Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults

Antisocial Personality Disorder in Mexican Women: A Study of Sociodemographic Variables and Comorbid Mental Disorders

INTRODUCTION

Antisocial personality disorder (APD) is mainly based on social irresponsibility that leads to delinquent, criminal, and exploitative behavior toward others, as well as difficulty in adapting to social norms. This disorder predominates in the male gender, and therefore, most of the research to date has been conducted in men. In the following study, we aimed to describe the main sociodemographic variables and psychiatric comorbidities presented in women with a diagnosis of APD.

METHODS

We assessed 54 women with a diagnosis of APD, of whom sociodemographic characteristics were collected, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV Axis II Disorders (SCID-II) and the Mini-International Neuropsychiatric Interview (M.I.N.I.) 5.0.0 were applied.

RESULTS

We found a weak positive correlation with the obsessive (rs = 0.28, p = 0.039), passive-aggressive (rs = 0.29, p = 0.034), paranoid (rs = 0.39, p = 0.004), narcissistic (rs = 0.36, p = 0.008), and borderline (rs = 0.35, p = 0.010) personality domains, with a median age of 24.00 (IQR = 11.50) years, and the majority mainly being single and unemployed. We also found high rates of suicidal risk, depression, anxiety, and substance abuse, which was consistent with what has been reported elsewhere.

CONCLUSION

Research on APD and its comorbidities in women is limited, especially in Mexico, where women with APD show similar patterns to those in developed countries. This suggests the need for gender-specific interventions and a dimensional approach to improve the diagnosis and treatment of APD.

The mediating effect of social network sites addiction on the relationship between childhood psychological abuse and depression in college students and the moderating effect of psychological flexibility

BACKGROUND

Experience of child psychological abuse in college students is likely to increase their risk of depression, but the potential psychological mechanisms between the two require further exploration. This study supplemented the risk and protective factors between child psychological abuse and depression in college students by introducing social network sites addiction (SNSA) as a mediating factor and psychological flexibility as a moderating factor.

METHODS

A cross-sectional survey was conducted on 655 college students from two universities in Hunan Province, China. Self-reported measures included childhood psychological abuse, depression, SNSA, and psychological flexibility. Descriptive and correlational analyses were performed on these variables, followed by the establishment of a structural equation model.

RESULTS

Child psychological abuse was positively associated with depression (r = .507, p < .001) and SNSA (r = .208, p < .001) in college students and negatively associated with psychological flexibility (r = -.293, p < .001). SNSA played a mediating role between childhood psychological abuse and depression (β = .170, SE = 0.035, p < .001) in college students, while psychological flexibility attenuated the strength of the relationship between the latter two (β = -.095, SE = 0.031, p < .01).

CONCLUSION

The study further elucidates the psychological mechanisms underlying the relationship between childhood psychological abuse and depression in college students. SNSA may mediate the relationship between the two, while psychological flexibility may buffer the strength of the relationship between them. Future research should explore interventions enhancing college students' psychological flexibility after childhood psychological abuse to cut the risk of depression.

The Role of School Engagement in the Link Between Adverse Childhood Experiences and Adolescent Mental Health

PURPOSE

Adverse childhood experiences (ACEs) increase the risk for poor adolescent mental health, yet mediational pathways that connect ACEs with mental health problems remain unaddressed. Our study investigates whether school involvement and disengagement mediate the longitudinal associations between ACEs and adolescent mental health problems.

METHODS

Using data from the longitudinal Adolescent Brain Cognitive Development Study, this study included 7,558 adolescents aged 9-10 years at baseline. ACEs were a cumulative risk score of 21 adverse experiences (e.g., emotional abuse, community violence) reported by parents and youths at baseline or 1-year follow-up. School involvement and disengagement were reported by youths at two-year follow-up. Internalizing and externalizing problems were reported by parents using the Child Behavior Checklist at 3-year follow-up.

RESULTS

A higher ACE score was associated with decreased school involvement (β = -0.08, 95% CI = [-0.10, -0.05]) and increased school disengagement (β = 0.09, 95% CI = [0.06, 0.11]) one year later, and with increased internalizing (β = 0.10, 95% CI = [0.07, 0.12]) and externalizing problems (β = 0.08, 95% CI = [0.06, 0.10]) 2 years later, adjusted for demographics and baseline mental health and school engagement levels. Decreased school involvement and increased disengagement mediated the associations between ACEs with the change in internalizing and externalizing problems over time.

