The mediating role of sleep problems and depressed mood between psychological abuse/neglect and suicidal ideation in adolescent childhood: a multicentred, large sample survey in Western China

BACKGROUND

Adolescent suicidal ideation are associated with factors including psychological abuse/neglect, sleep problems, and depressed mood, but the systematic effects of these factors on suicidal ideation remain unclear, which is a research gap this work aims to fill.

METHODS

A multi-center, the cluster sampling method was employed to collect general demographic data, such as age, gender, the experience of being left behind, and parents' marital status, from 12,192 students across 17 secondary schools in China. The Child Psychological Abuse and Neglect Scale (CPANS), Pittsburgh Sleep Quality Index (PSQI), the Chinese version of the Depressed mood, Anxiety and Stress Scale - 21 Items (DASS-21) and Chinese version of Positive and Negative Suicide Ideation Inventory (PANSI) were utilized. Data were analyzed using t-tests, chi-square tests, correlation analyses, and structural equation modeling mediation analyses.

RESULTS

The prevalence of psychological abuse/neglect and adolescent suicidal ideation was 34.8% and 13%, respectively. This mediation analysis suggests that, in the relationship between psychological abuse/neglect and suicidal ideation, sleep problems and depressed mood play both parallel and sequential mediating roles.

CONCLUSION

Sleep problems and depressed mood play a mediating role in the development of suicidal ideation in adolescents. Good sleep habits and depressed mood interventions help reduce the risk of suicidal ideation in adolescents who experience psychological neglect/abuse.

Relations between childhood psychological maltreatment and mental health dimensions within a higher-order model

Background

Experiences of childhood psychological maltreatment have been found to be associated with various mental health outcomes, and this association persists into adulthood.

Objective

This study investigated whether some types of psychological maltreatment are more harmful than others; whether the harms associated with different types of psychological maltreatment are generalized or specific to particular domains of psychopathology; and whether the associations vary by gender.

Method

Participants (N = 544, 63.9 % mother as primary caregiver) were Chinese adults from various regions in China. Participants completed measures of childhood psychological maltreatment experiences perpetrated by their primary caregiver and the mental health outcomes of depression, anxiety, anger, physical aggression, and hostility. The data were analyzed in a hierarchical model in which depression and anxiety were defined as indicators of an internalizing factor, while anger, physical aggression, and hostility were defined as indicators of an externalizing factor. Internalizing and externalizing then defined a higher-order general psychopathology factor. The results suggested equivalent harms of psychological abuse and psychological neglect. Further, the associations between psychological maltreatment and mental health were not unique to specific symptom domains but showed broadband associations with general psychopathology.

Results

These findings suggest that trans-diagnostic interventions may be the most effective approach for addressing the mental health impacts of psychological maltreatment.

Conclusion

Childhood psychological maltreatment may pose a broadband risk for any and all forms of psychopathology.

'It's not like we use the word emotional abuse'. A study on Norwegian child welfare workers understanding of emotional abuse

BACKGROUND

Despite the recognition of emotional abuse (EA) as the most pervasive and harmful of all forms of child maltreatment, it is argued to be less understood than other forms of child maltreatment. EA is regarded as a standalone form for maltreatment and an essential factor embedded in all other forms of maltreatment of children, such as physical and sexual abuse. Thus, it is crucial for child welfare workers to understand EA, as one of their core mandates is to prevent and protect children from all forms of maltreatment.

OBJECTIVE

This study aims to explore how child welfare workers in Norway describe and understand EA.

PARTICIPANTS AND SETTING

The study included 24 child welfare workers in 6 child welfare offices in Norway.

METHODS

The data were obtained from focus group interviews and analyzed using reflexive thematic analysis.

RESULTS

Overall, the findings reveal that EA was unfamiliar to the child welfare workers, and that there is a low degree of awareness on EA among the study participants. Further, EA is closely connected to whether parents provide sufficient emotional care for their children and is understood as part of the complex situation surrounding the child.

CONCLUSIONS

This article concludes with the need for reflective and sensitive discussions regarding understanding and awareness of EA in child welfare work. This has the potential to lead to greater insights into how EA is understood by child welfare workers as well as to enhance child welfare workers' abilities to describe, communicate about, and document EA.

