Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes

The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects.

Memory Accuracy After 20 Years for Interviews About Child Maltreatment

When adults allege childhood victimization, their long-term memory comes under scrutiny. This scrutiny can extend to the adults' memory of childhood interviews. The concerns raise important theoretical and applied issues regarding memory for long-past discussions of child maltreatment and trauma. In this longitudinal study, 104 adults, who as children (ages 3-15 years) were interviewed in child maltreatment investigations (Time 1), were questioned 20 years later (Time 2) about the Time 1 interviews. Verbatim documentation from Time 1 permitted scoring of memory accuracy. A subset of the participants (36%) reported no memory for the Time 1 interviews. Of the 64% who remembered being interviewed at Time 1, those who had been adolescents at Time 1 remembered the forensic interview discussion about abuse incidents better than discussion about general psychological issues. Adult trauma symptoms were associated with more accurate memory for interview content that directly concerned abuse experiences but not for non-abuse-specific information. Findings indicate that the veracity of adults' long-term memory for clinical/forensic conversations about childhood maltreatment depends on age at interview, interview content, and traumatization factors. Implications are discussed.

Trajectories of Posttraumatic Stress Symptoms Among Young Adults Exposed to a Typhoon: A Three-Wave Longitudinal Study

Objective: We used a latent class growth model to identify distinct PTSS trajectories and correlates of these trajectories among young adults who experienced Typhoon Hato, the strongest storm to strike China in the last 50 years. Methods: A longitudinal survey (three-waves) was conducted to explore the mental health status and its correlates among young adults exposed to the typhoon. Data from 362 participants were analyzed via a latent class growth model and multinomial logistic regression. Results: Three distinct classes of PTSS trajectories were identified, including: "resilience" (86.46%), "recovery" (9.12%), and "deterioration" (4.42%). The higher levels of direct typhoon exposure, media use, and posttraumatic growth significantly predicted the higher likelihood of participants being in the "recovery'' class. In addition, more social support significantly predicted the higher possibility of being in the "resilience" class. Finally, more severe depressive and anxiety symptoms significantly predicted the higher likelihood of being in the "deterioration" class. Conclusion: Further research should develop interventions to enhance protective factors (e.g., posttraumatic growth, media use), decrease risk factors (e.g., depressive and anxiety symptoms), and thereby prevent PTSS.

Post-Traumatic Stress and Autobiographical Memory Accuracy in Young Children: Traumatic Events Versus Stressful and Pleasant Events

This study examined the influence of trauma exposure and posttraumatic stress (PTS) severity on accuracy of recall of autobiographical memory of traumatic events and pleasant events in very young children. Two hundred sixteen 3-6 year-old children with trauma exposure were interviewed with standardized interviews. Forty-one non-trauma-exposed controls were interviewed about stressful events for comparison. Accuracy of recall for both traumatic and pleasant events was not associated with severity of PTS. Trauma-exposed children showed significantly less accurate recall of trauma events compared to pleasant events. This difference was limited to children who experienced repeated trauma or Hurricane Katrina-related trauma experiences as opposed to single-blow types of trauma experiences. There was no difference in accuracy of recall of trauma events in the trauma-exposed group versus stressful events in the control group. There was also no difference in accuracy of recall of pleasant events between the trauma-exposed and the control groups. These findings do not support traditional theories that autobiographical recall is impaired in those with posttraumatic stress disorder or with trauma exposure. These findings demonstrate that very young children have access to and can verbalize accurate autobiographical recall of trauma events, which is important for clinical assessment and treatment.

Disclosures of Sexual and Physical Abuse across Repeated Interviews

This study examined the recorded interviews of 132 children between 3 and 16-years of age who were involved in a forensic investigation evaluating allegations of sexual and/or physical abuse. As part of this investigation, two interviews were conducted over a 5-day period. The interviews were analyzed to examine how frequently these children disclosed substantiated allegations of abuse when asked directly about these experiences in one or both interviews. Results revealed that 39.2% of children with substantiated sexual abuse and 55.6% of those with substantiated physical abuse denied these experiences in one or both interviews. The denial rate was highest among school aged children (6- to-10-year- olds), as over a third of the girls and more than half of the boys in this age group denied the substantiated allegations in one or both interviews. Recantations were also relatively common, as 24% of the children who disclosed sexual and/or physical abuse prior to the assessment denied the allegations in one or both interviews. The youngest children (3- to 5-year-olds) were most likely to be inconsistent in their denials/disclosures across interviews. Custody status and relation to the perpetrator also predicted denials/disclosures of sexual, but not physical abuse. Overall, the data suggest that denials of both sexual and physical abuse are quite common and higher than rates found in most archival file reviews.

