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Chen D, Lin L, Feng X, Luo S, Xiang H, Qin K, Guo X, Chen W, Guo VY. Adverse childhood experiences, problematic internet use, and health-related quality of life in Chinese adolescents. Eur J Psychotraumatol 2023; 14:2218248. [PMID: 37335002 DOI: 10.1080/20008066.2023.2218248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/21/2023] Open
Abstract
Background: The influence of adverse childhood experiences (ACEs) on an individual's health is substantial. However, the associations between ACEs, problematic internet use (PIU), and health-related quality of life (HRQOL) in adolescents remain underexplored.Objective: To assess the association between ACEs and HRQOL in Chinese adolescents and to evaluate the mediating role of PIU in this association.Method: A sample of 6,639 adolescents (3,457 boys and 3,182 girls) aged between 11-20 years (mean [SD] age: 14.5 [1.6] years) were recruited from 6 junior and senior middle schools using a proportional sampling approach in a cross-sectional study. Data on ACE exposure was collected through the short form of Childhood Trauma Questionnaire, the ACE-International Questionnaire, and two additional questions. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0. The associations between ACEs and HRQOL were estimated using linear regression models. Mediation analysis was further conducted to explore the possible mediating role of PIU in the association between ACEs and HRQOL.Results: Our study collected 13 different ACEs. We found that adolescents exposed to any ACE had significantly lower scores in all HRQOL dimensions, psychosocial health summary scale, and total scale, than those without such exposure. Specifically, adolescents with ≥ 3 ACE exposure had a total scale score that was 14.70 (95%CI: 15.53 to 13.87) points lower than their non-exposed counterparts. Mediation analysis identified PIU as a significant mediator, with the proportion of the total effect attributable to PIU ranging from 14.38% for social functioning to 17.44% for physical functioning.Conclusions: Exposure to ACEs was associated with poorer HRQOL in Chinese adolescents, underscoring the importance to prevent ACEs and their negative impacts on adolescent well-being. These findings also highlighted the need of promoting appropriate internet use among adolescents exposed to ACEs, in order to avert potential impairment in their HRQOL.HIGHLIGHTSAdolescents with adverse childhood experiences have poorer health-related quality of life.The association between adverse childhood experiences and health-related quality of life shows a dose-response pattern.Problematic internet use partially mediates the associations between adverse childhood experiences and health-related quality of life in adolescents.
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Affiliation(s)
- Dezhong Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiuqiong Feng
- Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hongyu Xiang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Kang Qin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xun Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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Chen Q, Chan KL, Chen M, Lo CKM, Ip P. Associating sleep quality, quality of life and child poly-victimization. CHILD ABUSE & NEGLECT 2022; 133:105846. [PMID: 35994886 DOI: 10.1016/j.chiabu.2022.105846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 05/18/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The role of sleep deprivation in the relationship between child poly-victimization and pediatric quality of life (PedsQL) has received little attention. OBJECTIVE This study aims to provide a profile of the association between child victimization and poly-victimization and PedsQL among children, examining the role of sleep quality patterns in these relationships. PARTICIPANTS AND SETTING We conducted a cross-sectional school survey study of family structure and child victimization among families in Hong Kong in 2016-17 with two-stage stratified sampling. The final sample consisted of 5, 567 students recruited from a representative sample of 107 kindergartens, primary schools, and secondary schools in all districts of Hong Kong. METHODS Multi-phase regression analysis and simple slope analysis were conducted to examine the moderating effects of sleep quality between child victimization and PedsQL. RESULTS The findings showed that children who experienced four or more types of victimization were more likely to show parasomnia and daytime dysfunction symptoms than those experiencing one to three types of victimization and non-victims. It also revealed significant relationships between child poly-victimization and lower levels of PedsQL, which were moderated by parasomnia and daytime dysfunction. CONCLUSIONS This study has implications for clinicians in targeting the pattern of sleep changes combined with holistic screening in outpatient services for early detection of child poly-victims.