A social network analysis of perpetrators of child maltreatment reported by youth in foster care

OBJECTIVE

Prior research on child maltreatment has focused on distinct features of maltreatment (type, severity, chronicity) important for youth outcomes, yet perpetrators of child maltreatment reported by youth have gone largely unstudied. The present study examines connections between perpetrators, the total number and type of perpetrators reported, and the frequency at which each type of perpetrator was reported across 24 relationship types to provide a foundation for future research seeking to provide comprehensive measurement of perpetrator profiles.

METHODS

Data from 503 youth in foster care (8-21 years old) were collected through the Studying Pathways to Adjustment and Resilience in Kids (SPARK) Project. Youth reported on their history of physical, sexual, and psychological maltreatment. Social Network Analysis (SNA) was used to visualize links between perpetrators within maltreatment type and paired samples t-tests were used to compare differences between network edge weights.

RESULTS

Full sample SNA results were highly interconnected and variable across maltreatment types. Biological parents and peers were the most common perpetrators of physical and psychological abuse with peers and non-family adults being most common for sexual abuse. Family and community member groupings were most distinct in the physical and psychological abuse networks whereas in the sexual abuse network, ties between perpetrators were more equidistant.

CONCLUSIONS

Differences exist in perpetrator profiles across maltreatment types, adding a layer of complexity to how maltreatment experiences are captured, and variability in profiles might provide insight to differing youth outcomes. Understanding individual youth perpetrator profiles could be used to inform foster care placements and reduce the risk of revictimization.

Managing the Long-Term Effects of Psychological Abuse on (Im)migrant Domestic Workers

While researchers have highlighted the emotional distress of migrant domestic workers who experience abuse by employers, less is known about long-term effects of the psychological abuse that they experience. Drawing from a broader ethnographic study of Filipino and Indonesian migration to Chile, we analyze three Filipina domestic workers' migration narratives to examine how they narrate and manage the long-term effects of psychological abuse in the domestic workplace that they experienced more than ten years earlier. Building on insights from medical anthropology and using narrative analysis, we contribute to discussions on migrants' mental health and psychosocial wellbeing by showing how these migrants seek to make meaningful sense of their previous experiences to deal with the enduring effects. We show that they construct alternative narratives that foreground their experiences as linked to structural factors and suggest that their psychosocial wellbeing is linked to their ability to subvert or derive meaning from earlier experiences of structural violence.

The prevalence of emotional abuse in children living in Sub-Saharan Africa - A systematic review

OBJECTIVES

This study is meant to put a focus on the prevalence of emotional abuse in low-income states like the Sub-Saharan region.

METHODOLOGY

Searching PubMed, Google scholar, and web of science during February and April 2021 a total of 2264 articles were identified, 27 met the inclusion criteria. We added the results of 13 VAC (Violence Against Children and Youth) studies, conducted by UNICEF capturing information about experienced sexual, physical, or emotional violence in 13-24-year-olds, as well as 56 MIC (Multiple Indicator Cluster) studies, conducted by the CDC to research the disciplinary methods used with children aged 1-14 years in the past month by older household members. Finally, in a meta-analytic approach, we aimed to calculate a pooled estimate of the prevalence.

RESULTS

The included studies depicted a wide range in prevalence rates across countries. For example, while the VAC study in Lesotho in 2018 showed low incidence rates of emotional violence (6.9 % Females, 3.8 % Males), the average prevalence recorded by the MIC study was as high as 57.8 % for females and 59.2 % for males. On average, the MIC studies displayed a higher incidence and the discrepancy of prevalence of emotional abuse between females and males was small. Calculating a pooled estimate of the prevalence was not possible, due to the heterogeneity of the data.

CONCLUSIONS

In general countries displayed a high prevalence. A standardized use of a uniform definition of emotional abuse might help to display a more homogenous data set in the future, giving the opportunity for pooled estimates of prevalence.