Parents' attachment orientation, interviewers' support, and children's memory for a mildly distressing event

Parents' attachment orientations predict children's memory about distressing life events, such that parents who are less secure in close relationships tend to have children who are less accurate in their memory reports. This study examined whether socially supportive interviewing would reduce differences in children's memory performance associated with parents' attachment. Children (3 to 5 years, N = 63) and their primary caretakers took part in the Preschool Attachment Classification System (PACS), a moderately distressing event for children of preschool age that is based on the Strange Situation Procedure. Children's memory for the event was then tested shortly thereafter by either a supportive or a non-supportive interviewer. In the non-supportive condition, children whose parents scored higher on attachment avoidance provided lower proportions of correct free recall. However, the association was not significant for children in the supportive condition. In addition, higher parental attachment anxiety predicted lower proportions of correct free recall for children of highly avoidant parents, but not for children of parents lower in attachment avoidance. For direct questions, age differences in proportion correct and proportion incorrect favoured older children. Findings provide insight into interviewing techniques at time of memory retrieval that benefit children of insecure parents.

Working for the future: parentally deprived Nigerian Children have enhanced working memory ability

BACKGROUND

The dominant view based on the deficit model of developmental psychopathology is that early adverse rearing impairs cognition. In contrast, an emerging evolutionary-developmental model argues that individuals exposed to early-life stress may have improved cognitive abilities that are adapted to harsh environments. We set out to test this hypothesis by examining cognitive functions in parentally deprived children in Nigeria.

METHODS

Cognitive performance was compared between 53 deprived children who currently live in institutional homes and foster families and 51 nondeprived control participants. We used a multifaceted neurocognitive test battery for the assessment of inhibition, set-shifting and working memory.

RESULTS

Results showed that the deprived and nondeprived group did not significantly differ in their performance on set-shifting and inhibition tasks. Conversely, the deprived group performed significantly better than the nondeprived group in the working memory task.

DISCUSSION

We interpret the enhanced working memory ability of the deprived group as a correlate of its ecological relevance. In Nigeria, underprivileged children may need to rely to a larger extent on working memory abilities to attain success through academic work. This study provides further evidence that exposure to early adversity does not necessarily impair cognitive functions but can even enhance it under some conditions and in some domains.

The Relationship between Suggestibility, Fabrication, Distortion, and Trauma in Suspected Sexually Abused Children

Being a victim of abuse in childhood can lead to the development of trauma-related psychopathology, which could affect the testimony of the child victim. Post-traumatic stress disorder (PTSD) is a factor that can increase both the levels of suggestibility and the production of memory errors, such as confabulations, which can be identified in distortions and fabrications. No studies have analyzed the relationship between suggestibility, fabrications, distortions, and PTSD on samples of children and adolescents suspected of being sexually abused. This study aims to verify in a sample of 221 sexually abused children and adolescents the effect of PTSD, measured by Trauma Symptoms Checklist for Children, in increasing the levels of immediate and delayed suggestibility and the production of fabrications and distortions in immediate and delayed memory tasks, obtained by Gudjonsson Suggestibility Scale 2, controlling age and non-verbal intelligence. Our results show that PTSD increases the levels of immediate and delayed suggestibility, but it has no effect on memory recall in immediate recall tasks. Moreover, PTSD leads to a greater number of distorted and fabricated information inserted in delayed memory. Forensic implications of PTSD consequences on memory tasks and suggestibility levels of sexually abused children are discussed.