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Affiliation(s)
- Qiqi Chen
- Department of Social Work, Xiamen University, China
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Mengtong Chen
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Camilla Kin-Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, University of Hong Kong, Hong Kong
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Kobulsky JM, Yoon D, Villodas MT, Schuler BR, Wildfeuer R, Reyes JN. Neglect, Abuse, and Adaptive Functioning: Food Security and Housing Stability as Protective Factors for Adolescents. CHILDREN 2022; 9:children9030390. [PMID: 35327762 PMCID: PMC8946869 DOI: 10.3390/children9030390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
This study addresses gaps in knowledge of protective factors that support adaptive functioning among maltreated adolescents. The sample included 1003 high-risk youths participating in the Longitudinal Studies of Child Abuse and Neglect (53% female, 56% Black, and 82% living in poverty). Adolescent neglect (Exposure to Risky Situations, Lack of Monitoring, Inattention to Basic Needs, Permitting Misbehavior, Lack of Support) and physical, sexual, and emotional abuse were self-reported at age 16. Age 18 adaptive functioning measures included healthcare receipt (medical, dental, and mental health), self-rated global health, high school graduation or enrollment, prosocial activities, peer relationships (Companionship, Conflict, Satisfaction, and Intimacy), and independent living skills. Previous childhood maltreatment, demographics, and earlier prosocial activities and peer relationships were controls. Structural equation modeling showed that adolescent neglect and abuse were associated with lower adaptive functioning. Multigroup models showed protective effects for food security on the relationships between sexual abuse and self-rated health and between Inadequate Monitoring and Companionship. Housing stability buffered relationships between Inadequate Support and high school graduation or enrollment and between Permitting Misbehavior and independent living skills. Findings imply the need for adolescent-focused prevention, including the promotion of food security and housing stability to support adaptive functioning in maltreated adolescents. However, notable mixed findings show the need for additional research.
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Affiliation(s)
- Julia M. Kobulsky
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
- Correspondence: ; Tel.: +1-215-204-2843
| | - Dalhee Yoon
- Department of Social Work, Binghamton University-State University of New York, Binghamton, NY 13902, USA;
| | - Miguel T. Villodas
- Department of Psychology, College of Sciences, San Diego State University, San Diego, CA 92121, USA;
| | - Brittany R. Schuler
- School of Social Work, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
| | - Rachel Wildfeuer
- Department of Sociology, Temple University, Philadelphia, PA 19122, USA;
| | - José N. Reyes
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA 19122, USA;
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Park DH, Meltendorf T, Kahl KG, Kamp JC, Richter MJ, Gall H, Ghofrani HA, Hoeper MM, Olsson KM, Fuge J. Childhood Trauma in Patients With PAH-Prevalence, Impact on QoL, and Mental Health-A Preliminary Report. Front Psychiatry 2022; 13:812862. [PMID: 35222119 PMCID: PMC8866231 DOI: 10.3389/fpsyt.2022.812862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVE Child maltreatment is associated with increased risk of psychological consequences, contributes to morbidity and has long lasting effects on mental health and quality of life. Child maltreatment has not been assessed in patients with pulmonary arterial hypertension (PAH). We examined the prevalence of child maltreatment and determined their impact on disease severity in patients with PAH. METHODS A cross-sectional observational multicenter study at two PH centers in Germany was conducted. Patients with a confirmed diagnosis of PAH were given a self-administered questionnaire. Child maltreatment using the Childhood Trauma Questionnaire (CTQ), quality of life (QoL), anxiety, depression, and lifestyle factors were assessed and enhanced by clinical parameters 6-min walk distance (6MWD), WHO functional class (WHO FC), and serum levels of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP). Prevalence rates of child maltreatment were compared to the general population and impact of child maltreatment on disease severity was calculated by logistic regression analysis. RESULTS Two-hundred and seventeen patients, 71% female and a median age of 56 years were enrolled in this study. Patients with PAH had higher rates of emotional abuse and lower rates of physical neglect compared to the German population while rates of emotional neglect, physical abuse, and sexual abuse did not differ between patients and German population. Patients with any form of child maltreatment were more likely to be active smokers, had a worse QoL and more anxiety or depression. Moderate associations between child maltreatment, mental health, QoL, lifestyle factors and clinical parameters could be observed. Logistic regression analysis showed a significant impact of CTQ-total score on disease severity with an OR of 1.022 (95%-CI: 1.001-1.042, p = 0.035). CONCLUSION We found a higher rate of child maltreatment in patients with PAH in comparison to the German population. Correlations suggest moderate associations between CTQ-scores and mental health as well as QoL. Child maltreatment had significant impact on disease severity. However, effects were moderate. We conclude that child maltreatment has effects on mental health and quality of life in patients with PAH and may have limited effect on disease severity.
