, Italy
| | - P Jefferies
- Family and Community Resilience, Canada Research Chair in Child, Resilience Research Centre Dalhousie University, PO Box 15000, Halifax, NS, B3H4R2, Canada
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Lhaksampa TC, Grant B, Fix RL. The Impact of Early Violence Exposure on Adolescent Flourishing : Is There Light at the End of the Tunnel? J Prev (2022) 2024; 45:269-285. [PMID: 38289562 DOI: 10.1007/s10935-024-00765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 04/02/2024]
Abstract
Child maltreatment (CM) and intimate partner violence (IPV) are prevalent in the United States and associated with negative mental and physical health outcomes. Thus far, research and clinical care have focused on reducing symptoms of illness, but little is known about whether or how CM and IPV exposure can lead to flourishing in adolescence. To examine the impact of CM and IPV exposure on adolescent mental and physical flourishing as well as moderators and mediators affecting this pathway. A secondary data analysis of 2,232 children in the Future of Families Child Wellbeing Study (FFCWS) was conducted to examine waves 1-6 including variables on CM/IPV, general flourishing, mental flourishing, BMI, and healthy eating. Race, socioeconomic status (SES), and gender were included as moderators; depression and anxiety were included as mediating variables. Adolescent boys experienced significantly more general flourishing (β = 4.00, p < .001). There were significant direct effects of CM (p = .025) and anxiety (p = .019) on well-being, and anxiety mediated the pathway from CM to mental flourishing (CI [0.001, 0.017]). Depression (CI [0.001, 0.026]) and anxiety (CI [-0.023, - 0.005]) mediated the pathway from CM to BMI. Our findings indicated that exposure to CM and IPV impacted the likelihood of adolescent flourishing. Future research should evaluate whether and how these flourishing outcomes could be modified.
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Affiliation(s)
- Tenzin C Lhaksampa
- Moore Center for the Prevention of Child Sexual Abuse, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Bloomberg School of Public Health, Hopkins University, 625 N Broadway Suite 897, Baltimore, MD, 21205, USA.
| | - Bradley Grant
- School of Medicine, Johns Hopkins University, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
| | - Rebecca L Fix
- Moore Center for the Prevention of Child Sexual Abuse, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Chen C, Okawa S, Okubo R, Hagiwara K, Mizumoto T, Higuchi N, Nakagawa S, Tabuchi T. Mother-to-infant bonding difficulties are associated with future maternal depression and child-maltreatment behaviors: A Japanese nationwide longitudinal study. Psychiatry Res 2024; 334:115814. [PMID: 38412713 DOI: 10.1016/j.psychres.2024.115814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/29/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Mother-to-infant bonding difficulties (MIBD) are considered risk factors for postpartum depression and child-maltreatment behaviors. However, few longitudinal studies have examined this hypothesis. This study aims to explore the relationship between MIBD and subsequent maternal depression and child-maltreatment behaviors using longitudinal data from a 2021 Japanese nationwide survey. METHODS We studied 658 first-time mothers who had given birth within the past year and had not reported postpartum depression or child-maltreatment behaviors at baseline. The Japanese version of Mother-to-Infant Bonding Scale (MIBS) was used to measure MIBD. Subjects were monitored for six months and subsequently completed the Edinburgh Postnatal Depression Scale and responded to inquiries about child-maltreatment behaviors. RESULTS After adjusting for covariates, MIBD was associated with higher odds of maternal depression (OR=1.737, 95 % CI [1.078, 2.797]) and child-maltreatment behaviors (OR=2.040, 95 % CI [1.401, 2.970]) six months later. Further analysis indicated that MIBD was particularly associated with a heightened risk of emotional abuse (OR=2.172, 95 % CI [1.486, 3.176]). Sensitivity analysis confirmed these findings through multiple approaches, such as applying inverse probability weighting to mitigate selection bias, using an alternative MIBS cutoff score of 5, and adopting a time-varying model to account for the dynamic nature of depressive symptoms and child-maltreatment behaviors. CONCLUSION Proactive screening for MIBD could serve as a valuable tool in the early detection of maternal depression and potential child-maltreatment behaviors.
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Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Kosuke Hagiwara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tomohiro Mizumoto
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Naoko Higuchi
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Zara S, Kruse J, Brähler E, Sachser C, Fegert JM, Ladwig KH, Ernst M, Kampling H. Suicidal ideation in patients with diabetes and childhood abuse - The mediating role of personality functioning: Results of a German representative population-based study. Diabetes Res Clin Pract 2024; 210:111635. [PMID: 38521129 DOI: 10.1016/j.diabres.2024.111635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
AIMS Suicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning. METHODS In a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi2-Tests, logistic regression and mediation analyses. RESULTS The prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ2(1) = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ2(1) = 10.892, p <.001). A dose-response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]). CONCLUSIONS Diabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.
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Affiliation(s)
- Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany.
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Baldingerstrasse, 35043 Marburg, Germany; German Center for Diabetes Research (DZD), München 85764, Neuherberg, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; German Center for Mental Health (DZPG), partner site Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany; German Center for Mental Health (DZPG), partner site Ulm, Germany
| | - Karl-Heinz Ladwig
- German Center for Diabetes Research (DZD), München 85764, Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Department of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Germany
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Otterman G, Nurmatov UB, Akhlaq A, Korhonen L, Kemp AM, Naughton A, Chalumeau M, Jud A, Vollmer Sandholm MJ, Mora-Theuer E, Moultrie S, Lamela D, Tagiyeva-Milne N, Nelson J, Greenbaum J. Clinical care of childhood sexual abuse: a systematic review and critical appraisal of guidelines from European countries. Lancet Reg Health Eur 2024; 39:100868. [PMID: 38420107 PMCID: PMC10899013 DOI: 10.1016/j.lanepe.2024.100868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 03/02/2024]
Abstract
Background The clinical management of Child sexual abuse (CSA) demands specialised skills from healthcare professionals due to its sensitivity, legal implications, and serious physical health and mental health effects. Standardised, comprehensive clinical practice guidelines (CPGs) may be pivotal. In this systematic review, we examined existing CSA national CPGs (NCPGs) from European countries to assess their quality and reporting. Methods We systematically searched six international databases and multiple grey literature sources, reporting by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligible guidelines were CSA guidance from national health agencies or societies in 34 COST Action 19106 Network Countries (CANC), published between January 2012 and November 2022. Two independent researchers searched, screened, reviewed, and extracted data. NCPGs were compared for completeness with reference WHO 2017 and 2019 guidelines. We used the Appraisal of Guidelines for Research and Evaluation (AGREE II) to appraise quality and reporting. PROSPERO: CRD42022320747. Findings Of 2919 records identified by database searches, none met inclusion criteria. Of 4714 records identified by other methods, 24 NCPGs from 17 (50%) of CANC countries were included. In 17 (50%) of eligible countries, no NCPGs were found. Content varied significantly within and between countries. NCPGs lacked many components in state-of-the art clinical practice compared to WHO reference standards, particularly in safety and risk assessment, interactions with caregivers, and mental health interventions. Appraisal by AGREE II revealed shortcomings in NCPG development, regarding scientific rigour, stakeholder involvement, implementation and evaluation. Interpretation A notable number of European countries lack an NCPG; existing NCPGs often fall short. The healthcare response to CSA in Europe requires a coordinated approach to develop and implement high-quality CPGs. We advocate for a multidisciplinary team to develop a pan-European CSA guideline to ensure quality care for survivors. Funding Funding was provided by the International Centre for Missing and Exploited Children.
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Affiliation(s)
- Gabriel Otterman
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ulugbek B. Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Ather Akhlaq
- Institute of Business Management, Karachi, Pakistan
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Alison M. Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Aideen Naughton
- National Safeguarding Service, Public Health Wales, Cardiff, UK
| | - Martin Chalumeau
- Child Protection Unit - Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, France
| | - Andreas Jud
- Clinic for Child and Adolescent Psychiatry, Ulm University Clinics, Ulm, Germany
| | | | - Eva Mora-Theuer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Sarah Moultrie
- Pediatric Trauma Services, Benioff Children's Hospitals- Oakland, Oakland, CA, USA
| | - Diogo Lamela
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Porto, Portugal
| | - Nara Tagiyeva-Milne
- Department of Education, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Joanne Nelson
- Child and Adolescent Sexual Assault Treatment Service, Barnahus West, Saolta University Health Care Group, Galway, Ireland
| | - Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA, USA
| | - the COST Action 19106 Research Team
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
- Institute of Business Management, Karachi, Pakistan
- National Safeguarding Service, Public Health Wales, Cardiff, UK
- Child Protection Unit - Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, France
- Clinic for Child and Adolescent Psychiatry, Ulm University Clinics, Ulm, Germany
- Department of Forensic Sciences, Oslo University, Oslo, Norway
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Pediatric Trauma Services, Benioff Children's Hospitals- Oakland, Oakland, CA, USA
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University, Porto, Portugal
- Department of Education, Liverpool School of Tropical Medicine, Liverpool, UK
- Child and Adolescent Sexual Assault Treatment Service, Barnahus West, Saolta University Health Care Group, Galway, Ireland
- International Centre for Missing and Exploited Children, Alexandria, VA, USA
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11
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Brown MP, Witmer R, Johnson A. The influence of friendships on the mental health of maltreated youth: A pre-registered systematic review using a developmental psychopathology perspective. Dev Psychopathol 2024:1-12. [PMID: 38532717 DOI: 10.1017/s0954579424000476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Friendships are a potential factor that influence maltreated children's risk for psychopathology. This systematic review examined (1) how friendships influence the association between child maltreatment and psychopathology and (2) developmental differences in how friendships influence this association. Four databases were searched. Inclusion criteria were primary study, quantitative, measures of maltreatment and friendship up to the age of 18 years, measures of psychopathology up to the age of 24 years, and a non-maltreated sample. Exclusion criteria were qualitative, reviews or meta-analyses, no distinction between maltreatment and other trauma, and no differentiation between friendships and other support. Risk of bias was assessed. Data were narratively synthesized. Two hundred thirty-five articles were retrieved for full review. Fourteen met inclusion criteria (N = 98,676 participants). Eleven of the fourteen studies found that some aspect of friendships influenced the association between maltreatment and psychopathology, with positive qualities generally decreasing risk and negative qualities increasing risk for psychopathology. However, peer support exacerbated maltreated children's risk for psychopathology in two studies. Only three studies assessed friendship prior to adolescence, which precluded conclusions regarding developmental differences. Future research should consider developmental differences and use findings and validated measures from the peer relations literature to better understand how friendships influence maltreated youth's vulnerability to psychopathology.