Parent-Child Reminiscing about Past Pain as a Preparatory Technique in the Context of Children's Pain: A Narrative Review and Call for Future Research

Pain permeates childhood and remains inadequately and/or inconsistently managed. Existing research and clinical practice guidelines have largely focused on factors influencing the immediate experience of pain. The need for and benefits of preparing children for future pain (e.g., painful procedures) has been well established. Despite being a robust predictor of future pain and distress, memories of past painful experiences remain overlooked in pediatric pain management. Just as autobiographical memories prepare us for the future, children’s memories for past pain can be harnessed to prepare children for future painful experiences. Children’s pain memories are malleable and can be reframed to be less distressing, thus reducing anticipatory distress and promoting self-efficacy. Parents are powerful agents of change in the context of pediatric pain and valuable historians of children’s past painful experiences. They can alter children’s pain memories to be less distressing simply by talking, or reminiscing, about past pain. This narrative review summarizes existing research on parent–child reminiscing in the context of acute and chronic pediatric pain and argues for incorporation of parent–child reminiscing elements into preparatory interventions for painful procedures.

Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental illnesses: Results from the Singapore Mental Health Study

BACKGROUND

Adverse childhood experiences (ACEs) are associated with deleterious consequences throughout the lifespan of the individual, including an increased risk of mental disorders. However, an in-depth understanding of ACEs in diverse populations is still lacking especially in Asian populations, with few studies done at a population level.

OBJECTIVE

The current study aimed to establish the (i) prevalence of ACEs and its socio-demographic correlates, and, (ii) association of ACEs with mental disorders and suicidality in a multiethnic Asian country.

PARTICIPANTS AND SETTING

Singapore residents aged 18 years and older were recruited from the community as part of a nation-wide cross-sectional epidemiological study.

METHODS

Trained interviewers conducted face-to-face interviews with participants, and administered the Adverse Childhood Experiences - International Questionnaire and the Composite International Diagnostic Interview.

RESULTS

A total of 6126 participants completed the survey. The lifetime prevalence of ACEs in the sample was 63.9 %. Multiple logistic regression analyses revealed that odds of any ACE were higher among those above 65 years (OR = 1.7) and those without university education (OR = 2.2, 1.9, and 1.5 among those with primary and below, secondary and vocational education respectively). The presence of any ACE was significantly associated with increased odds of mood (OR = 3.7, 95 % CI: 2.3-6.0), anxiety (OR = 3.9, 95 % CI: 2.3-6.8) and alcohol use (OR = 1.7, 95 % CI: 1.1-3.0) disorders.

CONCLUSIONS

ACEs are not uncommon in Asian populations. There is a need to build trauma-informed communities that can incorporate the knowledge of the impact of early trauma into policies and programs.

Police Interviewers' Perceptions of Child Credibility in Forensic Investigations

During investigative interviews, police practice can influence key aspects of child credibility, namely the accuracy, competency, reliability, and truthfulness of their testimony. To date, police interviewers' perceptions of how best to assess child credibility at interview, and how practice impacts upon credibility, have been overlooked. We conducted a qualitative study that examined data from focus groups with 16 English police officers who regularly interview children. The focus group transcripts were analysed using thematic analysis, and four main themes were identified - the 4Es: eliciting information, evaluating credibility, empowering the interviewee, and a high-quality end product. Within these themes, police officers acknowledged some responsibility for the perceived credibility of child victims. Poor interviewing practice could decrease the accuracy of the information elicited and cross-examined in court. Registered intermediaries could empower child interviewees and increase their competency. A lack of reliability contributed to evaluating credibility, but this relationship was not straightforward. Finally, obtaining the most truthful account from child victims was not always possible, because there are many barriers to overcome. Our findings suggest the need for a continued focus on interview protocols that facilitate disclosure from child victims and a review of the professional relationship between those who interview children and prosecutors.

Individual Differences in Children's Suggestibility: An Updated Review

The present review is intended as an overview of our current understanding of how children's individual characteristics, in terms of demographic, cognitive, and psycho-social variables, may influence their susceptibility to suggestion. The goals are to revisit conceptual models of the mechanisms of suggestibility, to provide an updated practical guide for practitioners, and to make recommendations for future research. Results suggest that children with intellectual impairment and those with nascent language skills may be particularly vulnerable to suggestion. Further, memory for separate events, theory of mind, executive function, temperament, and social competence may not be related to suggestibility, whereas additional work is needed to clarify the potential contributions of knowledge, stress, mental health, parental elaborative style, and adverse experiences/maltreatment to children's suggestibility.