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Affiliation(s)
- Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Tanja Meltendorf
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan C. Kamp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Manuel J. Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Hossein A. Ghofrani
- Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany
- German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Giessen, Germany
| | - Marius M. Hoeper
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Karen M. Olsson
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
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Tsur N, Katz C, Talmon A. The shielding effect of not responding: Peritraumatic responses to child abuse and their links to posttraumatic symptomatology. CHILD ABUSE & NEGLECT 2021; 121:105224. [PMID: 34392074 DOI: 10.1016/j.chiabu.2021.105224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/13/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Extensive literature focuses on peritraumatic responses to trauma and their link to subsequent posttraumatic symptomatology. However, although posttraumatic symptomatology following child abuse (CA) has been documented, research on peritraumatic responses to CA is sparse. OBJECTIVE The current study utilizes a new typology of peritraumatic responses to CA and tests whether automatic and behavioral peritraumatic responses to CA differ in their long-term implications for posttraumatic symptomatology, i.e., posttraumatic stress (PTS symptoms), deficiency in self-organization (DSO symptoms; complex posttraumatic symptoms), and dissociation. PARTICIPANTS, SETTINGS AND METHODS One-hundred and eighty adult CA survivors reported on CA, peritraumatic responses, PTS symptoms, DSO symptoms, and dissociation. RESULTS The tendency to freeze and dissociate, and utilize extensive behavioral methods to survive the abuse were implicated in higher posttraumatic symptomatology (F(2,178) > 4.26, p < 0.01). The absence of automatic and behavioral responses were found to be implicated in the lowest levels of posttraumatic symptomatology (p < 0.01) and to buffer the effect of CA severity on PTS and DSO posttraumatic symptoms (0.047 > effect>0.029, p < 0.001). CONCLUSIONS The findings uncovered a novel response pattern, reflected in a tendency to eradicate responses to CA, which was the most protective in regard to its link to later posttraumatic symptomatology. Contrarily, the most scarring peritraumatic responses to CA that arose from the findings were the tendency to freeze and dissociate and utilize various excessive behavioral methods to endure the abuse. These findings imply that CA generates several possible responses, some of which, although allowing for survival in childhood, have adverse effects in adulthood.
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Affiliation(s)
- Noga Tsur
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Anat Talmon
- Department of Psychology, Stanford University, CA, United States of America
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Lo CKM, Ho FKW, Yan E, Lu Y, Chan KL, Ip P. Associations Between Child Maltreatment and Adolescents' Health-Related Quality of Life and Emotional and Social Problems in Low-Income Families, and the Moderating Role of Social Support. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7436-7455. [PMID: 30862240 DOI: 10.1177/0886260519835880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aimed to examine the associations between different types of child maltreatment and health-related quality of life (HRQoL) and emotional and social problems in adolescents, and to examine the moderating effect of social support on those associations. A cross-sectional survey was conducted between January and June 2016 in Hong Kong. The sample comprised 351 parent and adolescent dyads from low-income families. The parents reported on child maltreatment (physical abuse, psychological aggression, and neglect), and the adolescents reported on their HRQoL, emotional problems, and social problems. The adolescents' perceived social support was included as a potential moderator. Results of the study show that child physical abuse was strongly associated with emotional and social problems (B = 0.91-1.45, p < .05). Lower overall HRQoL was associated with psychological aggression (B = -3.96, p < .05) and neglect (B = -4.14, p < .05). Physical functioning was affected by psychological aggression (B = -3.16, p < .05), and emotional functioning was affected by neglect (B = -4.82, p < .05). Social functioning was impacted by all three types of maltreatment (B = -9.16 to -5.26, p < .05). This study extends previous literature by showing the varying effects of different types of child maltreatment on children's health in the context of low-income families. The findings of this study also support that peer social support may buffer the effects of child physical abuse on adolescents' emotional and social problems.