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Affiliation(s)
- Michelle P Brown
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Rhoda Witmer
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Alexsia Johnson
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, CA, USA
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12
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Yoon S, Ploss A, Hutzel M, Webb R, Hatfield A, Lee JY, Munshi A, Radney A, McClellan J. Parenting attitudes and behaviors among parents involved with the child welfare system and affected by substance use disorders. Child Abuse Negl 2024; 149:106657. [PMID: 38262180 DOI: 10.1016/j.chiabu.2024.106657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/13/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Co-occurring parental substance use and child maltreatment is a serious concern in the U.S child welfare system. OBJECTIVE The aim of the study was to examine parenting attitudes and practices among parents who participated in Ohio START (Sobriety, Treatment, And Reducing Trauma), a statewide initiative that provides support to families affected by co-occurring parental substance use and child maltreatment. PARTICIPANTS AND SETTING Study 1 involved quantitative data collected from 73 enrolled parents through pre-test and post-test telephone surveys. Study 2 (parent interviews) involved qualitative data collected through in-depth interviews with 34 enrolled parents. METHODS The paired-sample t-test and the McNemar test were conducted in Study 1 and thematic analysis was conducted in Study 2. RESULTS Quantitative analysis indicated significant improvements in parental expectations of children (t = -3.42, p = .001, Cohen's d = -0.40), parent-child family roles (t = -5.74, p < .001, Cohen's d = -0.67), and children's power and independence (t = -3.42, p = .001, Cohen's d = -0.40). Qualitative analysis revealed six themes related to changes in parenting after participation in Ohio START: (1) Being present for children, (2) Engaging in activities with children, (3) Enjoyment in providing care to children, (4) Maintaining employment for financial stability, (5) Better emotion regulation and stress management, and (6) a sense of pride. CONCLUSIONS Our findings demonstrate positive changes in parenting attitudes and practices among parents who participated in Ohio START and provide further support for the potential merits of this model and its continued expansion throughout Ohio.
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Affiliation(s)
- Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, USA; Department of Social Welfare, College of Social Sciences, Ewha Womans University, Seoul, South Korea.
| | - Alexa Ploss
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Margaret Hutzel
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Robin Webb
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Ally Hatfield
- Voinovich School of Leadership and Public Service, Ohio University, Athens, OH, USA
| | - Joyce Y Lee
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Additti Munshi
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Angelise Radney
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Jen McClellan
- Public Children Services Association of Ohio (PCSAO), Columbus, OH, USA
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13
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Chen Y. The effects of child maltreatment and exposure to intimate partner violence on the co-occurrence of anxious/depressive symptoms and aggressive behavior. Child Abuse Negl 2024; 149:106655. [PMID: 38244382 DOI: 10.1016/j.chiabu.2024.106655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Child maltreatment (CM) and exposure to intimate partner violence (IPV) pose significant threats to child behavioral health, particularly for young children in toddlerhood and early childhood. Children who experience CM and/or are exposed to IPV are more likely to develop anxious/depressive symptoms and aggressive behavior. OBJECTIVE This study is a three-year longitudinal examination of the effects of CM and exposure to IPV on the co-occurrence of anxious/depressive symptoms and aggressive behavior. PARTICIPANTS AND SETTING The sample included 459 children drawn from the National Survey of Child and Adolescent Well-Being II, a national longitudinal study that investigated the outcomes and well-being of children and families that were involved in Child Protective Services (CPS). METHODS Latent growth curve modeling was conducted to examine the correlation between the trajectories of anxious/depressive symptoms and aggressive behavior, and the effect of CM and IPV exposure on child behavioral outcomes. RESULTS A positive correlation was observed between anxious/depressive symptoms and aggressive behavior intercepts, and the slope parameters of both growth models were also positively correlated. CM and IPV exposure was associated with worse anxious/depressive symptoms and aggressive behavior over time. CONCLUSIONS The findings suggest the co-occurrence of anxious/depressive symptoms and aggressive behavior among CPS-involved children and demonstrate the negative effects of CM and IPV exposure on children over time. The findings pinpoint the necessity of comprehensive methodological considerations for research and a lens of trauma-informed care for practice.
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Affiliation(s)
- Yafan Chen
- School of Social Work, Rutgers, The State University of New Jersey, United States of America.
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14
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Kim BN, Jo H, Kang S, Kim SY, Park HY, Park J, Kang HS. Development and Validation of the Mental Health Scale for Maltreated Children. Psychiatry Investig 2024; 21:242-254. [PMID: 38569582 PMCID: PMC10990630 DOI: 10.30773/pi.2023.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/09/2023] [Accepted: 12/09/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE This study aimed to develop and validate a comprehensive self-report questionnaire to assess emotional and behavioral problems and psychological trauma in maltreated children. METHODS The Mental Health Scale for Maltreated Children (MHS-MC) was constructed to encompass five major symptoms (depression, anxiety, inattention/hyperactivity/impulsivity, aggression/defiance, and psychological trauma) prevalent in maltreated children. Critical items and ego-resilience subscale were also devised to increase clinical utility. After informed consent, 205 children (maltreated children, n=157, 76.6%) were recruited nationwide, and they answered a package of self-report measures, including the MHS-MC. Reliability, construct validity, concurrent validity, and criterion-related validity were examined to explore the psychometric properties. RESULTS The reliability was good to excellent. Confirmatory factor analysis yielded a five-factorial solution for the symptom subscales supporting construct validity. In logistic regression, the total scores of the MHS-MC predicted membership in the maltreated group. Criterion-related validity was generally satisfactory in that all subscales of the MHS-MC showed significant correlations with relevant measures in the expected direction. CONCLUSION This is the first attempt to develop a comprehensive psychological scale based on nationwide data collected from maltreated Korean children. We hope that the continued standardization of this scale will contribute to evidence-based clinical and policy decisionmaking for maltreated children.
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Affiliation(s)
- Bin-Na Kim
- Department of Psychology, Gachon University, Seongnam, Republic of Korea
| | - Hyeseon Jo
- Child Protection Office, National Center for the Rights of the Child, Seoul, Republic of Korea
| | - Suhyeon Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Soo-Yeon Kim
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Ha-young Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Jungkyu Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
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15
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Töpfer P, Siewert-Markus U, Klinger-König J, Grabe HJ, Stracke S, Dörr M, Völzke H, Ittermann T, Markus MRP. Sex-specific associations of childhood maltreatment with obesity-related traits - The Study of Health in Pomerania (SHIP). Child Abuse Negl 2024; 149:106704. [PMID: 38395019 DOI: 10.1016/j.chiabu.2024.106704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Child maltreatment (CM) is linked to obesity in adulthood. However, sex-differences and direct measurements of body fat have previously been insufficiently considered in this context. OBJECTIVE To assess sex-specific associations of CM with anthropometric markers of overweight/obesity and direct measures of body fat. PARTICIPANTS AND SETTING Analyses were conducted in 4006 adults from a population-based cohort in Northeastern Germany (SHIP-TREND-0). METHODS CM was assessed using the Childhood Trauma Questionnaire (CTQ). Obesity-related traits included anthropometric indicators (i.e., height, weight, body mass index [BMI], waist [WC] and hip circumference [HC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), fat mass (FM) and fat-free mass (FFM) derived from bioelectrical impedance analysis (BIA), and subcutaneous (SAT) and visceral adipose tissue (VAT) ascertained using magnetic resonance imaging (MRI). Sex-stratified linear regression models predicting obesity-related traits from total CTQ scores were adjusted for age and education. Exploratory analyses investigated effects of CTQ subscales on obesity-related traits. RESULTS In men, CM was positively associated with WHtR (β = 0.04; p = .030) and VAT (β = 0.02; p = .031) and inversely with body height (β = -0.05; p = .010). In women, CM-exposure was positively associated with body weight (β = 0.07; p = .018), BMI (β = 0.03; p = .013), WC (β = 0.07; p = .005), HC (β = 0.05; p = .046), WHR (β = 0.03; p = .015), WHtR (β = 0.04; p = .006), FM (β = 0.04; p = .006), and SAT (β = 0.06; p = .041). In both sexes, effects were mainly driven by exposure to emotional and physical abuse. CONCLUSIONS Results suggest that associations between CM-exposure and obesity-related traits in adulthood are primarily present in women. This may have implications for sex-specific obesity-related cardiometabolic risk after CM.
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Affiliation(s)
- Philipp Töpfer
- Department of Medical Psychology, University Medicine Greifswald, Germany.
| | | | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD) partner site Greifswald, Greifswald, Germany
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16
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Dean JR, Kaczor K, Lorenz D, Mason M, Simonton K. Characteristics of child abuse fatalities: Insights from a statewide violent death reporting system. Child Abuse Negl 2024; 149:106649. [PMID: 38295604 DOI: 10.1016/j.chiabu.2024.106649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Child maltreatment fatalities are a significant public health issue. Case level characteristics of abuse-related deaths can increase our understanding of maltreatment fatalities and inform region-specific prevention initiatives. OBJECTIVE Explore child abuse fatalities in the Illinois Violent Death Reporting System (IVDRS) for commonalities and distinctive features. METHODS, PARTICIPANTS AND SETTING A mixed methods study was conducted using IVDRS data from 2015 to 2018. All fatalities with a homicide or undetermined manner of death among decedents 10 years old or younger were included. Both discrete and narrative data were analyzed separately for victim, suspect, circumstance, and household characteristics. RESULTS Of the 106 deaths that met inclusion criteria, 74 % of homicide deaths (64/86) and 50 % of undetermined deaths (10/20) were due to abuse. Psychosocial characteristics most often identified in abusive deaths included family relationship problems, mental illness, and history of substance abuse. Other common characteristics included use of personal weapons or blunt instruments and death due to punishment. Including narrative data rather than discrete data alone identified 148 % more deaths with three characteristics commonly found in abusive deaths: history of abuse, shaken baby syndrome, and family history of violence. CONCLUSION This study demonstrates the capability of multi-source state-level data to enrich our understanding of child abuse fatalities. Employing the narrative review method in other states using the National Violent Death Reporting System may increase the identification of abuse fatalities. Improved recognition and characterization of abuse fatalities has the potential to help address systemic factors involved and enhance targeted prevention efforts. WHAT IS KNOWN Child abuse fatalities represent a significant and preventable public health issue in the United States. Case-specific characteristics are limited in national data sets, and their absence curtails prevention opportunities. WHAT THIS STUDY ADDS State-wide reporting systems of violent deaths offer rich and multisource data regarding child abuse fatalities including detailed victim, suspect, circumstance, and household characteristics. This data can be used to enhance our knowledge of maltreatment fatalities and may inform region-specific public health and prevention initiatives.