Systematic Investigation of Meta-Analysis Data on Treatment Effectiveness for Physical, Psychological, and Sexual Intimate Partner Violence Perpetration

Intimate partner violence can lead to physical, economical, mental, and sexual well-being issues, and even death, and it is most commonly experienced by women. There exist a number of treatment models for the prevention and treatment of intimate partner violence (IPV). In this study, we provided a comprehensive meta-regression analysis of the effectiveness of batterer treatment programs, with a view to characterizing the interplay between different forms of IPV (physical, psychological, and sexual). Using meta-regression, we explore the effect sizes and whether IPV treatment methods have distinct impacts on the outcomes. We use the difference normalized by pretreatment mean and variance foldchange to uncover the relationship between different violence subtypes and how they drive each other. Specifically, our study found that studies with more pre-treatment psychological and/or sexual violence, lead to less favorable outcomes while the studies that start with more physical violence are able to demonstrate their effects more effectively. Results of this study can be used to help the clinician effectively select the treatment for the perpetrator based on the violence type and severity of violence in order to more effectively treat the needs for each specific relationship.

Psychological and Physical Abuse and Cortisol Response to Stress: The Moderating Role of Psychosocial Resources

Child abuse is associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis functioning. However, the unique effects of psychological and physical abuse and protective factors against these effects remain largely unknown. To close these gaps, the present study examined the unique effects of psychological and physical abuse on cortisol stress response and explored the moderating role of psychosocial resources in these associations among a sample of Chinese preadolescent children (N = 150; aged 9-13 years; M_age = 10.69 years; 51% boys). The results showed that both psychological and physical abuse were associated with blunted cortisol reactivity slopes. Psychological abuse, but not physical abuse, was associated with lower peak cortisol values and flatter cortisol recovery slopes. Further, psychosocial resources moderated the association between abuse and hyporesponsiveness of the HPA axis. The association between psychological abuse and lower peak cortisol values and the association between physical abuse and steeper cortisol recovery slopes (faster cortisol recovery following the stressor) were observed only among children with low levels of psychosocial resources. These findings indicate the differential effects of psychological and physical abuse on various phases of cortisol stress response, and the protective role of psychosocial resources. This study also has practical implications, given that preadolescence serves as a critical period for maximizing benefit of interventions of adversity.

Psychological maltreatment: An operationalized definition and path toward application

Psychological maltreatment (PM) of children has been difficult to define and even more challenging to operationalize consistently. This fact contributes to child PM being under-recognized and under-addressed by professionals that interact with children with mental health, behavioral, and developmental issues; and by systems such as child welfare, clinical and judicial systems. In this paper, we propose a definition of child PM that is both overarching and operationalized in a manner that will support consistent, fair, and unbiased application in applied contexts. The operationalized definition delineates the nature of caregiver acts that can amount to PM, as well as the level of experienced and potential impact of said act (s) that constitute PM. We detail our rationale for the definition. We discuss the need for field trials to establish the utility of the definition. We explain the necessary training and systems that would be required for the definition to be consistently and accurately applied. We believe that this definition has the potential to substantially enhance systems' abilities to recognize and address child PM, and thereby enhance children's and families' wellbeing.

Prevalence of Adverse Childhood Experiences (ACEs) among young adults of Kashmir

OBJECTIVE

Studies on the prevalence of adverse childhood experiences (ACEs) in Kashmir, India, are yet to be conducted. This study aims to estimate the prevalence of ACEs among young adults across all the ten districts of Kashmir Valley.

METHODS

A cross-sectional research strategy was used to assess the prevalence of ACEs by employing a multi-stage sampling method. Data were collected from 800 students studying in different colleges and universities in Kashmir with the help of the "Adverse Childhood Experiences" (ACEs) scale.

RESULTS

Findings disclosed that less than a quarter of the respondents reported high exposure to ACEs (15.4 %), more than one-tenth of the participants reported extremely high exposure to ACEs (13.4 %), over a quarter of the sample reported moderate exposure to ACEs (26.3 %), one-third of the youth reported low exposure to ACEs (33.0 %) and over one-tenth of the respondents reported no exposure to ACEs (11.8 %). The prevalence of ACEs was found to be 88.2 % (females: 82.7 % and males: 90.8 %) in Kashmir. The ACEs with the highest level of prevalence were "often or very often sworn at, insulted, or put down" (49.8 %), followed by "often or very often acted in a way that made them afraid that they would be physically hurt" (47.6 %), "often or very often pushed, grabbed, shoved, or slapped" (41.6 %), "often or very often hit so hard that they had marks or were injured" (28.3 %) and "touched or sexually fondled" (25.3 %). Thirteen out of 21 adverse events during childhood were significantly associated with gender.