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Affiliation(s)
| | | | - Elsie Yan
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yu Lu
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ko Ling Chan
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Patrick Ip
- The University of Hong Kong, Pokfulam, Hong Kong
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Toussaint E, Bacro F, Schneider B. La qualité de vie à l’école des enfants placés en foyer : le rôle de l’attachement et des problèmes extériorisés. ANNEE PSYCHOLOGIQUE 2021. [DOI: 10.3917/anpsy1.212.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Jaye Capretto J. Developmental Timing of Childhood Physical and Sexual Maltreatment Predicts Adult Depression and Post-Traumatic Stress Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2558-2582. [PMID: 29294721 DOI: 10.1177/0886260517704963] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Child physical and sexual maltreatment have emerged as documented risk factors for a wide range of health problems in adulthood, including depression and post-traumatic stress symptoms. Prior research focuses on generalized childhood adversities without accounting for how different critical details about the maltreatment may affect outcomes in adulthood. The present study examines the impact of two critical details, timing and type of child maltreatment, on depression and post-traumatic stress symptoms in adulthood. Participants (N = 104) completed the Maltreatment and Abuse Chronology of Exposure scale (MACE) and the Inventory of Depression and Anxiety Scale-Second Version (IDAS-II). Hierarchical multiple regressions compared three different models of child maltreatment predictors and their differential utility for predicting depression and post-traumatic stress symptoms in adulthood: (a) number of child maltreatment experiences, (b) severity of child maltreatment, and (c) timing of child maltreatment. Results indicate that severity of child maltreatment and timing of child maltreatment are greater predictors for adult depression and post-traumatic stress symptoms than number of child maltreatment experiences. Compared with other developmental periods, early childhood sexual maltreatment experiences (5 years of age and below) and late childhood physical maltreatment experiences (13 years of age and above) were stronger predictors of adult depression and post-traumatic stress symptoms. Children maltreated during these age groups may be prioritized for prevention and intervention efforts, particularly when there are limited resources. Clinical interviews with maltreated children should also be expanded to include information about developmental timing and severity of maltreatment, which have ramifications for later health problems. Implications for assessment of maltreated children, prevention of adult depression and post-traumatic stress symptoms, and future research directions are discussed.
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Naderi S, Naderi S, Delavar A, Dortaj F. The effect of physical exercise on anxiety among the victims of child abuse. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00538-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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10
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Vink RM, van Dommelen P, van der Pal SM, Eekhout I, Pannebakker FD, Klein Velderman M, Haagmans M, Mulder T, Dekker M. Self-reported adverse childhood experiences and quality of life among children in the two last grades of Dutch elementary education. CHILD ABUSE & NEGLECT 2019; 95:104051. [PMID: 31344586 DOI: 10.1016/j.chiabu.2019.104051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) may have a life-long impact on mental health and are related to physical disease, such as diabetes and cardiovascular diseases in adulthood. Research on ACEs suffers from recall bias when performed with adults. OBJECTIVE To estimate the prevalence of ACEs and the interrelationships between ACEs as reported by children, and to determine the impact on their self-reported quality of life (QoL). Children's opinions on the ACE-Questionnaire were also obtained. METHOD A cross-sectional study was conducted with a child version of the ACE-Questionnaire. This questionnaire assesses parental separation or divorce, physical and emotional child abuse and neglect, sexual violence, domestic violence, household substance abuse, psychological issues or suicide, and incarceration of a household member. QoL was measured with the Kidscreen-10. PARTICIPANTS AND SETTING The questionnaire was completed by 644 children at a mean age of 11 years (range 9-13 years), in the two last grades of regular elementary schools, recruited throughout the Netherlands. RESULTS Data were weighted by ethnicity to obtain a representative sample of children in Dutch elementary education. Of all children, 45.3% had one or more out of ten ACEs. Child maltreatment was experienced by 26.4%. ACEs often co-occurred. A higher number of ACEs correlated with a lower mean level of QoL (p < 0.001). Mean QoL was 8.5 points lower (Cohen's d = 0.8) in children who experienced child maltreatment. Children's opinions on the questionnaire were positive in 82.4%. CONCLUSION Prevention of ACEs, professional training and trauma-focus in schools are urgently needed.
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Affiliation(s)
- Remy M Vink
- TNO, Department of Child Health, Leiden, the Netherlands.