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Affiliation(s)
- Julie Robin Dean
- Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, USA.
| | - Kim Kaczor
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, USA.
| | - Doug Lorenz
- Department of Bioinformatics and Biostatistics, University of Louisville, 485 E. Gray St. Louisville, KY 40202, USA.
| | - Maryann Mason
- Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL 60611, USA.
| | - Kirsten Simonton
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, USA.
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17
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Lima F, Taplin S, Maclean M, O'Donnell M. Infants entering out-of-home care: Health, developmental needs and service provision. Child Abuse Negl 2024; 149:106577. [PMID: 38044250 DOI: 10.1016/j.chiabu.2023.106577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND There are rising numbers of infants entering out-of-home care due to child protection concerns. Research has found that infants entering care are at higher risk of developmental vulnerability and poor health problems. OBJECTIVES To determine the prevalence of developmental vulnerability for children who entered care as infants, and the extent and likelihood of service provision in relation to their developmental vulnerability. PARTICIPANTS AND SETTING This study includes children who entered care before the age of 1 year for the first time between May 2010 and October 2011 in New South Wales, Australia, and who received final Children's Court care and protection orders by 30 April 2013. METHODS This is a prospective cohort study using interview data from the Pathways of Care Longitudinal Study (POCLS) as well as linked administrative child protection and health data. This study used standardised assessments (Age and Stages Questionnaire and the Brief Infant Toddler Social Emotional Assessment) included in the POCLS. Simple and multiple logistic regression analysis was conducted to investigate the likelihood of infants receiving professional services for developmental delays since placement. FINDINGS A high proportion of children who entered care as infants were identified as developmentally vulnerable through health indicators (36 %) and standardised assessments (70 %). Only 17 % of infants in care received services for developmental delay, with 20 % and 15 % of those identified as developmentally vulnerable through standardised assessments and health-related variables receiving services, respectively. CONCLUSIONS The findings point to the importance of developmental assessment of infants in care and the identification of developmental vulnerability and delays. The provision of early intervention services is essential for this group of high-risk infants and will be important in optimising their health, as well as social and emotional outcomes.
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Affiliation(s)
- Fernando Lima
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia.
| | - Stephanie Taplin
- School of Public Health, Faculty of Health, University of Technology Sydney, Canberra, ACT, Australia
| | - Miriam Maclean
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia
| | - Melissa O'Donnell
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia
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Brink FW, Lo CB, Rust SW, Puls HT, Stanley R, Galdo B, Lindberg DM. Pilot study using machine learning to improve estimation of physical abuse prevalence. Child Abuse Negl 2024; 149:106681. [PMID: 38368780 DOI: 10.1016/j.chiabu.2024.106681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/08/2023] [Accepted: 01/27/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes have been shown to underestimate physical abuse prevalence. Machine learning models are capable of efficiently processing a wide variety of data and may provide better estimates of abuse. OBJECTIVE To achieve proof of concept applying machine learning to identify codes associated with abuse. PARTICIPANTS AND SETTING Children <5 years, presenting to the emergency department with an injury or abuse-specific ICD-10-CM code and evaluated by the child protection team (CPT) from 2016 to 2020 at a large Midwestern children's hospital. METHODS The Pediatric Health Information System (PHIS) and the CPT administrative databases were used to identify the study sample and injury and abuse-specific ICD-10-CM codes. Subjects were divided into abused and non-abused groups based on the CPT's evaluation. A LASSO logistic regression model was constructed using ICD-10-CM codes and patient age to identify children likely to be diagnosed by the CPT as abused. Performance was evaluated using repeated cross-validation (CV) and Reciever Operator Characteristic curve. RESULTS We identified 2028 patients evaluated by the CPT with 512 diagnosed as abused. Using diagnosis codes and patient age, our model was able to accurately identify patients with confirmed PA (mean CV AUC = 0.87). Performance was still weaker for patients without existing ICD codes for abuse (mean CV AUC = 0.81). CONCLUSIONS We built a model that employs injury ICD-10-CM codes and age to improve accuracy of distinguishing abusive from non-abusive injuries. This pilot modelling endeavor is a steppingstone towards improving population-level estimates of abuse.
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Affiliation(s)
- Farah W Brink
- Nationwide Children's Hospital, 700 Childrens Drive, Columbus, OH 43205, United States; The Ohio State University College of Medicine, 370 West Ninth Avenue, Columbus, OH 43210, United States.
| | - Charmaine B Lo
- Nationwide Children's Hospital, 700 Childrens Drive, Columbus, OH 43205, United States; Abigail Wexner Research Institute, 700 Children's Drive, Columbus, OH 43205, United States
| | - Steven W Rust
- IT Research & Innovation, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Henry T Puls
- Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States; University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, United States
| | - Rachel Stanley
- Nationwide Children's Hospital, 700 Childrens Drive, Columbus, OH 43205, United States; The Ohio State University College of Medicine, 370 West Ninth Avenue, Columbus, OH 43210, United States
| | - Brendan Galdo
- IT Research & Innovation, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States
| | - Daniel M Lindberg
- The Kempe Center for the Prevention and Treatment of Child Abuse & Neglect, 13123 East 16(th) Avenue, Aurora, CO 80045, United States; Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, 13001 East 17(th) Place, Aurora, CO 80045, United States
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19
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Saitadze I, Dvalishvili DD. Protective role of informal social support and early childhood programs in reducing likelihood of subsequent reports of child maltreatment. Child Abuse Negl 2024; 149:106702. [PMID: 38422581 DOI: 10.1016/j.chiabu.2024.106702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 12/04/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND While past research has suggested the importance of informal social support and early childhood programs for the well-being of child welfare supervised families and children, little is known about whether or not these mechanisms function as protective factors for child welfare involved families and mediate the likelihood of repeat child maltreatment. OBJECTIVE The study examined the role of informal social support and early childhood program participation in mediating the effects of initial report of child neglect on subsequent child maltreatment reports. PARTICIPANTS & SETTING The study sample of children ages 0-6 (N = 1963) was drawn from the NSCAW-II dataset, a nationally representative longitudinal dataset of 5872 child welfare supervised children and their families. METHODS Structural Equation Modeling was used to examine the direct and indirect pathways: from initial report of neglect to all subsequent child maltreatment reports and from initial report of neglect to all subsequent child maltreatment reports through mediating variables such as informal social support and early childhood programs. RESULTS Results showed that informal social support plays an important role in reducing the likelihood of subsequent reports (b = -0.00, p = 0.005). One unit increase in informal social support reduced the odds of a child maltreatment re-report by 0.3 % (odds ratio for informal social support OR = 0.997). IMPLICATIONS It is important that child welfare supervised families are supported in enhancing their informal networks with their family members and friends and expanding non-familial informal networks in the community.
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Affiliation(s)
- Inga Saitadze
- 2180 3rd Ave, Silberman School of Social Work at Hunter College, CUNY, New York, NY 10035, United States of America.
| | - Darejan Daji Dvalishvili
- Institute for Quality Children's Services, College of Social Work, Florida State University, 296 Champions Way, Tallahassee, FL 32306-2507, United States of America.
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Holmes MR, Bender AE, Yoon S, Berg KA, Duda-Banwar J, Chen Y, Evans KE, Korsch-Williams A, Perzynski AT. Examination of protective factors that promote prosocial skill development among children exposed to intimate partner violence. Dev Psychopathol 2024:1-14. [PMID: 38414276 DOI: 10.1017/s0954579424000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This retrospective cohort study examined prosocial skills development in child welfare-involved children, how intimate partner violence (IPV) exposure explained heterogeneity in children's trajectories of prosocial skill development, and the degree to which protective factors across children's ecologies promoted prosocial skill development. Data were from 1,678 children from the National Survey of Child and Adolescent Well-being I, collected between 1999 and 2007. Cohort-sequential growth mixture models were estimated to identify patterns of prosocial skill development between the ages of 3 to 10 years. Four diverse pathways were identified, including two groups that started high (high subtle-decreasing; high decreasing-to-increasing) and two groups that started low (low stable; low increasing-to-decreasing). Children with prior history of child welfare involvement, preschool-age IPV exposure, school-age IPV exposure, or family income below the federal poverty level had higher odds of being in the high decreasing-to-increasing group compared with the high subtle-decreasing group. Children with a mother with greater than high school education or higher maternal responsiveness had higher odds of being in the low increasing-to-decreasing group compared with the low stable group. The importance of maternal responsiveness in fostering prosocial skill development underlines the need for further assessment and intervention. Recommendations for clinical assessment and parenting programs are provided.
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Affiliation(s)
- Megan R Holmes
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Anna E Bender
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
| | - Susan Yoon
- The College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Kristen A Berg
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
- Center for Health Care Research and Policy, The MetroHealth System, Case Western Reserve University, Cleveland, OH, USA
| | | | - Yafan Chen
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Kylie E Evans
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
- Breen School of Nursing and Health Professions, Ursuline College, Pepper Pike, OH, USA
| | - Amy Korsch-Williams
- Center on Trauma and Adversity, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Adam T Perzynski
- Center for Health Care Research and Policy, The MetroHealth System, Case Western Reserve University, Cleveland, OH, USA
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21
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Brodbeck J, Bötschi SIR, Vetsch N, Stallmann L, Löchner J, Berger T, Schmidt SJ, Marmet S. Fostering resilience and well-being in emerging adults with adverse childhood experiences: study protocol for a randomized controlled trial to evaluate the FACE self-help app. BMC Psychol 2024; 12:84. [PMID: 38374126 PMCID: PMC10877810 DOI: 10.1186/s40359-024-01560-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP). METHODS The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions). DISCUSSION The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood. TRIAL REGISTRATION NUMBER NCT05824182.
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Affiliation(s)
- Jeannette Brodbeck
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland.
- Department of Clinical Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland.
| | - Salome I R Bötschi
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| | - Neela Vetsch
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| | - Lina Stallmann
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
- Swiss Center for Affective Science, University of Geneva, Chemin des Mines 9, CH-1202, Geneva, Switzerland
| | - Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tuebingen, Germany
| | - Thomas Berger
- Department of Clinical Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland
| | - Stefanie J Schmidt
- Department of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland
| | - Simon Marmet
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
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22
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Mihret AM, Heinrichs N. Intergenerational effects of child maltreatment on adolescents' anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress. BMC Psychiatry 2024; 24:126. [PMID: 38360563 PMCID: PMC10870629 DOI: 10.1186/s12888-024-05586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC. METHODS A total of 231 adolescents (age: 13-21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors. RESULTS The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [- 0.770, - 0.012]). CONCLUSIONS We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.
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Affiliation(s)
- Amare Misganaw Mihret
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany.