Stress physiology and memory for emotional information: Moderation by individual differences in pubertal hormones

In contrast to a large body of work concerning the effects of physiological stress reactivity on children's socioemotional functioning, far less attention has been devoted to understanding the effects of such reactivity on cognitive, including mnemonic, functioning. How well children learn and remember information under stress has implications for a range of educational, clinical, and legal outcomes. We evaluated 8-14 year olds' (N = 94, 50 female) memory for negative, neutral, and positive images. Youth had seen the images a week previously as a part of a laboratory stress task. At encoding and retrieval, and in between, youth provided saliva samples that were later assayed for cortisol, salivary α amylase (sAA), testosterone, and dehydroepiandrosterone (DHEA). Overall, higher cortisol reactivity to the lab task predicted enhanced memory for emotional but not neutral images. However, cortisol further interacted with pubertal hormones (testosterone and DHEA) to predict memory. Among girls with lower pubertal hormone levels, greater cortisol reactivity was associated with enhanced memory for negative information, whereas among boys with higher pubertal hormone levels, cortisol reactivity was associated with enhanced memory for positive information. sAA, was unrelated to memory. Overall, our findings reveal that individual differences in hormone levels associated with pubertal development have implications for our understanding of how stress-responsive biological systems directly and interactively influence cognitive outcomes. (PsycINFO Database Record

Prosecution of Child Sexual Abuse Cases Involving Preschool-Aged Children: A Study of Swedish Cases from 2010 to 2014

Alleged child sexual abuse against preschool-aged children is often considered one of the most challenging cases for a prosecutor to handle. The aim of the current study was to examine differences between prosecuted and discontinued cases of alleged sexual abuse of preschool-aged children. Data from Swedish criminal cases of alleged sexual abuse of children ages 2-6 issued from 2010 to 2014 were analyzed (N = 130). Prosecuted cases were more likely to contain forensic evidence (documentation of abuse, corroborative DNA evidence, or a corroborative medical examination), or a confession from the suspect, while such evidence was not available in any discontinued case. Furthermore, cases where the child was older, where the prosecutor had decided to conduct an interview with the child, and where there was more than one alleged victim were more likely to be prosecuted. Factors that were associated with a decreased likelihood of prosecution were ongoing custody disputes between parents, foster care placements prior to the abuse, and if the report concerned a boy. Boys and younger children were also less likely to be interviewed. The results suggest that prosecution of sexual abuse cases involving preschool-aged children remains difficult and that there is room for improvements in these investigations.

When Is a Child's Forensic Statement Deemed Credible? A Comparison of Physical and Sexual Abuse Cases

A large national sample of 4,775 reports of child physical and sexual abuse made in Israel in 2014 was analyzed in order to examine whether assessments of credibility would vary according to abuse type, physical or sexual, and whether child and event characteristics contributing to the probability that reports of abuse would be determined as credible would be similar or different in child physical abuse (CPA) and child sexual abuse (CSA) cases. Results revealed that CPA reports were less likely to be viewed as credible (41.9%) compared to CSA reports (56.7%). Multigroup path analysis, however, indicated equivalence in predicting factors. In a unified model for both types of abuse, salient predictors of a credible judgment were older age, lack of a cognitive delay, and the alleged abusive event being a onetime less severe act. Over and beyond the effects of these factors, abuse type significantly contributed to the prediction of credibility judgments.

Suggestibility in neglected children: The influence of intelligence, language, and social skills

We administered the GSS-2, a standardised measure of suggestibility, to 5- to 12-year-old children to ascertain whether neglected children's responses to leading questions distinguish them from those of their non-neglected counterparts. Neglected children (n = 75) were more likely than an age-matched sample of non-neglected children (n = 75) to yield to leading questions, despite no difference in their ability to recall the test stimuli. Subsequent collection of individual difference data from the neglected sample revealed that this effect could not be attributed to intelligence, language ability, problem behaviours, age at onset of neglect, or time spent in out-of-home care. With respect to social skill, however, suggestibility was positively correlated with communicative skill, and marginally positively correlated with assertion and engagement. While on the surface our social skills findings seem counter-intuitive, it is possible that maltreated children with relative strengths in these areas have learned to comply with adults in their environment as a way to protect themselves or even foster belonging. Our data, while preliminary, raise interesting questions about whether targeted interventions could help these children to more actively participate in decisions about their lives.