| | | | | | - Iris Eekhout
- TNO, Department of Child Health, Leiden, the Netherlands
| | | | | | | | - Tim Mulder
- Augeo Foundation, Driebergen, the Netherlands
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Health-related quality of life of maltreated children and adolescents who attended a service center in Brazil. Qual Life Res 2018; 27:2157-2164. [PMID: 29766440 DOI: 10.1007/s11136-018-1881-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE This study's aim was to evaluate the health-related quality of life (HRQoL) and associated factors of maltreated children and adolescents. METHODS This cross-sectional study consisted of individuals between 8 and 17 years of age who were victims of maltreatment. The KIDSCREEN-52 was used to measure their HRQoL. Socioeconomic and demographic data were collected, as well as information about the type of abuse, type of perpetrator, and psychological support adherence. The Kruskal-Wallis test was used to analyze the scores of the KIDSCREEN-52 by the independent variables. RESULTS One hundred and thirteen victims answered the questionnaire. Girls and adolescents had a lower overall HRQoL score (p < 0.05). Children who suffered from sexual abuse had a lowest score on the moods and emotions dimension than children who suffered from physical abuse (p < 0.05). There was a lowest score on the autonomy dimension among the children who suffered maltreatment by an extrafamilial perpetrator than those who were victimized by an intrafamilial perpetrator (p < 0.05). A lower score on the psychological well-being was observed among the children who adhered to the psychological support program provided by the service compared to those who terminated the service before completion (p < 0.05). CONCLUSIONS Adolescents and girls were associated with lower HRQoL scores. There was no association between the overall HRQoL score and the characteristics of the maltreatment; however, the type of abuse and the victim's relationship with the perpetrator were only related to some dimensions. These findings may assist maltreatment care providers in planning strategies to reduce the consequences that violence may cause.
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Weber S, Jud A, Landolt MA, Goldbeck L. Predictors of health-related quality of life in maltreated children and adolescents. Qual Life Res 2017. [PMID: 28620875 DOI: 10.1007/s11136-017-1615-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Research on the consequences of child maltreatment has primarily focused on behavior and mental health; the children's overall well-being has not received the same attention. A number of studies have investigated health-related quality of life (HRQoL) among victims of child maltreatment, but there is still a lack of knowledge about predictors of HRQoL in maltreated children and adolescents. This study seeks to bridge the gap by drawing data from the German multi-site study Child Abuse and Neglect Case-Management (CANMANAGE). METHODS Parents or caregivers of 350 children and adolescents completed a proxy version of the Kidscreen-10-Index, a multidimensional instrument measuring child HRQoL. An additional 249 children age 8 years and older completed a self-report version. Multiple regression analyses were performed to identify potential predictors for both self- and proxy-rated HRQoL. RESULTS Comparisons with the reference group revealed a significantly lower mean proxy-rated HRQoL, the self-rated HRQoL of the study sample was not significantly impaired. Predictors of impaired self-reported HRQoL were older age, self-reported posttraumatic stress symptoms (PTSS), and self-reported emotional and behavioral symptoms. Predictors of impaired proxy-reported HRQoL again were older age, self-reported PTSS, and emotional and behavioral symptoms in the child/adolescent, as reported by the caregiver, as well as low socioeconomic status. Multivariate analysis explained 20% and 38% of the variability in self-reported and proxy-rated HRQoL, respectively. CONCLUSIONS It is important to treat PTSS and emotional and behavioral symptoms in maltreated children, as these two phenomena are strong cross-sectional predictors of a child's HRQoL. Trauma-focused cognitive behavioral therapies are one possible option to address the needs of such children.
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Affiliation(s)
- Sabine Weber
- Child Protection Group, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Andreas Jud
- Child Protection Group, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.,School of Social Work, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lutz Goldbeck
- Department of Child and Adolescent Psychiatry/Psychotherapy, Medical Centre, University of Ulm, Ulm, Germany
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Witt A, Münzer A, Ganser HG, Fegert JM, Goldbeck L, Plener PL. Experience by children and adolescents of more than one type of maltreatment: Association of different classes of maltreatment profiles with clinical outcome variables. CHILD ABUSE & NEGLECT 2016; 57:1-11. [PMID: 27254375 DOI: 10.1016/j.chiabu.2016.05.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/02/2016] [Accepted: 05/09/2016] [Indexed: 05/25/2023]
Abstract
Most victims of child abuse have experienced more than one type of maltreatment, yet there is a lack of understanding of the impact of specific combinations of types of maltreatment. This study aimed to identify meaningful classes of maltreatment profiles and to associate them with short-term clinical outcomes. A total of 358 German children and adolescents aged 4-17 with a known history of child maltreatment were included in the study. Through interviews and questionnaires, information was obtained from participants and their primary caregivers on history of maltreatment, sociodemographics, psychopathology, level of psychosocial functioning, and health-related quality of life. Types of abuse were categorized into six major groups: sexual abuse in general, sexual abuse with penetration, physical abuse, emotional abuse, neglect, and exposure to domestic violence. A latent class analysis (LCA) was performed to determine distinct multi-type maltreatment profiles, which were then assessed for their associations with the sociodemographic and clinical outcome variables. The LCA revealed that participants could be categorized into three meaningful classes according to history of maltreatment: (1) experience of multiple types of maltreatment excluding sexual abuse (63.1%), (2) experience of multiple types of maltreatment including sexual abuse (26.5%), and (3) experience of predominantly sexual abuse (10.3%). Members of Class 2 showed significantly worse short-term outcomes on psychopathology, level of functioning, and quality of life compared to the other classes. Three distinct profiles of multiple types of maltreatment were empirically identified in this sample. Exposure to multiple types of abuse was associated with poorer outcomes.