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany.
| | - Nina Heinrichs
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany
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23
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Chen XC, Xu JJ, Yin XT, Qiu YF, Yang R, Wang ZY, Han YW, Wang QK, Zhai JH, Zhang YS, Ran MS, Hu JM. Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury. J Affect Disord 2024; 347:57-65. [PMID: 37995923 DOI: 10.1016/j.jad.2023.11.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. METHODS Participants, 3918 community-based Chinese young men aged 18-34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. RESULTS The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %-6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LIMITATIONS The cross-sectional survey data limits the robustness of the proof to the causal relationships. CONCLUSIONS Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.
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Affiliation(s)
- Xia-Can Chen
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jia-Jun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Tong Yin
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Feng Qiu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Rui Yang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Zi-Ye Wang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yi-Wei Han
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Qi-Kai Wang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jin-Hui Zhai
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Shu Zhang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Jun-Mei Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China.
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24
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Lim-Reinders S, Ward MGK, Malic C, Keely K, Kang K, Jain N, Zwicker K. Identifying child maltreatment during virtual medical appointments through the COVID-19 pandemic: A physician-based survey. Paediatr Child Health 2024; 29:23-28. [PMID: 38332977 PMCID: PMC10848113 DOI: 10.1093/pch/pxad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/21/2023] [Indexed: 02/10/2024] Open
Abstract
Background Throughout the COVID-19 pandemic there has been a documented decline in reports to child protective services, despite an increased incidence of child maltreatment. This is concerning for increasing missed cases. This study aims to examine if and how Canadian paediatricians are identifying maltreatment in virtual medical appointments. Methods A survey was sent through the Canadian Paediatric Surveillance Program (CPSP) to 2770 practicing general and subspecialty paediatricians. Data was collected November 2021 to January 2022. Results With a 34% (928/2770) response rate, 704 surveys were eligible for analysis. At least one case of child maltreatment was reported by 11% (78/700) of respondents following a virtual appointment. The number of cases reported was associated with years in medical practice (P = 0.026) but not with the volume (P = 0.735) or prior experience (P = 0.127) with virtual care, or perceived difficulty in identifying cases virtually (Cramer's V = 0.096). The most common factors triggering concern were the presence of social stressors, or a clear disclosure. The virtual physical exam was not contributory. Nearly one quarter (24%, 34/143) required a subsequent in-person appointment prior to reporting the case and 32% (207/648) reported concerns that a case had been identified late, or missed, following a virtual appointment. Some commented that clear harm resulted. Conclusions Many barriers to detecting child maltreatment were identified by paediatricians who used virtual care. This survey reveals that virtual care may be an important factor in missed cases of child maltreatment and may present challenges to timely identification.
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Affiliation(s)
| | | | - Claudia Malic
- Division of Plastic Surgery, Department of Paediatric Surgery, University of Ottawa, Ottawa, Canada
| | - Kathryn Keely
- Division of Community Pediatrics, Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Kristopher Kang
- Division of General Paediatrics, Department of Paediatrics, Faculty of Medicine, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
| | - Nita Jain
- Child Protection Service Unit, Department of Paediatrics, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
| | - Kelley Zwicker
- Division of Community Pediatrics, Department of Pediatrics, University of Ottawa, Ottawa, Canada
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25
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Seltzer RR, Thompson BS. Pediatrician as Advocate and Protector: An Approach to Medical Neglect for Children with Medical Complexity. Pediatr Clin North Am 2024; 71:59-70. [PMID: 37973307 DOI: 10.1016/j.pcl.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
For children with medical complexity (CMC), gaps in medical care can result in significant harm. When concerns for medical neglect arise for CMC, pediatricians may experience ethical challenges in attempting to simultaneously avoid harm, promote well-being, respect family goals and values, and maintain a positive therapeutic relationship. This article proposes an ethics-guided approach to identifying and addressing underlying modifiable risk factors for medical neglect through collaboration with family caregivers and other stakeholders (eg, medical providers, school staff, and community resources). Pediatricians should recognize their critical role, beyond only as a mandated reporter, to be a mandated supporter.
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Affiliation(s)
- Rebecca R Seltzer
- Department of Pediatrics, Johns Hopkins School of Medicine; Johns Hopkins Berman Institute of Bioethics; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health.
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26
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Øverhaug OMS, Laue J, Vis SA, Risør MB. 'There's a will, but not a way': Norwegian GPs' experiences of collaboration with child welfare services - a grounded theory study. BMC Prim Care 2024; 25:36. [PMID: 38267870 PMCID: PMC10807144 DOI: 10.1186/s12875-024-02269-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Adverse childhood experiences can have immediate effects on a child's wellbeing and health and may also result in disorders and illness in adult life. General practitioners are in a good position to identify and support vulnerable children and parents and to collaborate with other agencies such as child welfare services. There is a need for better integration of relevant services. The aim of this study is to explore GPs' experiences of the collaboration process with child welfare services. METHOD This is a qualitative grounded theory study, with data consisting of ten semi-structured interviews with general practitioners across Norway. RESULTS The doctors' main concern was: 'There's a will, but not a way'. Three subordinate stages of the collaboration process were identified: (I) Familiar territory, with a whole-person approach to care by the doctor. (II) Unfamiliar territory, when child welfare becomes involved. Here, a one-way window of information and a closed door to dialogue perpetuate the doctors' lack of knowledge about child welfare services and uncertainty about what is happening to their patients. (III) Fragmented territory, where doctors experience lost opportunities to help and missing pieces in the patient's history. CONCLUSION General practitioners are willing to contribute to a collaborative process with child welfare, but this is hampered by factors such as poor information flow and opportunities for dialogue, and limited knowledge of the partner. This implies lost opportunities for doctors to help families and contribute their knowledge and potential actions to a child welfare case. It can also impede whole-person care and lead to fragmentation of patient pathways. To counteract this, electronic two-way communication could enable a collaborative process and relationships that enhance coordination between the parties. Making space for all parties and their individual roles was considered important to create a positive collaborative environment.
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Affiliation(s)
| | - Johanna Laue
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Svein Arild Vis
- Regional Centre for Child and Youth Mental Health & Child Welfare, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Mette Bech Risør
- Department of Community Medicine, The General Practice Research Unit, UiT The Arctic University of Norway, Tromsø, Norway
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Mohammed YY, Abu-Nazel MW, Aly RSI, Shata ZN. The role of adverse childhood experiences in predicting child abuse perpetration among married mothers in Alexandria, Egypt: a cross-sectional study. BMC Womens Health 2024; 24:59. [PMID: 38263083 PMCID: PMC10804716 DOI: 10.1186/s12905-024-02903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are receiving increased amounts of attention as a critical public health issue. ACEs have a massive impact on future violence victimization and perpetration. They are also associated with lifelong mental and physical health consequences as well as premature mortality. The present study aimed to investigate the role of different ACEs among married mothers in predicting the risk of child abuse perpetration in offspring. METHODS A cross-sectional study was conducted on 350 mothers of children aged 2-12 years attending family health centres in Alexandria. The mothers completed a predesigned interview questionnaire on sociodemographic data and data related to ACEs, spousal violence, and child abuse perpetration. Suitable bivariate and multivariate statistical tests were used to analyse the collected data using version 20.0 of the Statistical Package for Social Sciences (SPSS). RESULTS Two-thirds of mothers (66.3%) reported ever having been exposed to any ACE, and 18.6% of them had experienced 3 or more ACEs. Psychological abuse (46%) and witnessing domestic violence (17%) were the most common. Psychological aggression (95.4%), minor physical assault (79%), and neglect (52%) were the most common forms of child abuse perpetrated by the mothers. The number of ACEs experienced by mothers showed a moderate positive significant correlation with the 5 forms of child abuse examined. Different ACEs, mother's age, socioeconomic status, and current exposure to spousal violence were found to be independent predictors of different forms of child abuse (psychological aggression, neglect, minor physical assault, and severe physical assault). CONCLUSION Different practices of family violence are strongly connected throughout different stages of an individual's life and across generations. Further understanding of the interconnections among forms of violence and addressing them should be prioritized. Additionally, concerted national strategies across all levels and sectors are needed to address this complex problem.
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Affiliation(s)
- Yasmine Yousry Mohammed
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt.
| | - Mervat Wagdy Abu-Nazel
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt
| | | | - Zeinab Nazeeh Shata
- Family Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Avenue - El Hadara, Alexandria, Egypt
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28
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Gao Y, Liang C, Liu X, Bai R, Xing S. Self-esteem buffers the stress sensitizing effect of childhood maltreatment on adolescent nonsuicidal self-injury. J Affect Disord 2024; 345:85-93. [PMID: 37865345 DOI: 10.1016/j.jad.2023.10.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/10/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Adversity in childhood increases the risk of psychopathology, perhaps by influencing sensitivity to recent stressful life events (SLEs). However, little is known about the stress-sensitizing effect of childhood adversity on nonsuicidal self-injury (NSSI), whether stress sensitization exists in specific types of SLEs, and the stress-buffering effect of self-esteem. This study aimed to investigate whether exposure to child maltreatment increases adolescent's vulnerability to the effects of dependent and independent SLEs on later NSSI and whether self-esteem buffers this risk. METHODS We conducted a two-wave study with 18-month intervals. 601 Chinese adolescents completed self-report measures of child maltreatment, SLEs, self-esteem, and NSSI. RESULTS Results supported the stress sensitization hypothesis for child maltreatment regarding dependent SLEs, with dependent SLEs significantly predicting later NSSI only in maltreated adolescents. Moreover, self-esteem buffered the relationship between dependent SLEs and NSSI in maltreated adolescents but amplified the relationship in non-maltreated adolescents. In the maltreated group, dependent SLEs predicted increased NSSI only in those with low self-esteem. In contrast, in the control group, dependent SLEs were significantly associated with NSSI in individuals with high self-esteem. LIMITATIONS We did not collect information on the timing of exposure to child maltreatment. Future studies that assess child maltreatment during critical periods of development may be able to identify sensitive period in which maltreatment sensitizes individuals to stress in adolescents. CONCLUSION Findings provide preliminary evidence that child maltreatment has a stress-sensitizing effect on adolescent NSSI. Improving self-esteem may mitigate the associations between SLEs and NSSI in adolescents exposed to child maltreatment.