DISCUSSION

The present study highlights the roles of school involvement and disengagement in linking ACEs to worsened mental health outcomes. The findings may inform tailored school-based interventions that address mental health challenges faced by adolescents exposed to ACEs.

Childhood Maltreatment and Perinatal Complications: A Scoping Review of Official Health Data

Child maltreatment (CM) poses significant risks to victims, resulting in enduring physical, psychological, and developmental consequences. Adult survivors of CM seem especially vulnerable to perinatal complications. However, existing research on perinatal outcomes presents mixed results and relies heavily on self-reported data, which may not align with official medical data. Hence, a systematic review using official health data may provide clarity on this association; it may orient future research and the provision of perinatal services. This scoping review aimed to synthesize and evaluate the quality of the literature that utilizes official health data to explore associations between CM and perinatal complications. Following Arksey and O'Malley's model, searches across four databases (PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations/Thesis) produced 8,870 articles. After screening, 23 articles met the inclusion criteria (e.g., recorded perinatal complications using official health data, and peer-reviewed studies or dissertation). Evidence indicates CM survivors have less prenatal care visits, more fetal loss and preterm births, lower gestational age, and increases in emergency cesarean sections. Adults had more cervical insufficiency, lower episiotomies and sphincter ruptures, and overall pregnancy and postpartum complications while adolescents had lower Apgar scores. No associations were observed on other outcomes (e.g., vaginal bleeding, group B streptococcus, and fetal distress). Mixed findings emerged for other perinatal and maternal health concerns such as birth weight and blood pressure. CM survivors may face an increased risk of experiencing perinatal complications. Findings point to the relevance of leveraging health data for CM research and adopting trauma-informed practices in perinatal services.

The relationship between childhood psychological abuse and depression in college students: internet addiction as mediator, different dimensions of alexithymia as moderator

BACKGROUND AND OBJECTIVE

Childhood psychological abuse (CPA) is highly associated with depression among college students. However, the underlying mechanisms between these variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia and its different dimensions as moderating factors, to further complement the psychological mechanisms between CPA and depression among college students.

METHODS

A self-report survey was conducted on 625 college students from two universities in Hunan Province, China. The survey included CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed.

RESULTS

CPA is positively correlated with depression, internet addiction, and alexithymia among college students. Internet addiction partially mediates the relationship between CPA and depression among college students, while alexithymia enhances the relationship between CPA and internet addiction as well as depression among college students. The moderating effect of the different dimensions of alexithymia is inconsistent, with the modulation effect of difficulty in identifying feelings being the strongest.

CONCLUSION

This study further elucidates the psychological mechanisms between CPA and depression among college students. Internet addiction serves as a mediating factor, while alexithymia may strengthen the relationship between CPA and internet addiction, as well as between CPA and depression.

Maltreatment and Parent-Child Attachment as Predictors of Dating Violence and Risky Sexual Behaviour Among High-Risk Teens

A history of maltreatment can increase risk for dating violence (DV) and risky sexual behaviour (RSB) among adolescents. Secure parent-child attachment may reduce this risk, yet few studies have examined this as a protective factor. This study differentiated developmentally appropriate, exploratory sexual behaviours from RSB and examined whether maltreatment experiences and parent-child attachment in adolescence predicted DV and RSB reported five years later in a high-risk sample. Participants were 179 adolescents (46% girls; M age = 15.34, range = 12-18 years) at risk for aggressive and antisocial behaviour. Adolescents reported their maltreatment histories and attachment to their parents at Time 1; five years later, at Time 2, they reported their experiences with DV perpetration and victimization and engagement in RSB. Both bivariate correlations and structural analyses demonstrated that maltreatment was associated with DV perpetration and victimization but not RSB, and attachment avoidance was associated with fewer RSB but not DV. Attachment anxiety was associated with physical DV perpetration and greater condom use, but only at the correlational level; attachment anxiety was not associated with DV or RSB in the structural model. There were no significant interaction effects. Findings highlight the importance of considering key developmental factors such as maltreatment and parent-child attachment in understanding adolescent risk for DV and RSB, and may inform future research that accounts for contextual factors such as motivation for violence perpetration and contraceptive use with multiple and/or casual sex partners.

Global prevalence of violence against children and adolescents during COVID-19: A meta-analysis

BACKGROUND

Recent studies suggest that children and adolescents are at an increased risk of experiencing violence during the COVID-19 pandemic. However, there is limited knowledge about the prevalence of violence against children and adolescents across different regions in the world.