CONCLUSION

The findings suggest the need to advocate early targeted interventions, reduce ACEs and their impact, and design efficient measures to improve the health and well-being of young adults in Kashmir.

Child psychological/emotional abuse and neglect: A definitional conceptual framework

Purpose

This study developed a definitional conceptual framework to clarify the nature of the definitions of psychological/emotional abuse and neglect (PEA) and to test the efficacy of this framework by applying it to three different types of definitions.

Methods

The definitional conceptual framework was developed from conceptual issues addressed by the previous literature. The framework was then applied to three types of definitions: (i) abstract definitions in the literature describing what PEA is, (ii) operational definitions in practice guidelines provided for professionals, and (iii) research studies on professionals' definitions of PEA.

Results

The framework was able to show that definitions of PEA were often not specific about their inherent definitional components or how the ways in which they were similar or different from other definitions. To the extent that the nature of the definitions was explicit, the framework was able to clearly distinguish the considerable variation in the nature of PEA definitions both within and across the three types of definitions.

Conclusions

Policy, practice, and research on PEA (and other forms of child abuse and neglect) are unlikely to progress without clarity about the definitions being used (in terms of their conceptual components) and the rationale for using the specific definitions chosen. The framework provided by the study is an effective tool for describing the components used in PEA definitions and thus distinguishing the differences between definitions. The framework should also be applicable for other types of child abuse and neglect.

Psychological and physical abuse towards four-year-old children as reported by their parents: A national Finnish survey

BACKGROUND

In Finnish society, child maltreatment is a health and social problem with harmful consequences. Identifying families at risk may help preventing child maltreatment recurrence.

OBJECTIVE

The aim of this nationwide retrospective cross-sectional study was to describe the child- and family-related risk factors associated with physical and psychological abuse experienced by 4-year-old children.

METHODS

This study analyzed nationwide survey data collected by the Finnish Institute for Health and Welfare. Overall, 17,009 parents (46%) visiting at a child health clinic filled out the survey consent form. For 8720 children, one or both parents completed the questionnaire (24%). Analyses were carried out using χ² tests and binary logistic regression.

RESULTS

Of the 4-year-olds, 44% had experienced at least one form of psychological abuse and 14% physical abuse. These forms of violence co-occurred in 25% of the reported cases (p < 001). Intimate partner violence (IPV) and child maltreatment co-occurred in 19.6% of psychological abuse (p < .001) and 22.5% of physical abuse cases (p < .001). Parents exposed to IPV was the risk factor most likely to predict an increased risk for both psychological abuse (OR 4.01, CI 3.41-4.72; p < .001), and physical abuse (OR 2.19, CI 1.81-2.64; p < .001). Approving of hair-pulling or pinching the child (i.e., using corporal punishment) was most likely to predict an increased risk of physical abuse (OR 13.70, CI 11.69-16.06; p < .001).

CONCLUSIONS

The findings emphasize the importance of preventing all forms of child maltreatment by identifying families at risk and supporting parenthood according to families' needs.

Prevalence of abuse among the elderly population of Syangja, Nepal

Background

Elder abuse is recognized as a serious public health concern and top priority aging issues. World Health Organization reported that around 1 out of 6 old people in the world experienced some form of abuse. This study was carried out to find out the prevalence of different forms of abuse among elderly Nepalese people.

Methods

The cross-sectional, quantitative analytical study was carried out among 373 elders of the Syangja district of Nepal. The study population was selected through simple, proportionate, and systematic sampling methods. Data was collected through face-to-face interviews using a structured questionnaire.

Results

The majority of participants were female (54.5%). The prevalence of elderly abuse was found to be 54.5%. The most common form of abuse among the elderly population was neglect (23.1%), psychological abuse (20.6%), physical abuse (6.5%), financial abuse (2.4%), and sexual abuse (1.9%). Elderly females were significantly more likely to experience physical and psychological abuse.

Conclusion

More than half of the elderly experienced at least one form of abuse. Neglect was found to be the most common form of abuse. The abuse was prevalent among elderly who were ill and with the habit of tobacco and alcohol consumption.