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Affiliation(s)
- Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Chunxi Liang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
| | - Rong Bai
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shufen Xing
- School of Psychology, Capital Normal University, Beijing, China
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29
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Bouchelle Z, Darwiche S, Dalembert G. Financial support policies as a mechanism to reduce child welfare involvement. Curr Probl Pediatr Adolesc Health Care 2024:101554. [PMID: 38184448 DOI: 10.1016/j.cppeds.2023.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2024]
Affiliation(s)
- Zoe Bouchelle
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Denver Health, Denver, CO, United States; Guaranteed Income and Health Consortium, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Sabrina Darwiche
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - George Dalembert
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, United States
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Rhoden-Neita MA, Huang H, Fava NM. The Effects of Childhood Adversity and Self-Regulation on the Well-Being of Adults with Delinquency Histories: A Mediation Model. J Evid Based Soc Work (2019) 2024; 21:117-139. [PMID: 37847740 DOI: 10.1080/26408066.2023.2265923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
PURPOSE Most youth with delinquency histories experience childhood adversity leaving them vulnerable to poor adult well-being. Previous research indicates that self-regulation difficulties could explain how childhood adversity affects adult well-being. Yet, very few studies target adult self-regulation intervention. Therefore, this study examined the intervening effects of emerging adult self-regulation on the association between childhood adversity and adult well-being. METHOD Using data from the first four waves of the Add Health Study, the researchers conducted structural equation modeling for mediation with bootstrapping. The researchers tested the mediation effects of emerging adult self-regulation on the association between childhood adversity (child maltreatment and violent victimization) and later adult well-being (mental health problems, alcohol and drug use, criminal behaviors) among people with delinquency histories and/or arrest prior to age 18 (N = 1,792). RESULTS Several significant direct effects and one partial mediation effect were found. For example, child maltreatment significantly predicted adult mental health problems and criminal behaviors. Self-regulation (via the dissatisfaction with life and self subscale) mediated the association between child maltreatment and adult mental health problems. DISCUSSION Findings highlight the need for social workers to focus on prevention services and trauma-informed treatment for people with delinquency histories. In addition, evidence-based practice requires self-regulation interventions for adults with histories of childhood adversity and delinquency to focus on their emotional and cognitive functioning as well as self-esteem. CONCLUSION Implementing self-regulation interventions during emerging adulthood can be useful to mitigate later adult mental health problems among people with histories of childhood adversity and delinquency.
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Affiliation(s)
| | - Hui Huang
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Nicole M Fava
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
- Center for Children and Families, Florida International University, Miami, Florida, USA
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Fava NM, Coxe SJ, Fortenberry JD, Bay-Cheng LY. Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults. Arch Sex Behav 2024; 53:359-373. [PMID: 37847345 DOI: 10.1007/s10508-023-02706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/18/2023]
Abstract
Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.
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Affiliation(s)
- Nicole M Fava
- School of Social Work, Robert Stempel College of Public Health & Social Work, Center for Children and Families, Florida International University, AHC-5, Room 587, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Stefany J Coxe
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | | | - Laina Y Bay-Cheng
- Psychology Department, LaMarsh Centre for Child & Youth Research, York University, Toronto, ON, Canada
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Lamela D, Pasion R, Costa R, Pinto TM, Morais A, Jongenelen I. Mother-child reporting discrepancies of child physical abuse: Associations with internalizing and externalizing symptoms. Child Abuse Negl 2024; 147:106575. [PMID: 38041965 DOI: 10.1016/j.chiabu.2023.106575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 10/02/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Mother-child discrepancies frequently occur in reports of child physical abuse. Such report discrepancies raise important challenges for interpreting and integrating data from multiple informants in forensic and clinical settings. OBJECTIVES The main goal of this study was to identify patterns of mother-child discrepancies in reporting CPA using latent profile analysis. We then tested differences between profiles on mothers' mental health problems and children's internalizing and externalizing symptoms. PARTICIPANTS AND SETTING Participants were 159 mother-child dyads with police-documented exposure to intimate partner violence. METHOD Participants were recruited from Child Protective Services and shelter residences from all regions of Portugal. After obtaining informed consent, assessment protocols were administered separately to mothers and children. RESULTS We identified two convergent profiles (mother-child agreement on reports of both high and low exposure to CPA) and one divergent profile (the child reported significantly higher exposure to CPA than the mother). Mothers from the divergent profile reported more depressive and post-traumatic stress symptoms than mothers from the convergent profiles. Children of the divergent profile and one of the convergent profiles (mother-child agreement on high exposure to CPA) showed the highest internalizing and externalizing symptoms. CONCLUSIONS These results illustrate how examining informant discrepancies in the assessment of abusive parenting practices increases our understanding of children's psychological adjustment in high-risk contexts.
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Black T, Fallon B, Brown H, Innes S, William K. Twenty-five years of child welfare data in Ontario, Canada: Examining the response of child welfare to reports of children's exposure to intimate partner violence (IPV). Child Abuse Negl 2024; 147:106567. [PMID: 38016390 DOI: 10.1016/j.chiabu.2023.106567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/08/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Increases in child welfare investigations involving children's exposure to intimate partner violence (IPV) in Ontario are likely the result of three factors: 1) changes to legislation, policy, and assessment instruments; 2) increased awareness of the risks of exposure to IPV for children, and 3) referrals from professionals (e.g., police). OBJECTIVES Using data from 6 cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993, 1998, 2003, 2008, 2013, and 2018), this paper will examine the changes of the incidence rates of IPV exposure, providing important context for a type of investigation that is not well understood in Ontario. METHODS The incidence of investigations where the primary concern of the investigating worker is IPV was derived and compared across OIS cycles. Investigation were compared across cycles using incidence counts. RESULTS After the nearly 2-fold increase of investigations for all maltreatment types in Ontario between 1998 and 2003, IPV investigations are the only type that continue to increase. There is a growing gap between these investigations and substantiating child maltreatment. Rates of placement have not changed over time, remaining low. Rates of transfers and referrals have increased but not significantly. CONCLUSIONS The continued growth in the rate of child welfare investigations involving exposure to IPV as well as the overwhelming endorsement of substantiated exposure to IPV, while maintaining the same proportion of transfers to ongoing child welfare services and low placement rates, is a significant concern for Ontario.
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Affiliation(s)
- Tara Black
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada.
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | - Hannah Brown
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | - Sarah Innes
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | - Kineesha William
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
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Kampling H, Riedl D, Hettich N, Lampe A, Nolte T, Zara S, Ernst M, Brähler E, Sachser C, Fegert JM, Gingelmaier S, Fonagy P, Krakau L, Kruse J. To trust or not to trust in the thrall of the COVID-19 pandemic: Conspiracy endorsement and the role of adverse childhood experiences, epistemic trust, and personality functioning. Soc Sci Med 2024; 341:116526. [PMID: 38169177 DOI: 10.1016/j.socscimed.2023.116526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/27/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Abstract
RATIONALE Conspiracy endorsement is a public health challenge for the successful containment of the COVID-19 pandemic. While usually considered a societal phenomenon, little is known about the equally important developmental backdrops and personality characteristics like mistrust that render an individual prone to conspiracy endorsement. There is a growing body of evidence implying a detrimental role of adverse childhood experiences (ACEs) - a highly prevalent developmental burden - in the development of epistemic trust and personality functioning. This study aimed to investigate the association between ACEs and conspiracy endorsement in the general population, specifically questioning a mediating role of epistemic trust and personality functioning. METHODS Based on cross-sectional data from a representative German survey collected during the COVID-19 pandemic (N = 2501), we conducted structural equation modelling (SEM) where personality functioning (OPD-SQS) and epistemic trust (ETMCQ) were included as mediators of the association between ACEs and conspiracy endorsement. Bootstrapped confidence intervals (5000 samples, 95%-CI) are presented for all paths. RESULTS ACEs were significantly associated with conspiracy endorsement (β = 0.25, p < 0.001) and explained 6% of its variance. Adding epistemic trust and personality functioning as mediators increased the explained variance of conspiracy endorsement to 19% while the direct association between ACEs and conspiracy endorsement was diminished (β = 0.12, p < 0.001), indicating an indirect effect of personality functioning and epistemic trust in the association between ACEs and conspiracy endorsement. Fit indices confirmed good model fit. CONCLUSIONS Establishing an association between ACEs and conspiracy endorsement further increases the evidence for early childhood adversities' far-reaching and detrimental effects. By including epistemic trust and personality functioning, these findings contribute to a deeper understanding of the underlying mechanisms in the way that ACEs may be associated with conspiracy endorsement.
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Affiliation(s)
- Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany.
| | - David Riedl
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria; Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nora Hettich
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Astrid Lampe
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria; VAMED Rehabilitation Center, Schruns, Austria
| | - Tobias Nolte
- Anna Freud National Centre for Children and Families, London, United Kingdom; Wellcome Trust Centre for Neuroimaging, Institute of Neurology, UCL, London, United Kingdom
| | - Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt Am Wörthersee, Austria
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Stephan Gingelmaier
- Psychology and Diagnostics for Emotional and Social Development for the Emotionally Impaired, University of Education Ludwigsburg, Germany
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Marburg, Germany
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Melkman EP. Educators' experiences of coping with cases of child abuse and neglect: Challenges and supports. Child Abuse Negl 2024; 147:106553. [PMID: 38006632 DOI: 10.1016/j.chiabu.2023.106553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Although educational staff are uniquely positioned to identify and intervene in cases of child abuse and neglect (CAN), concerns have been raised as to their capacity to intervene appropriately in such cases. OBJECTIVE The current study examines the perspectives of educators on their experience of reporting CAN and on the barriers and facilitators experienced within this process. METHODS To that end, in-depth interviews were conducted with 29 educational staff in Israel (27 Jewish, 2 Arabs), including 17 school teachers and 12 counselors who had experienced coping with cases of CAN within their professional role. RESULTS The findings showed that educators experienced immense challenges related to the reporting of CAN. At the professional level, deciding whether or not reporting was required or would serve the best interest of the child, was the most pronounced challenge reported. The heavy burden of protecting children as well as the bearing witness to the abuse and neglect of young children had a tremendous emotional impact on interviewees, arousing feelings of helplessness and undermining their sense of trust in the world. Support provided within schools emerged as a very substantial facilitator of reporting that fulfilled various functions, including providing educators with professional guidance, a sense of togetherness in the face of challenge and emotional containment. CONCLUSIONS In order for educators to be able to successfully cope with such sensitive and complex cases they must be receive regular support and supervision that would address their professional as well as their emotional needs.
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Affiliation(s)
- Eran P Melkman
- The Jaime and Joan Constantiner School of Education, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.