OBJECTIVE

To estimate the pooled prevalence of violence against children and adolescents during the COVID-19 pandemic and explore how geographical and methodological factors explain the variation across studies.

METHODS

We conducted a systematic search of MEDLINE, Embase, and PsycInfo databases for articles published from January 1, 2020 to October 1, 2022. The study protocol was pre-registered with PROSPERO (CRD42022338181). We included published and unpublished studies available in English that reported the prevalence of violence (e.g., physical, emotional, or sexual violence, neglect, bullying) against children and adolescents (age <18 years) during the pandemic. Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A total of 2740 nonduplicate titles and abstracts were screened, and 217 full-text articles were reviewed for eligibility.

RESULTS

Twenty-five studies with 66,637 participants met inclusion criteria. Based on random-effects meta-analysis, the pooled prevalence of violence against children and adolescents was 24 % (95%CI 18 %-30 %). The reported prevalence was higher in studies conducted in low- and middle-income countries compared to high-income countries.

CONCLUSIONS

Over one in five children and adolescents globally reported ever experiencing violence during the COVID-19 pandemic. Our findings highlight the urgent need for effective child protection policies and interventions, as well as multisectoral collaboration, to reduce violence against children and adolescents.

The relationship between childhood psychological abuse and depression in college students: a moderated mediation model

BACKGROUND

Childhood psychological abuse (CPA) are highly correlated with depression among college students, but the underlying mechanisms between variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia as a moderating factor, in order to further elucidate the potential risk factors between CPA and depression among college students.

METHODS

A self-report survey was conducted among 1196 college students from four universities in three provinces in China. The survey included measures of CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed.

RESULTS

CPA was positively correlated with depression among college students, as well as internet addiction with alexithymia. Internet addiction partially mediated the relationship between CPA and depression among college students, while alexithymia strengthened the relationships among the paths in the moderated mediation model.

CONCLUSION

This study provides further insights into the psychological mechanisms underlying the relationship between CPA and depression among college students. Internet addiction serves as a mediating factor in this relationship, while alexithymia may enhance the strength of the relationships among the three variables.

The relationship between childhood psychological abuse and depression in college students: a moderated mediation model

Background

Childhood psychological abuse (CPA) are highly correlated with depression among college students, but the underlying mechanisms between variables need further exploration. This study aims to investigate internet addiction as a mediating factor and alexithymia as a moderating factor, in order to further elucidate the potential risk factors between CPA and depression among college students.

Methods

A self-report survey was conducted among 1196 college students from four universities in three provinces in China. The survey included measures of CPA, internet addiction, alexithymia, and depression. Descriptive and correlational analyses were performed on these variables, and a moderated mediation model was constructed.

Results

CPA was positively correlated with depression among college students, as well as internet addiction with alexithymia. Internet addiction partially mediated the relationship between CPA and depression among college students, while alexithymia strengthened the relationships among the paths in the moderated mediation model.

Conclusion

This study provides further insights into the psychological mechanisms underlying the relationship between CPA and depression among college students. Internet addiction serves as a mediating factor in this relationship, while alexithymia may enhance the strength of the relationships among the three variables.

Childhood maltreatment and alcohol and tobacco use trajectories in rural Chinese adolescents

BACKGROUND

There is a high prevalence of childhood maltreatment among Chinese children and adolescents, but little is known about its impact on alcohol and tobacco use trajectories and how positive school and neighborhood environments moderate the associations. The objective of this study was to assess the association between multiple forms of childhood maltreatment and longitudinal alcohol and tobacco use trajectories, and to assess the possibility that perceived connections to school and neighborhood moderate these associations.

METHODS

This longitudinal cohort study included 2594 adolescents (9 to 13 years) from a low-income rural area in China. Childhood exposure to abuse and neglect was assessed using the Childhood Trauma Questionnaire. Participants reported past-month alcohol and tobacco use at three time points over 1 year.

RESULTS

Growth curve models revealed that childhood sexual abuse was associated with a higher risk of past-month drinking (OR = 1.53, 95% CI 1.19-2.03, p < 0.001) and smoking (OR = 1.82, 95% CI 1.30-2.55, p < 0.001). Neglect was associated with a higher risk of past-month drinking (OR = 1.52, 95% CI 1.06-1.90, p < 0.05) and smoking (OR = 2.02, 95% CI 1.34-3.02, p < 0.001). None of the maltreatment forms predicted a faster increase in either drinking or smoking. These associations were found independent of personal, family, and contextual characteristics. School and neighborhood connection moderated the association between physical abuse and past-month drinking, such that physical abuse was associated with a greater risk of drinking only for youth who perceived low school or neighborhood connections.