Intrapersonal Emotion Regulation Processes Influence What Children Remember About Their Emotional Experiences

Little work has tested how emotion regulation (ER) processes influence children's memory for negative experiences. We investigated how two intrapersonal ER processes (affect-biased attention and changes in negative feelings) predicted children's (N = 184, 93 girls, ages 3-11) memory. Recall of a sad or scary film was tested after a delay. The way discrete emotional information was remembered varied with ER and children's age. Older children with greater affect-biased attention or less reduction of fear demonstrated privileged memory for central information from the scary film. Older children with greater affect-biased attention but greater reductions in sadness recalled more from the sad film overall. Findings suggest ER processes should be considered when examining children's memory for negative emotional information.

Does parental coaching affect children's false reports? Comparing verbal markers of deception

The present study examined differences in children's true and false narratives as a function of parental coaching by comparing the verbal markers associated with deception. Children (N = 65, 4-7 years old) played the same game with an adult stranger over three consecutive days. Parents coached their children to falsely allege that they had played a second game and to generate details for the fabricated event. One week after the last play session, children were interviewed about their experiences. For children with the least amount of parental coaching, true and false reports could be distinguished by multiple verbal markers of deception (e.g., cognitive processes, temporal information, self-references). The fabricated reports of children who spent more time being coaching by a parent resembled their truthful reports. These findings have implications for real-world forensic contexts when children have been coached to make false allegations and fabricate information at the behest of a parent.

What Drives False Memories in Psychopathology? A Case for Associative Activation

In clinical and court settings, it is imperative to know whether posttraumatic stress disorder (PTSD) and depression may make people susceptible to false memories. We conducted a review of the literature on false memory effects in participants with PTSD, a history of trauma, or depression. When emotional associative material was presented to these groups, their levels of false memory were raised relative to those in relevant comparison groups. This difference did not consistently emerge when neutral or nonassociative material was presented. Our conclusion is supported by a quantitative comparison of effect sizes between studies using emotional associative or neutral, nonassociative material. Our review suggests that individuals with PTSD, a history of trauma, or depression are at risk for producing false memories when they are exposed to information that is related to their knowledge base.

Links between early child maltreatment, mental disorders, and cortisol secretion anomalies

Early child maltreatment has been widely associated with the development of mental disorders in both childhood and adulthood. However, such association cannot be systematically established, as only few factors are observed regularly, such as high prevalence of comorbidities and externalized disorders. Similarly, the association between early abuse and cortisol secretion anomalies has been well-documented. Whereas early hypercortisolism followed by hypocortisolism was often described, the results proved inconsistent and at times contradictory. The physiopathological mechanisms are quite complex and varied, including mixed neurotoxicity and stress response anomalies, linked to circadian rhythm disturbances. One of the difficulties inherent to research on this topic is to better define maltreatment in childhood. Studying children's groups at risk of maltreatment, such as children followed by juvenile justice or in child welfare systems, could be a very good tool, provided that social, judiciary, and mental health professionals are able to work together and implement common research objectives.

Beyond Risk and Protective Factors: An Adaptation-Based Approach to Resilience

How does repeated or chronic childhood adversity shape social and cognitive abilities? According to the prevailing deficit model, children from high-stress backgrounds are at risk for impairments in learning and behavior, and the intervention goal is to prevent, reduce, or repair the damage. Missing from this deficit approach is an attempt to leverage the unique strengths and abilities that develop in response to high-stress environments. Evolutionary-developmental models emphasize the coherent, functional changes that occur in response to stress over the life course. Research in birds, rodents, and humans suggests that developmental exposures to stress can improve forms of attention, perception, learning, memory, and problem solving that are ecologically relevant in harsh-unpredictable environments (as per the specialization hypothesis). Many of these skills and abilities, moreover, are primarily manifest in currently stressful contexts where they would provide the greatest fitness-relevant advantages (as per the sensitization hypothesis). This perspective supports an alternative adaptation-based approach to resilience that converges on a central question: “What are the attention, learning, memory, problem-solving, and decision-making strategies that are enhanced through exposures to childhood adversity?” At an applied level, this approach focuses on how we can work with, rather than against, these strengths to promote success in education, employment, and civic life.