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Zhang H, Wang W, Lachman JM. The efficacy of an evidence-based parenting program in preventing child maltreatment in mainland China. Child Abuse Negl 2024; 147:106544. [PMID: 38006633 DOI: 10.1016/j.chiabu.2023.106544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND There is limited evidence regarding the effectiveness of online parenting programs for preventing child maltreatment in low- and middle-income countries. Therefore, this study aimed to examine the effectiveness of the online Parenting for Lifelong Health for Young Children (PLH-YC) program in preventing child maltreatment among Chinese families specifically. METHODS A quasi-experiment was conducted, wherein 274 parents with children aged 2-9 years were assigned to either the online PLH-YC group (n = 135) or a waitlist control group (n = 139). Data were collected at baseline and one week after intervention. A difference-in-differences (DiD) design with propensity score weighting was used to estimate the between-group difference for child maltreatment as well as the associated risk and protective factors. RESULTS Compared to the parents in the control group, parents in the online PLH-YC intervention reported a significant reduction in the occurrence of corporal punishment (b = -1.21; 95 % CI [-2.37, -0.03]), emotional abuse (b = -3.09; 95 % CI [-5.36, -0.82]), and general maltreatment (b = -4.94; 95 % CI [-8.86, -1.02]) as well as an increased frequency of positive parenting strategies (b = 6.46; 95 % CI [2.21, 10.72]). Additionally, parents with high levels of depressive symptoms were significantly more likely to drop out of the program, and those with lower education levels engaged in fewer sessions. CONCLUSION The online PLH-YC program can benefit families with young children by reducing the incidence of child maltreatment through improved positive parenting strategies. More randomized controlled trials with long-term follow-ups are required to further verify the accuracy of the results obtained in this study.
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Affiliation(s)
- Huiping Zhang
- Center for Studies of Sociological Theory and Method, Renmin University of China, P.R. China; Department of Social Work and Social Policy, Renmin University of China, P.R. China.
| | - Weiwei Wang
- Center for Studies of Sociological Theory and Method, Renmin University of China, P.R. China; Department of Social Work and Social Policy, Renmin University of China, P.R. China
| | - Jamie M Lachman
- Department of Social Policy and Intervention, Center for Evidence Based Intervention, University of Oxford, United Kingdom
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Mazurka R, Cunningham S, Hassel S, Foster JA, Nogovitsyn N, Fiori LM, Strother SC, Arnott SR, Frey BN, Lam RW, MacQueen GM, Milev RV, Rotzinger S, Turecki G, Kennedy SH, Harkness KL. Relation of hippocampal volume and SGK1 gene expression to treatment remission in major depression is moderated by childhood maltreatment: A CAN-BIND-1 report. Eur Neuropsychopharmacol 2024; 78:71-80. [PMID: 38128154 DOI: 10.1016/j.euroneuro.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/01/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Preclinical research implicates stress-induced upregulation of the enzyme, serum- and glucocorticoid-regulated kinase 1 (SGK1), in reduced hippocampal volume. In the current study, we tested the hypothesis that greater SGK1 mRNA expression in humans would be associated with lower hippocampal volume, but only among those with a history of prolonged stress exposure, operationalized as childhood maltreatment (physical, sexual, and/or emotional abuse). Further, we examined whether baseline levels of SGK1 and hippocampal volume, or changes in these markers over the course of antidepressant treatment, would predict treatment outcomes in adults with major depression [MDD]. We assessed SGK1 mRNA expression from peripheral blood, and left and right hippocampal volume at baseline, as well as change in these markers over the first 8 weeks of a 16-week open-label trial of escitalopram as part of the Canadian Biomarker Integration Network in Depression program (MDD [n = 161] and healthy comparison participants [n = 91]). Childhood maltreatment was assessed via contextual interview with standardized ratings. In the full sample at baseline, greater SGK1 expression was associated with lower hippocampal volume, but only among those with more severe childhood maltreatment. In individuals with MDD, decreases in SGK1 expression predicted lower remission rates at week 16, again only among those with more severe maltreatment. Decreases in hippocampal volume predicted lower week 16 remission for those with low childhood maltreatment. These results suggest that both glucocorticoid-related neurobiological mechanisms of the stress response and history of childhood stress exposure may be critical to understanding differential treatment outcomes in MDD. ClinicalTrials.gov: NCT01655706 Canadian Biomarker Integration Network for Depression Study.
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Affiliation(s)
- Raegan Mazurka
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
| | | | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Nikita Nogovitsyn
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Laura M Fiori
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Canada
| | | | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Roumen V Milev
- Departments of Psychiatry and Psychology, And Providence Care Hospital, Queen's University, Kingston, ON, Canada
| | - Susan Rotzinger
- Department of Psychiatry, University of Toronto, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Gustavo Turecki
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Gandarilla Ocampo M, Drake B, Simon J, Jonson-Reid M. Does a child maltreatment report source predict differences in immediate and subsequent report outcomes? Child Abuse Negl 2024; 147:106587. [PMID: 38043457 DOI: 10.1016/j.chiabu.2023.106587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/15/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Mandated reporting policies, a core response to the identification of child maltreatment, are widely debated. Currently, there are calls to abolish or scale back these policies to include only certain professionals. These calls warrant evaluation of whether there are any differences in child welfare outcomes based on report source. OBJECTIVE To determine if the initial report source predicts immediate and long-term risk of re-referral, substantiation, and placement. PARTICIPANTS AND SETTING We used yearly National Child Abuse and Neglect Data System (NCANDS) hotline report and placement data. Children (0-14y) with a first ever hotline report in 2012-2014 were followed for three years. The final sample included 2,101,397 children from 32 states. METHODS We use descriptive and bivariate statistics to show initial report outcomes by reporter source type and logistic regression models to evaluate the effect of report source on immediate and subsequent report outcomes. RESULTS Professional sources varied in levels of substantiation and placement, with law enforcement, medical, and social service sources showing much higher rates. Reports from professional sources have higher odds of initial report substantiation and foster care entry, and slightly lower odds of later re-report than nonprofessional sources. We found no differences between professional and nonprofessional sources in subsequent foster care entry. CONCLUSIONS Reports from professional, nonprofessional, and unclassified sources have varying levels of risk in some of their short- and long-term outcomes. To the degree that child protective services embrace a long-term preventative role, reports by nonprofessional report sources may provide opportunities for prevention.
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Affiliation(s)
- María Gandarilla Ocampo
- Brown School, Washington University in Saint Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
| | - Brett Drake
- Brown School, Washington University in Saint Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
| | - James Simon
- School of Social Work, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, United States of America.
| | - Melissa Jonson-Reid
- Brown School, Washington University in Saint Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
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Kobulsky J, Schroeder K, Schuler B, Patrick EL, Lang Y, Wu J. Developmental timing of child maltreatment in relation to obesity and substance use disorder in late adolescence. Psychol Violence 2024; 14:24-33. [PMID: 38504668 PMCID: PMC10947074 DOI: 10.1037/vio0000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Objective Obesity and substance use are leading preventable causes of mortality, yet their origins in violence remain poorly understood. This study examined child maltreatment in relation to obesity and symptoms consistent with substance use disorder (SUD) in late adolescence, determining the roles of the child maltreatment type and timing, and gender. Methods The sample (N = 1,161) was drawn from the Longitudinal Studies of Child Abuse and Neglect. Obesity and SUD were measured at 18-years. Lifetime child protective services records and youth self-reports indicated physical abuse, sexual abuse, supervisory neglect, failure-to-provide neglect, and emotional maltreatment during early childhood, middle childhood, and adolescence. Results In the overall sample, emotional maltreatment during adolescence was associated with obesity (OR = 2.03, 95% CI: 1.25, 3.30) and SUD (OR = 2.00, 95% CI: 1.20, 3.35), and adolescent physical abuse with obesity (OR = 2.20, 95% CI: 1.36, 3.58). In girls, early childhood physical abuse was associated with SUD (OR = 2.35, 95% CI: 1.08, 5.12), and emotional maltreatment during adolescence with obesity (OR = 2.16, 95% CI: 1.10, 4.23) and SUD (OR = 3.21, 95% CI: 1.37, 7.3 5). Adolescent physical abuse and obesity were associated in boys (OR = 3.18, 95% CI: 1.45, 6.98). Gender moderation was identified for an inverse relationship between supervisory neglect and obesity in girls (OR = .26, 95% CI: .07, .99). Conclusions Type and timing contribute to the effects of child maltreatment, contingent upon gender. Intervention focused on adolescent emotional maltreatment may reduce both SUD and obesity.
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Affiliation(s)
- Julia Kobulsky
- Temple University, College of Public Health, School of Social Work, 1301 W. Cecil B. Moore, Philadelphia, PA 19122
| | - Krista Schroeder
- Temple University, College of Public Health, Department of Nursing
| | - Brittany Schuler
- Temple University, College of Public Health, School of Social Work, 1301 W. Cecil B. Moore, Philadelphia, PA 19122
| | - Emily L. Patrick
- Temple University, College of Public Health, School of Social Work, 1301 W. Cecil B. Moore, Philadelphia, PA 19122
| | - Yanda Lang
- Temple University, College of Public Health, Department of Epidemiology and Biostatistics
| | - Jingwei Wu
- Temple University, College of Public Health, Department of Epidemiology and Biostatistics
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Kletečka-Pulker M, Doppler K, Völkl-Kernstock S, Fischer L, Eitenberger M, Mussner M, Klomfar S, Mora-Theuer EA, Grylli C, Atanasov AG, Greber-Platzer S. Influence of various factors on the legal outcome of cases of child abuse-experiences gathered at an interdisciplinary forensic examination center in Vienna, Austria. Int J Legal Med 2024; 138:3-14. [PMID: 37828300 PMCID: PMC10772007 DOI: 10.1007/s00414-023-03094-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/14/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND OBJECTIVE To improve the currently low conviction rate in cases of child abuse a forensic examination center for children and adolescents (FOKUS) was established in Vienna, Austria. Besides a state of the art treatment combined with forensic documentation, one of FOKUS' key goals is to identify potential areas for improvements within the process legal proceedings in cases of child abuse through constant scientific monitoring. The accompanying study at hand includes all patients referred to FOKUS within a two year timeframe (n = 233), monitoring their progression from first contact with the medical professionals from FOKUS to the end of criminal proceedings. A detailed analysis of case files was performed in those cases that were reported to the legal authorities by the clinicians of FOKUS (n = 87). Aim of the study is to investigate which factors contribute to the initiation of legal proceedings and a successful conviction. RESULTS Multivariate logistic regression analyses showed that main proceedings were opened more often in cases where the offender was an adult (p < 0.001) or admitted his guilt (p < 0.001) and if digital traces were available (p = 0.001) or trial support (p = 0.024) present. Furthermore, the combined occurrence of medical documentation and victim disclosure was related to a higher probability of opening main trials. CONCLUSION These findings underline how challenging the successful persecution of an offender in cases of child abuse is.
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Affiliation(s)
- Maria Kletečka-Pulker
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Klara Doppler
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Department of Children and Adolescent Psychiatry, Medical University Vienna, 1090, Vienna, Austria
| | - Laura Fischer
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
| | - Magdalena Eitenberger
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
| | - Mark Mussner
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Sophie Klomfar
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Eva Anna Mora-Theuer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Chryssa Grylli
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Polish Academy of Sciences, Jastrzebiec, 05-552, Magdalenka, Poland
| | - Susanne Greber-Platzer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria.