Sexual abuse and chronic pelvic pain in a gynecology outpatient clinic. A pilot study

INTRODUCTION AND HYPOTHESIS

Almost 20% of women will suffer from sexual abuse at some point in their lives. This is a known risk factor for developing chronic pelvic pain (CPP), which is a major health problem worldwide. We conducted a pilot study in a Gynecology Outpatient Clinic to find the correlation between these two clinical entities and provide better evidence for their diagnosis and treatment.

METHODS

A semi-structured interview for the evaluation of sexual violence in women (EVS) was used as a screening tool and a complement to routine gynecological examination to identify patients suffering from sexual abuse. Patients included were also assessed for comorbidities, including CPP, and other coexisting mental health problems.

RESULTS

Of the 61 patients screened, 33 (54.1%) had pelvic pain. Also, 11 patients (18%) had suffered sexual abuse at some point in their lives, which was only disclosed when the specific interview was performed. Ten patients (90.8%) out of 11 that had been sexually abused also had pelvic pain. This was found to be statistically significant in this sample (p = 0.008) with a more than 11-fold greater risk of having pelvic pain (OR, 11.7; 95% CI, 1.4-98.7). Most patients did not have psychological violence (77%) but those that did (23%) had a seven-fold greater risk of having pelvic pain (OR, 7.4; 95% CI, 1.5-36.9).

CONCLUSION

Specific tools should intentionally be used for evaluating sexual abuse and chronic pelvic pain, since a strong correlation exists between these two entities and they are seldom reported by patients.

Prevalence and associated factors of elder psychological abuse- a cross- sectional screening study, based on a hospitalized community from Poland

OBJECTIVE

The aim of the present work was to exploring the prevalence, perpetrators and predictors of elder psychological abuse.

METHOD

We conducted the cross- sectional study, based on a hospitalized community. The sample consisted of 200 respondents aged ≥60. The Chi-square test and logistic regression models were used.

RESULTS

A total of 29 % respondents experienced at least one type of psychological abuse in the last 12 months. The percentage of women who statistically more often than men experienced arrogance, isolating, insulting and mocking was 71-77 %. It has been shown that the lower the monthly income, the higher the risk of psychological violence. Statistically, the highest percentage of violence in the form of arrogance, vulgarity and blackmail, threats was recorded in people aged 60-65 (48.9 % and 56.3 %, respectively). On the other hand, logistic regression analysis showed that the oldest respondents aged >70 more than three times more often than people from the youngest age category are victims of violence. The rate of arrogance, vulgarity (odd ratio (OR) 2.90;p < 0.01) and mocking (OR 3.56; p < 0.01) is statistically significantly higher, respectively, in people living in towns than in villages. People with chronic diseases are statistically more likely to experience violence in the form of isolation (OR 4.74; p = 0.04). Cohabitants, spouses or sons are the most frequent perpetrators of elder abuse and neglect.

CONCLUSION

This study reveals that statistically more often, psychological abuse is experienced by women, older adults living in urban areas and people with a low socioeconomic status and chronic disease.

Traumatic Injuries Due to Interpersonal and Domestic Violence in the United States

BACKGROUND

Domestic and intimate partner violence (DV) are under-reported causes of injury. We describe the health care utilization of DV patients, hypothesizing they are at increased risk of mortality.

METHODS

We queried the 2014 Nationwide Emergency Department Sample for adult patients (18 y and older) with a primary diagnosis of trauma. DV was abstracted using International Statistical Classification of Diseases, ninth Revision codes for partner or spouse intimate violence, abuse, or neglect. The primary outcome was mortality; secondary outcomes included admission rates and charges.

RESULTS

Among 14 million trauma patients, 654,356 (5.0%) had a diagnosis of DV. Compared with other trauma patients, DV patients were younger (34.6 versus 46.8 y, P < 0.001), more often male (69.5% versus 50.1%, P < 0.001), and more likely to be uninsured (31.5% versus 15.6%, P < 0.001). 9154 (1.4%) were injured because of intimate partner violence, of which 90.2% were female. Drug and alcohol abuse (22.2%), anxiety (1.8%), and depression (1.3%) were high among all DV trauma patients. DV emergency department charges were higher ($4462 versus $2,871, P < 0.001). In adjusted analyses, DV trauma patients had 2.1 higher odds of mortality (aOR: 2.31, P < 0.001). DV trauma patients were also associated with a $1516 increase in emergency department charges compared with non-DV trauma patients (95% CI: $1489-$1,542, P < 0.001).