CONCLUSIONS

Findings demonstrate the importance of early experiences of childhood maltreatment for adolescent alcohol and tobacco use. Enhancing school and neighborhood connectedness for physically abused youth may help protect them from alcohol use.

Associations between Early Psychosocial Deprivation, Cognitive and Psychiatric Morbidity, and Risk-taking Behavior in Adolescence

OBJECTIVE

Early psychosocial deprivation increases the risk of later cognitive and psychiatric problems, but not all deprived children show these difficulties. Here, we examine the extent to which psychosocial deprivation increases the risk of later cognitive and psychiatric difficulties and the downstream consequences of this for risk-taking behavior in adolescence.

METHOD

Children abandoned to institutions early in life were randomly assigned to care-as-usual or a foster care intervention during infancy. A separate group of never-institutionalized children was recruited as a comparison sample. The current follow-up study included 165 children (51% female), 113 with a history of institutionalization and 52 with no such history. At age 12, caregivers reported on children's psychiatric difficulties, and their IQ was assessed by standardized testing. At 16 years, risk-taking behavior was assessed from youth self-reports.

RESULTS

Latent profile analysis revealed three subgroups of children with varying levels of cognitive and psychiatric difficulties: Low-Morbidity (n = 104, 62.7%), Medium-Morbidity (n = 46, 27.9%), and High-Morbidity (n = 15, 9.4%). Nearly half of the institutionalized children belonged to the High- or Medium-Morbidity subgroups; and institutionally-reared children were significantly more likely to belong to one of these profiles than never-institutionalized children. Compared to the Low-Morbidity subgroup, membership in the Medium-Morbidity profile was associated with higher levels of risk-taking behavior at age 16 years.

CONCLUSIONS

Children who experience psychosocial deprivation are considerably more likely to present with elevated cognitive and psychiatric difficulties in early adolescence and, for some children, this elevation is linked to heightened risk-taking behavior in later adolescence.

Childhood emotional neglect and problematic social media use among Chinese adolescents: A moderated mediation model

Prior studies have found that emotional neglect in childhood exert a far-reaching influence on adolescent problematic behaviors. However, the effects and underlying mechanisms of childhood emotional neglect on adolescent PSMU remains largely unknown. Thus, the present study tested whether future negative time perspective (FNTP) mediated, and student-student relationship moderated, the link between childhood emotional neglect and adolescent PSMU. A sample of 842 Chinese adolescents (46.9% girls; M_age = 14.76 years; SD_age = 1.64) responded anonymously to questionnaires regarding demographic variables, childhood emotional neglect, FNTP, student-student relationship, and PSMU. The results showed that after controlling for gender and age, FNTP mediated the association between childhood emotional neglect and adolescent PSMU. Further, student-student relationship moderated the association between childhood emotional neglect and FNTP, and the positive association was stronger for adolescents with positive student-student relationship. These findings highlight those tailored approaches are necessary for the prevention and intervention of adolescent PSMU.

Sexual Risk Behavior among Adolescents Seeking Treatment for Posttraumatic Stress Disorder: Exploring Psychosocial & Symptom Correlates

Adolescents exposed to trauma experience disproportionate rates of HIV/STI. However, integrated treatment for trauma and sexual risk behavior is rare. To inform integrated prevention efforts, the current study describes prevalence and correlates of sexual risk behavior among adolescents seeking treatment for symptoms of posttraumatic stress and substance use disorders. Adolescents aged 13-18 years (N = 135; 88% female) with histories of interpersonal violence exposure completed pre-treatment questionnaires in a randomized controlled trial of an integrated psychotherapy for trauma and substance use symptomology. Adolescents reported high rates of sexual risk behaviors relative to national estimates and general mental health treatment samples. Symptoms of reexperiencing, substance use, and peer deviance were related to sexual risk behavior beyond the influence of other trauma symptoms. Individual and contextual psychosocial factors may be stronger predictors of sexual risk behavior than posttraumatic stress disorder symptoms among adolescents with trauma symptomology. Integrated interventions targeting traumatic stress, substance use, and sexual risk behavior concurrently may prevent revictimization and HIV/STI incidence among trauma-exposed youth.