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Affiliation(s)
- Andreas Witt
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
| | - Annika Münzer
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
| | - Helene G Ganser
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
| | - Jörg M Fegert
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
| | - Lutz Goldbeck
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
| | - Paul L Plener
- University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
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14
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Greger HK, Myhre AK, Lydersen S, Jozefiak T. Child maltreatment and quality of life: a study of adolescents in residential care. Health Qual Life Outcomes 2016; 14:74. [PMID: 27161357 PMCID: PMC4862063 DOI: 10.1186/s12955-016-0479-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 05/03/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Childhood maltreatment is an important risk factor for mental and physical health problems. Adolescents living in residential youth care (RYC) have experienced a high rate of childhood maltreatment and are a high-risk group for psychiatric disorders. Quality of life (QoL) is a subjective, multidimensional concept that goes beyond medical diagnoses. There is a lack of research regarding the associations between childhood maltreatment and QoL. In the present study, we compare self-reported QoL between adolescents in RYC in Norway with and without maltreatment histories, and adolescents from the general population. We also study the impact of number of types of adversities on QoL. METHODS Adolescents aged 12-23 years living in RYC in Norway were invited to participate in the study; 400 participated, yielding a response rate of 67 %. Maltreatment histories were assessed through interviews with trained research assistants, and completed by 335 adolescents. Previous exposure to maltreatment was reported by 237 adolescents. The Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents (KINDL-R) was used. Nonexposed peers in RYC (n = 98) and a sample of adolescents from the general population (n = 1017) were used for comparison. General linear model analyses (ANCOVA) were conducted with five KINDL-R life domains as dependent variables. Linear regression was used to study the effect of number of types of adversities. RESULTS Exposed adolescents in RYC reported poorer QoL than peers in control groups. Compared with nonexposed peers in RYC, the 95 % confidence intervals for mean score differences on the KINDL-R subdomains (0-100 scale) were 1.9-11.4 (Physical Well-being), 2.2-11.1 (Emotional Well-being), -0.7-10.0 (Self-esteem), and 1.8-10.9 (Friends). Compared with the general population sample, the 95 % confidence intervals for mean score differences were 9.7-17.6 (Physical Well-being), 7.9-15.3 (Emotional Well-being), 3.6-12.5 (Self-esteem), and 5.3-12.8 (Friends). Number of types of adversities was associated with a poorer QoL score on all subdomains (Physical- and Emotional Well-being, Self-esteem, Friends, and School). CONCLUSIONS Childhood maltreatment was associated with a poorer QoL score. We suggest the use of QoL and maltreatment measures for all children and adolescents in RYC.
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Affiliation(s)
- Hanne Klæboe Greger
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway. .,Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway.
| | - Arne Kristian Myhre
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Pb 8905 MTFS, 7491, Trondheim, Norway.,Children's Clinic, St.Olavs Hospital, Pb 3250 Sluppen, 7006, Trondheim, Norway
| | - Stian Lydersen
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway
| | - Thomas Jozefiak
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway.,Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway
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15
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Schreier HMC, Chen E, Miller GE. Child maltreatment and pediatric asthma: a review of the literature. Asthma Res Pract 2016; 2:7. [PMID: 27965775 PMCID: PMC5142435 DOI: 10.1186/s40733-016-0022-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/17/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. MAIN This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report an association between maltreatment experiences and asthma outcomes in childhood. However, this literature is in its early stages; there are only a handful studies, most of them rely on self-reports of both child maltreatment and asthma history, and none have investigated the physiological underpinnings of this association. Taken together, however, the studies are suggestive of child maltreatment playing a role in pediatric asthma incidence and expression that should be explored further. CONCLUSION Existing data are sparse and do not allow for specific conclusions. However, the data are suggestive of child maltreatment influencing asthma risk and morbidity long before the adult years. Future research should focus on understanding how child maltreatment contributes to asthma disease risk and progression in this highly vulnerable population.