CONCLUSIONS

Injuries related to all types of DV are emerging as a public health crisis among both genders. To mitigate under-reporting, it is important to identify at-risk patients and provide them with appropriate resources.

The effect of intimate partner violence on women's mental distress: a prospective cohort study of 3010 rural Indian women

PURPOSE

Intimate partner violence (IPV) encompasses physical, sexual, and psychological abuse, as well as controlling behavior. Most research focuses on physical and sexual abuse, and other aspects of IPV are rarely investigated. We estimated the effect of these neglected aspects of IPV on women's mental distress.

METHODS

We used data from 3010 women living in rural tribal communities in Rajasthan, India. Women completed baseline interviews and were re-interviewed approximately 1.5 years later. We measured IPV with questions adopted from the Demographic and Health Survey's Domestic Violence Module, which asked seven questions about physical abuse, three questions about psychological abuse, and five questions about partner controlling behavior. Mental distress was measured with the 12-item General Health Questionnaire (score range 0-12). We used Poisson regression models to estimate the relation between changes in IPV and mental distress, accounting for time-fixed characteristics of individuals using individual fixed effects.

RESULTS

Women reported an average of 2.1 distress symptoms during baseline interviews. In models that controlled for time-varying confounding (e.g., wealth, other types of abuse), experiencing psychological abuse was associated with an increase of 0.65 distress symptoms (95% CI 0.32, 0.98), and experiencing controlling behavior was associated with an increase of 0.31 distress symptoms (95% CI 0.18, 0.44). However, experiencing physical abuse was not associated with an increase in distress symptoms (mean difference = - 0.15, 95% CI - 0.45, 0.15).

CONCLUSIONS

Psychological abuse and controlling behavior may be important drivers of the relation between IPV and women's mental health.

Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse

BACKGROUND

Although research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors.

OBJECTIVE

This study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended.

PARTICIPANTS

Participants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed.

METHODS

Childhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes.

RESULTS

Childhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types.

CONCLUSIONS

These results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.

Intimate partner sexual violence and risk for femicide, suicidality and substance use among women in antenatal care and general out-patients in Thailand

BACKGROUND

Little is known about the occurrence and health consequences of intimate partner sexual assault. The aim of this study was to assess the prevalence and correlates of sexual assault in the context of intimate partner violence (IPV) in Thailand.

METHODS

In a cross-sectional survey adult female participants were systematically screened (self-administered or interview administered) for IPV in antenatal care and general outpatient clinics in nine randomly selected hospitals in two provinces in the central region. Measures included the Abuse Assessment Screen, Severity of Violence Against Women Scale, Danger assessment and suicidal behaviour.

RESULTS

From 14,288 women screened, 1.5% were positive for IPV and 207 participated in the study. The mean age of the study participants was 26.8 years (SD = 9.3). Fifty-seven women, 27.5% of the sample, reported sexual assault, one or more times, during the relationship in the past 12 months. Most reported some form of psychological abuse (82.1%), physical violence (67.1%) and danger (72.0%). In all, 21.3% reported psychological, physical and sexual violence. Bivariate analyses found that older age, being recruited in the general out-patient department, greater number of children, high psychological abuse, high physical violence, danger and suicidal behaviour in the past 12 months were associated with sexual assault. In multivariable backward conditional logistic regression physical violence (OR = 5.32, CI = 2.52-11.24) and suicidal behaviour (OR = 3.28, CI = 1.37-7.83) were found to be associated with sexual assault.

CONCLUSIONS

The study found a moderate rate of sexual assault in intimate violent partner relationships and those sexual assaults are more likely to co-occur with physical intimate partner violence and suicidal behaviour. This knowledge may be helpful in the detection and management of sexual assault in intimate violent partner relationships of women in health care settings in Thailand.