The relationship between child neglect and adolescent interpersonal functioning: A systematic review

BACKGROUND

Neglect is a highly prevalent, yet historically understudied form of maltreatment. Recent research has revealed the far reaching and unique effects that neglect has on subsequent cognitive, behavioural and socio-emotional development, and on long-term physical and mental health outcomes. Adolescent interpersonal functioning is important to explore given the significant relational transitions that occur during this stage of development, and the known impact that these social changes can have on future life outcomes.

OBJECTIVE

This systematic review synthesises the literature exploring the relationship between neglect and adolescent interpersonal functioning in peer relationships.

METHODS

Seven databases and three grey literature sites were systematically searched, and identified records screened against inclusion criteria.

RESULTS

Twenty-one articles were included in the final sample, exploring five different indicators of adolescent interpersonal functioning. Around half of the papers investigating quality of peer relationships found that neglect, particularly emotional neglect, is associated with reduced relationship quality, and there is consistent evidence that neglect increases the risk of gang involvement and deviant peer affiliation.

CONCLUSIONS

These findings may be used to strengthen a trauma-informed approach to work with adolescents. Research on neglect and adolescent romantic relationships is sparse. Overall, the literature is varied and further research using longitudinal data and consistent measures of neglect would be of value.

Impact of COVID-19 Mitigation Measures on Inner-City Female Youth in New York City

PURPOSE

New York City (NYC) was the global epicenter of the COVID-19 pandemic in spring 2020. A "shelter in place" mandate was issued in March 2020. The effect on vulnerable populations of adolescent and young adult females has not been well documented.

METHODS

We administered a monthly online survey between May and November 2020 to adolescent and young adult females participating in a longitudinal study at Mount Sinai Adolescent Health Center. Surveys asked about death of loved ones, financial impacts, social interactions, exposure to dangerous situations, and mental health impacts. Differences in responses by age, race/ethnicity, and living situation were assessed, and compared to data obtained on the same cohort prior to the pandemic.

RESULTS

Four hundred seventeen females aged 15-28 years completed at least one survey, 94% of whom were youth of color. A third of responders (33%) had lost relatives or other people they were close to (loved ones). Most (68%) reported one or more financial losses, and 21% reported food insecurity, with those not living with parents or a guardian experiencing significantly higher rates. One in 10 reported experiencing sexual abuse or interpersonal partner violence during the "shelter in place" period. Over a third (37%) reported symptoms of clinical depression, which represented a significant increase compared to before the pandemic (p = .01). The negative financial impacts and higher proportion of patients with depressive symptomatology remained elevated for adolescents without support at home.

CONCLUSIONS

The COVID-19 pandemic had unprecedented negative short-term financial and psychosocial health impacts on inner-city female youth with potential long-term negative impacts.

Behavioral Activation System and Early Life Parental Abuse Are Associated with Antisocial Behaviors in Mexican Adolescents

Antisocial behavior (AB) is a complex phenomenon, predicted by a wide range of biological, environmental, and personality factors. These have high human and economic costs especially in adolescents, highlighting the importance of investigating factors that may be associated with these behaviors. Among the most potent predictors of AB are early life experiences and personality. To this end, the present study sought to investigate the association between early life parental abuse and behavioral activation system (BAS) personality traits assessed within the reinforcement sensitivity theory (RST) framework and antisocial behaviors in Mexican adolescents. Our sample consisted of 342 adolescents (Mage = 17, SD = 2.47) from northwestern Mexico. Participants, after parental consent and participant consent/assent (if minors), self-reported early life parental abuse, current BAS personality traits, and antisocial behaviors. Through structural equation models, our results suggest there is a positive association between early life parental abuse and antisocial behaviors, as well as a negative association with BAS personality traits (R2 = 37%). These results contribute to the current literature by suggesting that personality and environmental variables can predict adolescent antisocial behaviors. Future studies should explore the interplay between these variables longitudinally and investigate both risk and protective factors, as well as negative and positive outcomes.

A Violência Mora ao Lado? Violência Familiar e Comunitária entre Adolescentes

Resumo Para descrever a ocorrência de situações de violência contra adolescentes na família e na comunidade, foi conduzido estudo transversal em escolas públicas de municípios do Brasil. O Questionário da Juventude Brasileira Versão Fase II foi utilizado. Participaram 2.860 adolescentes, sendo 58,5% do sexo feminino. Cerca de um terço dos participantes sofreram violência física na família. Na comunidade, 32,7% dos adolescentes reportaram ter sofrido situações de violência psicológica. Situações de violência física ocorreram mais entre meninos, em participantes de 15 a 19 anos e nos que experimentaram álcool ou drogas ilícitas. Considera-se como importante que ações preventivas contra violência de naturezas distintas sejam contínuas e abrangentes, incluam diferentes subgrupos e garantam o suporte necessário.