The structural linguistic complexity of lawyers' questions and children's responses in Scottish criminal courts

In the first study to systematically assess the structural linguistic complexity of lawyers' questions of children in Scotland, we examined 56 trial transcripts of 5- to 17-year-old children testifying as alleged victims of sexual abuse. Complexity was assessed using 8 quantitative measures of each utterance's components (number of questions, phrases, clauses, sentences, false starts, average word count, word length, and sentence length) and a composite measure was used in the analyses. Lawyers did not alter the complexity of questions when prompting children of different ages. Defense lawyers asked more structurally complex questions than prosecutors. Directive questions were the least structurally complex questions, followed by option-posing questions. Suggestive questions, followed by invitations, were the most structurally complex questions. Option-posing and suggestive questions were more complex when asked by defense lawyers than prosecutors. Of suggestive questions, confrontation and tagged questions were more complex than any other question type. Increased structural complexity led to more unresponsiveness, more expressions of uncertainty, and more self-contradictions regardless of which lawyer asked, the question type, or the children's ages. These findings highlight the additional risks associated with asking some types of questions in structurally complex ways and highlight the need for further innovations (e.g., the use of intermediaries) to facilitate the questioning of vulnerable witnesses in Scottish criminal courts.

Association between child maltreatment and prospective and retrospective memory in adolescents: The mediatory effect of neuroticism

The purpose of this study was to examine the relationship between child maltreatment and prospective and retrospective memory in children/adolescents by investigating the mediating role of neuroticism. In total, 662 children/adolescents aged 10-16 years were recruited from a middle school in China, and they completed questionnaires comprising the Childhood Trauma Questionnaire, Prospective and Retrospective Memory Questionnaire, and the Neuroticism subscale of the NEO Five-Factor Inventory. The severity of maltreatment was positively associated with the severity of impairment of memory (prospective and retrospective considered together) in children/adolescents. Children/adolescents exposed to maltreatment tended to display higher levels of neuroticism. Neuroticism partially mediated the association between child maltreatment and memory in all the subjects. The results of multigroup analyses showed neuroticism fully mediated the relationship between child maltreatment and memory for boys, in which the effect size of indirect effect was 0.52, and partially mediated the association for girls with 0.44 effect size of indirect effect. Early intervention aimed to reduce neuroticism might contribute to a better prognosis in children/adolescences with poor memory function.

Maltreatment increases spontaneous false memories but decreases suggestion-induced false memories in children

We examined the creation of spontaneous and suggestion‐induced false memories in maltreated and non‐maltreated children. Maltreated and non‐maltreated children were involved in a Deese–Roediger–McDermott false memory paradigm where they studied and remembered negative and neutral word lists. Suggestion‐induced false memories were created using a misinformation procedure during which both maltreated and non‐maltreated children viewed a negative video (i.e., bank robbery) and later received suggestive misinformation concerning the event. Our results showed that maltreated children had higher levels of spontaneous negative false memories but lower levels of suggestion‐induced false memories as compared to non‐maltreated children. Collectively, our study demonstrates that maltreatment both increases and decreases susceptibility to memory illusions depending on the type of false memory being induced.

Getting to Know You: Familiarity, Stereotypes, and Children's Eyewitness Memory

The present study concerned how the acquisition of social information, specifically knowledge about personal characteristics, influences young children's memory and suggestibility. Effects of two sources of knowledge about a target person were systematically examined: familiarity and stereotypes. Children, aged 4-5 and 7-9 years (N = 145), were randomly assigned, per age group, to experimental conditions based on a familiarity (6 hours vs. no prior exposure) × stereotype (negative depiction as messy and clumsy vs. no stereotype) factorial design. Children then watched the target person engage in a target event (a series of contests) at a preschool ("Camp Ingrid"). The children's memory and suggestibility about the target person and target event were tested after a delay of 2 weeks. Results indicated that the negative stereotype resulted in an increase in children's correct responses both to free-recall stereotype-related questions (when children were unfamiliar with the target person) and to closed-ended questions overall (for younger children). However, the stereotype was associated with greater error to stereotype-related closed-ended questions. Moreover, familiarity increased children's accuracy to closed-ended questions. Implications for theory and application are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Developmental Differences across Middle Childhood in Memory and Suggestibility for Negative and Positive Events