Psychological Abuse, Mental Health, and Acceptance of Dating Violence Among Adolescents

PURPOSE

Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the present study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility).

METHODS

Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility and symptoms of anxiety and depression).

RESULTS

As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms.

CONCLUSIONS

Findings from the present study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress.

Social problem solving strategies and posttraumatic stress disorder in the aftermath of intimate partner violence

Social factors are often associated with the development or maintenance of posttraumatic stress disorder (PTSD) in the aftermath of interpersonal traumas. However, social problem solving strategies have received little attention. The current study explored the role of social problem solving styles (i.e., rational approaches, impulsive/careless strategies, or avoidance strategies) as intermediary variables between abuse exposure and PTSD severity among intimate partner violence survivors. Avoidance problem solving served as an intermediating variable for the relationship between three types of abuse and PTSD severity. Rational and impulsive/careless strategies were not associated with abuse exposure. These findings extend the current understanding of social problem solving among interpersonal trauma survivors and are consistent with more general avoidance coping research. Future research might examine whether avoidance problem solving tends to evolve in the aftermath of trauma or whether it represents a longstanding risk factor for PTSD development.

More than words: the emotional maltreatment of children

Emotional maltreatment may be the most complex, prevalent, and damaging form of child maltreatment and can occur simultaneously with other forms of abuse. Children in the first few years of life seem to be at the greatest risk of suffering the most negative outcomes. Medical professionals can help identify and protect victims of emotional maltreatment by carefully observing caregiver-child interactions, paying attention to a family's social history, making referrals to community or counseling programs when necessary, and reporting any suspicions of maltreatment to Child Protective Services. A well-coordinated, multidisciplinary response must be enacted whenever emotional maltreatment is suspected or reported.

Parental Psychological Abuse toward children and Mental Health Problems in adolescence

OBJECTIVE

Present study was conducted to explore the relationship between parental psychological abuse toward their children and mental health problems in adolescence.

METHOD

Three hundred participants age range 13-17 years, (57% boys and 43% girls) participated in the study from both public and private high schools of Lahore. Psychological maltreatment experience scale (PMES) and Youth Self-Report(YSR) were used for assessment and diagnosis.

RESULTS

Findings revealed that psychological abuse by parents significantly related with mental health problems in adolescents, for mother abuse (r= .24 to.67, p< .05) and father abuse (r= .20 to.70, p< .05). Adolescents who perceived their parents as more abusive exhibited greater problems. Regression analysis indicated that hypothesized factors of parental psychological abuse predicted the mental health problems in adolescents (contributed from 10% to 49% of variance).

CONCLUSION

Psychological abuse by parents is related with mental health problems in adolescents. These findings will contribute to a better understanding of non-injurious psychological abuse and its impact on adolescents. Findings of the study can be used to bring the attention of parents, public and professionals' towards damaging effects of psychological abuse on adolescents.

Child abuse and suicidal ideation among adolescents in China

The present study examined the relationship among physical abuse, psychological abuse, perceived family functioning and adolescent suicidal ideation in Shanghai, China. Perceived family functioning was investigated as a possible moderator between physical abuse, psychological abuse and suicidal ideation. A cross sectional survey using convenience sampling was conducted. A total of 560 valid self-administered questionnaires were completed by the students aged from 12 to 17 in Shanghai. Descriptive statistical analyses, Pearson correlations analyses, and hierarchical regression analyses were adopted as methods of data analyses. Results indicated that physical abuse was significantly associated with greater adolescent suicidal ideation, while a higher level of perceived family functioning was significantly associated with lower suicidal ideation. However, psychological abuse was not associated with suicidal ideation. Perceived family functioning was shown to be a moderator between physical abuse and suicidal ideation. Specifically, mutuality and family communication moderated the relationship between physical abuse and suicidal ideation. To decrease adolescent suicidal ideation, measures are suggested to prevent physical abuse and enhance family functioning. First, it is important to increase the parents' awareness of the meaning and boundaries of physical abuse, as well as the role it plays in contributing to adolescent suicidal ideation. Second, parents should be taught appropriate parenting skills and knowledge and be guided to treat the children as individuals with their unique personality, rights and privileges. Third, it is important to promote family harmony, effective communication as well as mutual trust, concern and understanding among family members.