Feasibility of Using Child Maltreatment Measurement Instruments in the Primary Care Setting: A Systematic Review

PROBLEM

Child maltreatment is a devastating epidemic affecting millions of children and adolescents in the United States (U.S.) every year. Primary care providers (PCPs) encounter these victims but need resources to aid in the recognition of maltreatment. The purpose of this review is to evaluate child maltreatment measurement instruments and determine feasibility of use by U.S. PCPs.

ELIGIBILITY CRITERIA

A systematic search was conducted in the PubMed, CINAHL, and PsycInfo databases from 2014 until 2020. Eligibility criteria included articles conducted in the U.S., with use of a child maltreatment measurement instrument, and subjects less than 18 years old. Eligible articles were reference searched to find the original studies for each instrument and were included if they were published in a peer-reviewed paper, could be located, and addressed the development or validation of the instrument.

SAMPLE

Of the 3816 articles, 111 used a child maltreatment measurement instrument. Sixteen of the 27 identified instruments were evaluated for feasibility using a quality rating with criteria including psychometrics, construct measurement, administration, availability, and cost.

RESULTS

Six instruments were recommended for use by PCPs.

CONCLUSIONS

This is the first review evaluating the use of child maltreatment measurement instruments by PCPs and it highlights the combination of psychometric evaluation and other pertinent feasibility criteria to recommend several instruments for use by PCPs.

IMPLICATIONS

Use of these instruments by PCPs may serve to identify children and families who are at risk for or suffering from maltreatment.

Profiles of Childhood Maltreatment: Associations with Sexual Risk Behavior during Adolescence in a Sample of Racial/Ethnic Minority Girls

This study examines associations between childhood maltreatment and developmental trajectories of sexual risk behaviors (SRBs) in a sample of 882 sexually active adolescent girls, predominantly Hispanic or Black, assessed every 6 months between 13 and 23 years. Latent profile analyses revealed four distinct maltreatment profiles: Low Maltreatment (76%), Moderate Emotional Neglect Only (15%), Severe Physical/Emotional Abuse (3%), and Severe Sexual Abuse (6%). Multilevel growth analyses showed the Moderate Emotional Neglect Only and Severe Sexual Abuse profiles exhibited more SRBs starting in late adolescence, and the Severe Sexual Abuse profile also exhibited a faster increase than the Low Maltreatment profile. Understanding heterogeneity within maltreated populations may have important implications for healthy sexual development.

The interaction between pubertal timing and childhood maltreatment on the risk of human papillomavirus infection among adolescent girls and young women

PURPOSE

The goal of this study was to evaluate the effect of pubertal timing, and its interaction with prior childhood maltreatment, on the risk of cervical human papillomavirus (HPV) among sexually active adolescent minority female adolescents and young adults.

METHODS

This cross-sectional study includes 842 adolescent girls and young women (aged 12 to 20 years; predominately Black and Hispanic) enrolled in an HPV vaccine surveillance study at a large adolescent health clinic in New York City between 2007 and 2016. Pubertal timing was assessed by self-reported age at menarche at baseline, with "early" and "late" defined as one standard deviation below (<11 years) or above (>13 years) the mean. Childhood exposure to abuse (sexual, physical and emotional) and neglect (physical and emotional) was assessed using the Childhood Trauma Questionnaire. Over 40 types of HPV infection were detected using the polymerase chain reaction in cervical Pap specimens.

RESULTS

Results from multivariable logistic regression showed that early and late pubertal timing were marginally associated with a higher risk of HPV infection, adjusting for demographic and health covariates. Childhood maltreatment moderated the association between early pubertal timing and HPV infection: early pubertal timing was associated with a higher risk for HPV infection among maltreated girls (OR = 3.32, 95%CI:1.61-6.85), but not among non-maltreated girls (OR = 0.96, 95%CI:0.61-1.50; p-interaction<0.01).

CONCLUSIONS

Variation in the timing of puberty and history of childhood maltreatment may have implications for adolescent sexual and reproductive health. Findings suggest that clinicians need to assess the biological and psychosocial risks in caring for youth.