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Affiliation(s)
- Hannah M. C. Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802 USA
| | - Edith Chen
- Department of Psychology and Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL USA
| | - Gregory E. Miller
- Department of Psychology and Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL USA
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16
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Nezu S, Iwasaka H, Saeki K, Obayashi K, Ishizuka R, Goma H, Furuichi Y, Kurumatani N. Reliability and validity of Japanese versions of KIDSCREEN-27 and KIDSCREEN-10 questionnaires. Environ Health Prev Med 2016; 21:154-63. [PMID: 26883049 DOI: 10.1007/s12199-016-0510-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 01/17/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to assess the reliability and validity of Japanese versions of the KIDSCREEN-27 (J-KIDSCREEN-27) and KIDSCREEN-10 (J-KIDSCREEN-10) questionnaires, which are shorter versions of the KIDSCREEN-52 (J-KIDSCREEN-52). METHODS The present analyses are based on a pre-existing dataset of the J-KIDSCREEN-52 validation study, including 1564 children and adolescents aged 8-18 years and their 1326 parents. All were asked to complete the J-KIDSCREEN and Pediatric Quality of Life Inventory (PedsQL) questionnaires. Test-retest reliability was assessed with Intraclass Correlation Coefficients (ICCs) in a one-way random effects model, and internal consistency reliability was measured using Cronbach's alpha coefficients. Agreement between child and parent scores was evaluated using ICCs in a two-way mixed effects model. To assess concurrent validity, a sub-sample of 535 parents evaluated their child's mental health status using the Strengths and Difficulties Questionnaire (SDQ). RESULTS For children, test-retest ICCs were ≥0.60 and Cronbach's alpha ≥0.70 for every dimension of both instruments. Correlations of corresponding dimensions between the J-KIDSCREEN-27 or -10 and the PedsQL were acceptable. For parents, test-retest ICCs were ≥0.60, Cronbach's alpha ≥0.70, and ICCs between child and parent scores ≥0.41 in every dimension of both instruments. In multivariate logistic regression models, after adjusting for confounders, lower health-related QOL in every dimension of both instruments, except Physical Well-being, was significantly associated with higher odds ratios for borderline and clinical ranges of the SDQ. CONCLUSION The child/adolescent and parent/proxy versions of the J-KIDSCREEN-27 and J-KIDSCREEN-10 demonstrated acceptable levels of reliability and validity.
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Affiliation(s)
- Satoko Nezu
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Hidemi Iwasaka
- Center for Special Needs Education, Nara University of Education, Nara, Japan
| | - Keigo Saeki
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Kenji Obayashi
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Rika Ishizuka
- Department of Food and Nutrition Faculty of Contemporary Human Life Science, Tezukayama University, Nara, Japan
| | - Hideyo Goma
- Department of Education for Children with Disabilities, Kyoto University of Education, Kyoto, Japan
| | - Yasuko Furuichi
- Pediatrics of Higashiosaka City General Hospital, Higashiosaka, Osaka, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
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Weber S, Jud A, Landolt MA. Quality of life in maltreated children and adult survivors of child maltreatment: a systematic review. Qual Life Res 2015; 25:237-255. [PMID: 26245708 DOI: 10.1007/s11136-015-1085-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect. METHODS The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers. RESULTS The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related. CONCLUSION Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.
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Affiliation(s)
- S Weber
- Child Protection Group, University Children's Hospital Zurich, Zurich, Switzerland
| | - A Jud
- Child Protection Group, University Children's Hospital Zurich, Zurich, Switzerland
| | - M A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland. .,Department of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.