In the present study, we investigated age differences in children's eyewitness memory and suggestibility for negative and positive events that children often experience during middle childhood. We first examined 216 ratings by children aged 8-12 years of the frequency and intensity of personal negative and positive experiences (Study 1). Based on those ratings, videotapes depicting the most frequent and intense negative (an accident) and positive (a family excursion) events were developed. A new sample of 227 children aged 8-12 years was tested for recognition memory of the videotapes using the three-stage post-event misinformation procedure (Study 2). Compared with 8- to 9-year-olds, 10- to 12-year-olds exhibited less memory malleability and less compliance with false information. Age improvements in recognition accuracy were also evident for children who watched the negative event, but not for those who watched the positive event. Compliance predicted misinformation effects, particularly in regard to peripheral details. Thus, using ecologically representative emotional events, age differences in suggestibility and memory accuracy emerged, especially for negative events.Theoretical and forensic implications concerning children's eyewitness memory and suggestibility are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Cortisol response and psychological distress predict susceptibility to false memories for a trauma film

For eyewitness testimony to be considered reliable, it is important to ensure memory remains accurate following the event. As many testimonies involve traumatic, as opposed to neutral, events, it is important to consider the role of distress in susceptibility to false memories. The aim of this study was to investigate whether cortisol response following a stressor would be associated with susceptibility to false memories. Psychological distress responses were also investigated, specifically, dissociation, intrusions, and avoidance. Participants were allocated to one of three conditions: those who viewed a neutral film (N = 35), those who viewed a real trauma film (N = 35), and a trauma "reappraisal" group where participants were told the film was not real (N = 35). All received misinformation about the film in the form of a narrative. Participants provided saliva samples (to assess cortisol) and completed distress and memory questionnaires. Cortisol response was a significant predictor of the misinformation effect. Dissociation and avoidance were related to confabulations. In conclusion, following a stressor an individual may differ with regard to their psychological response to the event, and also whether they experience a cortisol increase. This may affect whether they are more distressed later on, and also whether they remember the event accurately.

Childhood Maltreatment and Educational Outcomes

Children (0-18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow's model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner's ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children's academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively or negatively influence the educational outcomes of maltreated children. The theoretical, research, and applied implications stemming from the findings are considered.

Simulating Memory Impairment for Child Sexual Abuse

The current study investigated effects of simulated memory impairment on recall of child sexual abuse (CSA) information. A total of 144 adults were tested for memory of a written CSA scenario in which they role-played as the victim. There were four experimental groups and two testing sessions. During Session 1, participants read a CSA story and recalled it truthfully (Genuine group), omitted CSA information (Omission group), exaggerated CSA information (Commission group), or did not recall the story at all (No Rehearsal group). One week later, at Session 2, all participants were told to recount the scenario truthfully, and their memory was then tested using free recall and cued recall questions. The Session 1 manipulation affected memory accuracy during Session 2. Specifically, compared with the Genuine group's performance, the Omission, Commission, or No Rehearsal groups' performance was characterized by increased omission and commission errors and decreased reporting of correct details. Victim blame ratings (i.e., victim responsibility and provocativeness) and participant gender predicted increased error and decreased accuracy, whereas perpetrator blame ratings predicted decreased error and increased accuracy. Findings are discussed in relation to factors that may affect memory for CSA information.

Child maltreatment, trauma-related psychopathology, and eyewitness memory in children and adolescents

Two experiments were conducted to examine eyewitness memory in children and adolescents (9- to 15-years-old) with and without known histories of maltreatment (e.g., physical abuse, exposure to domestic violence). In Experiment 1, participants (N = 35) viewed a positive film clip depicting a congenial interaction between family members. In Experiment 2, participants (N = 31) watched a negative film clip in which a family argument was shown. Younger age and higher levels of trauma-related psychopathology significantly predicted commission errors to direct questions when the positive family interaction had been viewed, but not when the negative family interaction had been shown. Maltreatment history was not a significant unique predictor of memory performance for the positive or negative film clip. Implications for a scientific understanding of the effects of child maltreatment on memory are discussed.

Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study

Background

Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache.

Methods

The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006–2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes.

Results

In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex.

Conclusions

Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to account for these factors in preventive and clinical interventions. Trauma-informed, social relationship-based interventions may represent a major opportunity to alter trajectories of recurrent headache.