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Zhang N, Ma S, Wang P, Yao L, Kang L, Wang W, Nie Z, Chen M, Ma C, Liu Z. Psychosocial factors of insomnia in depression: a network approach. BMC Psychiatry 2023; 23:949. [PMID: 38104061 PMCID: PMC10725021 DOI: 10.1186/s12888-023-05454-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Insomnia symptoms in patients with major depressive disorder (MDD) are common and deleterious. Childhood trauma, personality traits, interpersonal distress, and social support contribute to insomnia, but how they interact to affect insomnia remains uncertain. METHODS A total of 791 patients with MDD completed the Insomnia Severity Index, Eysenck Personality Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, Childhood Trauma Questionnaire, Social Support Rating Scale and Hamilton Depression Scale-17. This study utilized network analyses to identify the central symptoms of insomnia and their associations with psychosocial factors. RESULTS Worrying about sleep was identified as the central symptom in the insomnia network, insomnia and associated personality network, insomnia and associated interpersonal disturbance network, insomnia and associated childhood trauma network, insomnia and associated social support network, and the integrated network of insomnia symptoms and associated psychosocial factors. In the networks of insomnia symptoms and individual psychosocial factors, most psychosocial factors (other than childhood trauma) were directly or indirectly related to insomnia symptoms; however, neuroticism was the only factor directly associated with insomnia symptoms before and after controlling for covariates. In the final integrated network of insomnia symptoms and psychosocial factors, neuroticism was a bridge node and mediated the relationships of social support and interpersonal disturbances with insomnia symptoms, which is clearly presented in the shortest pathways. CONCLUSIONS Worrying about sleep and neuroticism were prominent in the integrated network of insomnia symptoms and associated psychosocial factors, and the edge between them connected psychosocial factors and insomnia symptoms in MDD patients.
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Affiliation(s)
- Nan Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Peilin Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Zhaowen Nie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Mianmian Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China
| | - Ci Ma
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA.
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430000, China.
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, 430072, China.
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Xu H, Li M, Cai J, Yuan Y, He L, Liu J, Wang L, Wang W. Comparison of ACE-IQ and CTQ-SF for child maltreatment assessment: Reliability, prevalence, and risk prediction. Child Abuse Negl 2023; 146:106529. [PMID: 37931543 DOI: 10.1016/j.chiabu.2023.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Child maltreatment has profound effects on mental health. The Childhood Trauma Questionnaire Short Form (CTQ-SF) and the Adverse Childhood Experiences International Questionnaire (ACE-IQ) are commonly used retrospective assessment tools for evaluating child maltreatment. OBJECTIVE This study aims to conduct a comprehensive comparison of the CTQ-SF and ACE-IQ, encompassing internal consistency, prevalence, and the predictive efficacy of trauma-related outcomes. It also seeks to enhance the scoring method of ACE-IQ based on the established comparability between the two instruments. PARTICIPANTS AND SETTING 1484 college students from northern China were recruited, assessing demographic characteristics and outcomes related to traumatic experiences, including post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (CPTSD), borderline personality disorder (BPD), anxiety, and depression. METHODS A contingency correlation analysis was performed to evaluate the degree of agreement between the CTQ-SF and ACE-IQ. Binary logistic regression models were utilized to compare the predictive capabilities of distinct instruments. RESULTS CTQ-SF and ACE-IQ instruments display favorable internal consistency and notable correlations across shared categories. However, the predictive relationships between trauma type and adverse outcomes are inconsistent across instruments. The ACE-IQ, encompassing 13 trauma categories, demonstrate a lower AIC and BIC index, indicating a superior model fit for elucidating outcomes. CONCLUSION This study introduces a scoring methodology for ACE-IQ, improving the comparability of the two measures and emphasizing the importance of capturing the full range of maltreatment types a child may have experienced. These findings have significant implications for clinical and epidemiological research, providing valuable insights for understanding the impact of child maltreatment.
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Affiliation(s)
- Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
| | - Man Li
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China; Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin 300387, China
| | - Jinping Cai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yidan Yuan
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Li He
- Teachers' College of Beijing Union University, Beijing, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Weiwen Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Rebbe R, Reddy J, Huang JS, Kuelbs CL, Putnam-Hornstein E. Counts and child protection reports of diagnosed child maltreatment before and after the COVID-19 pandemic onset. Child Abuse Negl 2023; 146:106450. [PMID: 37708644 PMCID: PMC10872595 DOI: 10.1016/j.chiabu.2023.106450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/01/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Mechanisms for reporting child maltreatment (CM) were affected by changes in service provision immediately following the onset of the COVID-19 pandemic. OBJECTIVE To examine changes in counts and CPS reporting of CM medical encounters before and after the onset of COVID-19. PARTICIPANTS AND SETTING All emergency department and inpatient medical encounters with at least one CM diagnosis during the study period at Rady Children's Hospital San Diego, the largest pediatric hospital in California between 2016 and November 2021. METHODS Using linked medical record and CPS administrative data, interrupted time series models tested for changes in monthly counts and percentages of CM medical encounters reported to CPS with the onset of COVID-19. Logistic regression tested for the likelihood of a CPS report being associated with a CM encounter. RESULTS CM medical encounters totaled 2528, including 793 after the onset of COVID-19. Interrupted time series models indicated with the onset of the pandemic, the counts of CM encounters increased 18 % (RR: 1.18, 95 % CI 1.03-1.34) and the percentages reported to CPS increased 10 % (RR: 1.10, 95 % CI: 1.05-1.17). CM encounters that occurred after the onset of the COVID-19 pandemic had increased odds of a CPS report (fully adjusted model: OR: 1.08; 95 % CI: 1.05-1.12). CONCLUSIONS This study found increases in monthly counts and a higher percentage of CM medical encounters with CPS reports after the pandemic onset.
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Affiliation(s)
- Rebecca Rebbe
- University of North Carolina at Chapel Hill School of Social Work, 325 Pittsboro St, Chapel Hill, NC 27599, USA.
| | - Julia Reddy
- University of North Carolina at Chapel Hill School of Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
| | - Jeannie S Huang
- Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92123, USA; University of California, San Diego Department of Pediatrics, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Cynthia L Kuelbs
- Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92123, USA; University of California, San Diego Department of Pediatrics, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Emily Putnam-Hornstein
- University of North Carolina at Chapel Hill School of Social Work, 325 Pittsboro St, Chapel Hill, NC 27599, USA; Children's Data Network, University of Southern California, 669 W 34th St, Los Angeles, CA 90089, USA.
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Kuper JL. Weaving culture with consequence: Immigrant status and child maltreatment outcomes in early adulthood. Child Abuse Negl 2023; 146:106451. [PMID: 37734182 DOI: 10.1016/j.chiabu.2023.106451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/11/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Child maltreatment is associated with a host of negative consequences over the life course, the most concerning of which is violence. Nevertheless, many abused and neglected youth do not grow up and commit violence. Meanwhile, research consistently finds an immigrant paradox, where foreign-born nativity is protective against a range of negative life outcomes. It may be that immigrants to the U.S. are more resilient to child maltreatment and less likely to engage in violence later in life. OBJECTIVE This study contributes to the literature on victimization and the immigrant paradox by determining whether the effect of child maltreatment on later violence varies between immigrants and non-immigrants. PARTICIPANTS AND SETTING The present study uses a subsample of 964 foreign- and 12,808 native-born persons from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health. METHODS Logistic regression models are specified and interaction terms are used to determine moderating effects of immigrant status on the link between child maltreatment and later violence. RESULTS Findings indicate that child maltreatment significantly increased the odds of violent behavior in early adulthood by nearly 64 %, and this result was not moderated by immigrant status. Supplemental analyses continued to show generality in maltreatment effects. CONCLUSIONS The idea that child maltreatment is less harmful among foreign-born persons, or that they are able to "bounce back" from this form of victimization due to their unique multicultural assets, is not evidenced here. Key policy implications include a need for culturally competent victim services.
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Affiliation(s)
- Julie L Kuper
- College of Criminology and Criminal Justice, Florida State University, United States of America.
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Abraham-Bizot A, Greco C, Quartier P, Loschi S, Soyeux E, Ikowsky T, Lambert AS, Reiter F, Mikaeloff Y, Kone-Paut I. Medical child abuse: Medical history and red flags in French adolescents. Child Abuse Negl 2023; 146:106523. [PMID: 37950944 DOI: 10.1016/j.chiabu.2023.106523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND Medical child abuse (MCA; or Munchausen syndrome by proxy) is a severe form of adult and medical maltreatment of children. Currently, few data on MCA in adolescents exist. OBJECTIVE To describe the clinical characteristics and medical history of children and adolescents aged 10 to 18 years with suspected or confirmed MCA in the pediatric hospital setting. METHODS We included patients aged 10 to 18 years who were seen in five tertiary care hospitals in the Paris area and identified by physician recall such as suspected MCA between 2015 and 2021. RESULTS We included 29 adolescents; the mean (SD) age was 12.9 (10.8-15.0) years at suspected diagnosis. Medical wandering was common, with a mean of 23 (12.8-33.2) alleged symptoms and 33 (9.2-56.8) specialized consultations in a mean of six different hospitals. The mean number of emergency visits was 11.8 (0-25.9) and radiologic exams 24.3 (5-43.6). Overall, 62 % (18/29) of the adolescents had an underlying organic pathology. The impact of MCA on quality of life was major, with a high rate of school dropout (96 %). The mean delay to the suspected diagnosis was 5.8 (2.6-9) years, and even when recognized, it was rarely the subject of a social or judiciary report (only 42 % of adolescents). In total, 50 % of the adolescents subsequently exhibited Munchausen syndrome. CONCLUSION Adolescent MCA is poorly known among the medical profession. Increasing awareness, education and knowledge of risk factors could contribute to better care.