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18
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Jozefiak T, Sønnichsen Kayed N. Self- and proxy reports of quality of life among adolescents living in residential youth care compared to adolescents in the general population and mental health services. Health Qual Life Outcomes 2015. [PMID: 26197764 PMCID: PMC4509467 DOI: 10.1186/s12955-015-0280-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Child welfare services are aimed at providing care and protection, fostering well-being and prosocial behaviour. Thus, Quality of Life (QoL) should be an important outcome measure in Residential Youth Care (RYC) institutions. However, the dearth of research in this area gives rise to serious concern. The present study is the first large scale, nationwide study assessing QoL among adolescents living in RYC. To provide a reference frame, adolescent self- and primary contact proxy reports were compared to the general population and to adolescent outpatients in Child and Adolescent Mental Health Service (CAMHS). Also, we investigated the association between self-report of QoL in adolescents living in RYC and proxy reports of their primary contacts at the institution. Methods All residents between the ages of 12–23 years living in RYC in Norway were the inclusion criteria. Eighty-six RYC institutions (with 601 eligible youths) were included, 201 youths/ parents did not give their consent. Finally, 400 youths aged 12–20 years participated, yielding a response rate of 67 %. As a reference frame for comparison, a general population (N = 1444) and an outpatient sample of adolescents in CAMHS (N = 68) were available. We used the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). General Linear Model analyses (ANCOVA) were conducted with five KINDL life domains as dependent variables and group as independent variable. Results Self- and proxy reports of QoL in adolescents living in RYC revealed a significantly (p < 0.001) poorer QoL compared to the general population on the life domains Physical- and Emotional well-being, Self-esteem, and relationship with Friends. Adolescents evaluated their physical well-being as worse compared to adolescents in CAHMS. Self- and proxy reports in RYC differed significantly on two of five life domains, but correlated low to moderate with each other. Conclusions The results in this study raise major concerns about the poor QoL of the adolescents living in RYC, thereby challenging the child welfare system and decision makers to take action to improve the QoL of this group. The use of QoL as outcome measures is highly recommended.
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Affiliation(s)
- Thomas Jozefiak
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Faculty of Medicine, Trondheim, Norway. .,Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway.
| | - Nanna Sønnichsen Kayed
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Faculty of Medicine, Trondheim, Norway.
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19
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The German 19-item version of the Child Oral Health Impact Profile: translation and psychometric properties. Clin Oral Investig 2015; 20:301-13. [DOI: 10.1007/s00784-015-1503-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 06/01/2015] [Indexed: 02/01/2023]
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20
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Lanier P, Kohl PL, Raghavan R, Auslander W. A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population. CHILD MALTREATMENT 2015; 20:72-79. [PMID: 25366676 DOI: 10.1177/1077559514557517] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment.
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Affiliation(s)
- Paul Lanier
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Brown Center for Violence and Injury Prevention, Washington University in St. Louis, St. Louis, MO, USA
| | - Patricia L Kohl
- Brown Center for Violence and Injury Prevention, Washington University in St. Louis, St. Louis, MO, USA Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Ramesh Raghavan
- Brown Center for Violence and Injury Prevention, Washington University in St. Louis, St. Louis, MO, USA Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Wendy Auslander
- Brown Center for Violence and Injury Prevention, Washington University in St. Louis, St. Louis, MO, USA Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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21
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Snoeren F, Hoefnagels C, Evers SMAA, Lamers-Winkelman F. Design of a prospective study on mental health and quality of life of maltreated children (aged 5-16 years) after a report to an advice and reporting center on child abuse and neglect. BMC Public Health 2013; 13:942. [PMID: 24106987 PMCID: PMC3852518 DOI: 10.1186/1471-2458-13-942] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 09/20/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Child maltreatment is recognized as a widespread problem with huge implications for mental health and quality of life. Studies have repeatedly shown that victims of child maltreatment report significantly more adverse life outcomes than non-victims. The main objective of the study is (1) to examine the mental health and quality of life of maltreated children over a 1.5 year period beginning shortly after a report has been filed with an Advies- en Meldpunt Kindermishandeling (AMK) (advice and reporting center on child abuse and neglect). Secondary objectives are: (2) to examine how relevant determinants influence the mental health and quality of life of maltreated children, and (3) to examine differences in mental health and quality of life outcomes when comparing families of Dutch origin with families originating from Morocco and Suriname. METHODS/DESIGN A prospective study will be performed, in which parent-child dyads will be followed over a 1.5 year period. Participants will be recruited shortly after the report to the AMK and they will be asked to complete a questionnaire four times, at baseline and every six months thereafter. Data will be analyzed using a longitudinal multi-level analysis. DISCUSSION The study is expected to yield evidence about the mental health and quality of life of maltreated children and about determinants that influence their mental health and quality of life outcomes. Strengths of this study are (1) the design which makes it possible to start examining outcomes shortly after or even during the actual maltreatment and to follow parent-child dyads for 1.5 years, and (2) asking children as informants about their own situation by making use of self-report questionnaires as much as possible. Limitations include the risks of selection bias and loss to follow-up during 1.5 years of data collection. TRIAL REGISTRATION NTR3674, funded by ZonMw, project 15700.2012.
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Affiliation(s)
- Froukje Snoeren
- Netherlands Institute of Mental Health and Addiction, Trimbos Institute, PO Box 725, Utrecht, 3500 AS, Netherlands.
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