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Affiliation(s)
- Alexia Abraham-Bizot
- Adolescent Medicine Department, APHP Hôpital Bicetre, Le Kremlin Bicêtre, France.
| | - Céline Greco
- Department of Pain and Palliative Care Unit, APHP, Hôpital Necker-Enfants Malades, F-75015 Paris, France; IMAGINE Institute, INSERM, U1163, Université Paris Cité, F-75015 Paris, France
| | - Pierre Quartier
- Pediatric Immunology-Hematology and Rheumatology Unit, RAISE Rare Disease Reference Centre, IMAGINE Institute, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Cité, France
| | - Solène Loschi
- Pediatric Emergency Department, APHP Hôpital Armand Trousseau - Sorbonne Université, INSERM UMR1153, Paris, France; Child protection Team, PEPS, APHP Hôpital Armand Trousseau - Sorbonne Université, France
| | - Esther Soyeux
- Department of Pain and Palliative Care Unit, APHP, Hôpital Robert Debré, Paris, France
| | - Tania Ikowsky
- Child protection Team, ESPER, APHP Hôpital Robert Debré, Paris, France
| | - Anne-Sophie Lambert
- Pediatric Endocrinology Department, APHP Hopital Bicetre, Le Kremlin Bicêtre, France
| | - Florence Reiter
- Pediatric Pain Unit, APHP Hôpital Armand Trousseau, Paris, France
| | - Yann Mikaeloff
- CESP, INSERM U1018, UFR Médecine, Université Paris-Saclay, F-91190 Gif-sur-Yvette, France; Child and adolescent protection Centre, APHP Hôpital Paul Brousse, Villejuif, France
| | - Isabelle Kone-Paut
- Pediatric rheumatology department and CEREMAIA, APHP Hôpital Bicêtre, Le Kremlin Bicêtre, France
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Brown MP, Rogosch F, Shacklewood C, Cicchetti D. The role of child maltreatment and adolescent victimization in predicting adolescent psychopathology and problematic substance use. Child Abuse Negl 2023; 146:106454. [PMID: 37741073 PMCID: PMC10872623 DOI: 10.1016/j.chiabu.2023.106454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Maltreated children are more likely to experience adolescent victimization, which may underlie the association between maltreatment and adolescent psychopathology and substance use. OBJECTIVE To determine whether number of adolescent victimization types predicts adolescent psychopathology and problematic substance use over and above number of child maltreatment subtypes; whether adolescent victimization mediates the relations between maltreatment and change in adolescent psychopathology and problematic substance use; and whether maltreatment moderates the relation between adolescent victimization and changes in these outcomes. PARTICIPANTS AND SETTING Participants were 545 (295 maltreated, 250 non-maltreated; 328 males, 217 females) racially and ethnically diverse (52.8 % Black, 27.5 % White, 12.8 % Bi-racial; 13.4 % Latino/a) children and families from the Rochester, New York, USA area assessed across three waves of data (Wave 1, Mage = 7.6 years; Wave 2, Mage = 13.8 years; Wave 3, Mage = 16.2 years). METHODS Maltreatment was coded at Wave 1 using Department of Human Services records. Adolescents self-reported psychopathology, problematic substance use, and victimization at Waves 2 and 3. RESULTS Structural equation modeling revealed that adolescent victimization predicted adolescent psychopathology (β = 0.24, p < .001) and problematic substance use (β = 0.27, p < .001) over and above child maltreatment. Adolescent victimization did not mediate the association between child maltreatment change in psychopathology and problematic substance use and child maltreatment did not moderate the association between adolescent victimization and these outcomes. CONCLUSIONS We discuss the importance of future research utilizing multi-wave designs to examine relations between these constructs and of assessing for more proximal victimization.
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Affiliation(s)
- Michelle P Brown
- Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN 55455, USA.
| | - Fred Rogosch
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY 14608, USA
| | - Curtisha Shacklewood
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29169, USA.
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN 55455, USA; Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY 14608, USA.
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Zhang Y, Shen F, Paredes J, Lindsay D, Liu Q, Madre N, Penna A, Morris T. Exploring the complex links between childhood exposure to intimate partner violence, maltreatment, and self-regulation: A three-wave cross-lagged study. Child Abuse Negl 2023; 146:106507. [PMID: 37879255 DOI: 10.1016/j.chiabu.2023.106507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/27/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) often co-occurs with childhood maltreatment and negatively impacts children's development. While previous research has shown a direct link between these experiences and children's self-regulation, less is known about the potential unique effect and bidirectional associations between them. OBJECTIVE The present study aims to investigate the bidirectional effects among maternal IPV experiences, child maltreatment, and children's behavioral self-regulation. PARTICIPANTS AND SETTING 4,402 participants from three waves of the longitudinal study of the Future of Families and Child Wellbeing Study (FFCWS) were included in the study. METHODS Cross-lagged path analyses were conducted to examine the longitudinal reciprocal relationships among IPV, child maltreatment, and children's behavioral regulation when children were 3, 5, and 9 years old. RESULTS IPV exposure at ages 3 and 5 was negatively associated with levels of behavioral self-regulation at ages 5 and 9, even after accounting for physical maltreatment, psychological maltreatment, or neglect. Neglect at ages 3 and 5 was found to be associated with lower levels of behavioral self-regulation at later ages, when IPV exposure was considered in the models. Lower levels of behavioral self-regulation at age 3 were found to be linked with higher levels of psychological maltreatment, physical maltreatment, neglect, and IPV exposure at age 5. CONCLUSION This study revealed bidirectional effects between maternal IPV experiences, child maltreatment, and children's behavioral self-regulation. Furthermore, the study demonstrated that exposure to IPV during early childhood significantly predicts long-term behavioral self-regulation difficulties, even after controlling for the effects of child maltreatment.
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Affiliation(s)
- Ying Zhang
- Clarkson University, United States of America.
| | - Fei Shen
- Kean University, United States of America
| | | | | | | | | | - Alan Penna
- Clarkson University, United States of America
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Dimitropoulos G, Lindenbach D, Anderson A, Rowbotham M, Wang E, Heintz M, Ehrenreich-May J, Arnold PD. A qualitative study on the implementation of a transdiagnostic cognitive behavioral therapy for children in a child welfare residential treatment program. Child Abuse Negl 2023; 146:106487. [PMID: 37837713 DOI: 10.1016/j.chiabu.2023.106487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Youth with severe emotional or behavioral issues who are involved with child welfare authorities are sometimes placed in intensive care services in a residential treatment program. Evidence-based psychotherapies are often used in residential treatments, but there is very little research on how to adapt psychotherapy for residential treatment. OBJECTIVE To describe the implementation of a transdiagnostic cognitive behavioral therapy (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children) in a residential treatment program for children. PARTICIPANTS AND SETTING Staff (n = 20) at a residential facility in Calgary, Canada. METHODS A combination of qualitative interviews and focus groups were conducted before and after therapy to identify barriers and facilitators to implementation. Data were analyzed and reported using the Consolidated Framework for Implementation Research and the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies. RESULTS Modifications were made to the program including creating inclusive language, integrating relevant content targeting pediatric irritability, delivering sessions online for caregivers, and using additional staff to support youth to learn and practice the application of the content and behavioral interventions. Key barriers to implementation of the Unified Protocol included staff turnover and the difficulty of sustaining a critical mass of knowledge surrounding the Unified Protocol. The major facilitators to implementation were the perceived quality of the program and advantages of the program to children and their caregivers. CONCLUSIONS This study supports the feasibility and acceptability of providing transdiagnostic cognitive behavioral therapies for children in residential treatment and provides a template for how to implement evidence-based practice in residential treatment.
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Affiliation(s)
- Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.
| | - David Lindenbach
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Alida Anderson
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Melissa Rowbotham
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Emily Wang
- Pathways to Prevention: A Centre for Childhood Trauma, Hull Services, Calgary, Alberta, Canada
| | - Madison Heintz
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | | | - Paul D Arnold
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
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Fix RL, Newman AT, Assini-Meytin LC, Letourneau EJ. The public's knowledge about child sexual abuse influences its perceptions of prevention and associated policies. Child Abuse Negl 2023; 146:106447. [PMID: 37757649 PMCID: PMC10842597 DOI: 10.1016/j.chiabu.2023.106447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/23/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) prevention requires efforts from all members of society. OBJECTIVE The current study aimed to examine factors associated with (1) perceptions of CSA as unpreventable and (2) support for policies to prevent CSA and to punish people who perpetrated CSA. We focused on the roles of knowledge and misperceptions about child sexual abuse. PARTICIPANTS AND SETTING We collected survey data online from a large (N = 5068), nationally representative sample of adults in the United States. RESULTS Analyses revealed factors promoting perceptions of CSA as unpreventable. Support for or against policies that aim to prevent CSA or to punish perpetrators of CSA were associated with individual factors such as older age (B = 0.08, -0.13), Republican political affiliation (B = 0.10, 0.07), and misperceptions about CSA (B = 0.15, 0.06). CONCLUSIONS Findings highlight malleable factors that could be targeted to collectivize calls for CSA prevention and to promote support for effective policies to prevent CSA. In particular, ensuring accurate knowledge about CSA, and collective responsibility and government efficacy specific to CSA prevention, were identified as helping shape views of CSA as preventable.
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Affiliation(s)
- Rebecca L Fix
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States of America.
| | - Alex T Newman
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States of America
| | - Luciana C Assini-Meytin
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States of America
| | - Elizabeth J Letourneau
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States of America
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Davidson J, Karadzhov D, Collins H, Brown A. Complexities of protecting children from violence during the COVID-19 pandemic: Providers' and policymakers' best practices, innovations and challenges in 12 countries. Child Abuse Negl 2023; 146:106480. [PMID: 37801758 DOI: 10.1016/j.chiabu.2023.106480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Globally, the COVID-19 pandemic has put children at an increased risk of neglect, violence and other human rights violations. Despite growing evidence of its impact on child protective services, there has been a dearth of research from low- and middle-income countries. OBJECTIVE This cross-sectional qualitative study explored service providers' and policymakers' views and experiences of children's protection, in real-time, in the last quarter of 2020. METHODS A smartphone app-based survey containing both open- and closed-ended questions was used. The data were analyzed using descriptive statistics and qualitative content analysis. PARTICIPANTS AND SETTING Eighty-four respondents participated, including service providers, service managers and policymakers, mostly representing non-governmental organizations (NGOs), civil society organizations (CSOs) and governments across 12 countries (predominantly Kenya, South Africa and the Philippines). RESULTS Most respondents reported their sectors had experienced challenges in protecting children from violence - particularly delays in reporting abuse and pursuing justice, and reaching those living in poor and/or rural areas. Good practices and innovations in children's protection during the pandemic were reported in several domains: advocacy and signposting; justice; health care; education and awareness-raising; children's visibility; and virtual service delivery. Community resources and involvement were also highlighted as vital. The ineffectiveness of child protection laws, policies and organizational responses, however, hindered the implementation of effective practices. CONCLUSIONS The COVID-19 pandemic has accentuated the complexities and interconnectivity of systems, processes and actors and their joint impact on children's protection and rights. Collectively, the findings reinforce the criticality of collaborative, urgent and child-centered responses.
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Affiliation(s)
- Jennifer Davidson
- Institute for Inspiring Children's Futures, University of Strathclyde, Glasgow, Scotland, United Kingdom.
| | - Dimitar Karadzhov
- Institute for Inspiring Children's Futures, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Hilllary Collins
- Research Associate, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Aaron Brown
- Children & Young People's Centre for Justice, University of Strathclyde, Glasgow, Scotland, United Kingdom
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