Dating violence, childhood maltreatment, and BMI from adolescence to young adulthood

Current Weight Status of Sexually Assaulted Pediatric Female Patients in an Emergency Department Setting

Background: The relationship between childhood sexual abuse (CSA) and childhood obesity (CO) is unclear with studies reporting conflicting results in female populations. This study aims to assess the association between suspected CSA and current emergency department (ED) weight status when compared with trauma patients. Methods: This is a single-center retrospective case-control study that utilized pediatric ED data (2016-2018) from identified female patients (6-17 years old) with a chief complaint of sexual assault and trauma registry patients. Focus was on female patients for literary comparisons. Two weight measurements were calculated based on available height data: BMI-for-age and weight-for-age. Nonparametric testing and binary logistic regression were utilized. Results: There were 2044 study participants: 1454 (71.1%) cases and 590 (28.9%) controls. Cases were older, underrepresented minorities (URMs), and carried public insurance (all p-values <0.001). Using BMI-for-age, patients with a sexual assault complaint had a 67% increased odds for CO after adjusting for age, URM status, and insurance type [adjusted odds ratio (aOR) = 1.67 (95% confidence intervals [CIs] 1.07-2.62); p-value = 0.03], whereas the weight-for-age metric increased the aOR odds by 58% [aOR = 1.58 (95% CI 1.14-2.17); p-value = 0.01] when compared with pediatric trauma patients. Similar results were found in a sensitivity analysis using patients matched on age and URM. Conclusion: Our data demonstrated an association between suspected CSA and CO. More research is needed to identify the biopsychosocial implications for this relationship and the potential to augment clinical care.

Long-term Adverse Outcomes Associated With Teen Dating Violence: A Systematic Review

CONTEXT

Evidence suggests that teen dating violence (TDV) is associated with long-term adverse outcomes, but these associations have not been systematically assessed.

OBJECTIVES

To conduct a systematic review of the longitudinal associations between TDV and negative outcomes, including mental and physical health, reoccurrence of violence in intimate relationships, and high-risk behaviors (substance use and sexual behaviors).

DATA SOURCES

Peer-reviewed articles published in English were searched in PsycINFO/Eric/PsycArticles, PubMed, and Web of Science database from inception to November 2022.

STUDY SELECTION

Prospective studies that assessed TDV during adolescence, had a follow-up of at least ≥1 year, and evaluated the associations of TDV with health, violence in romantic intimate relationships, or risk behaviors were included.

DATA EXTRACTION

Study characteristics, baseline data, and follow-up outcomes were extracted from included studies.

RESULTS

Thirty-eight studies involving 23 unique samples were analyzed. Findings showed that TDV in adolescence was associated with future teen dating and intimate partner violence in adulthood. Studies also indicated that TDV was longitudinally associated with increasing high-risk behaviors (i.e., marijuana and alcohol use) and poor mental health outcomes (particularly for victimization). There was unclear evidence on the longitudinal link between TDV and suicidal attempts. Significant associations between TDV and negative outcomes were reported more frequently among females compared with males.

LIMITATIONS

Length of follow-up varied across studies.

CONCLUSIONS

Dating violence in adolescence may represent a risk factor for a wide range of long-term outcomes. Female adolescents reporting TDV may be at higher risk of adverse outcomes compared with males.

Childhood emotional but not physical or sexual maltreatment predicts prosocial behavior in late adolescence: A daily diary study

BACKGROUND

Childhood maltreatment (CM), including physical, emotional, and sexual maltreatment, is detrimental to adolescents' psychological and behavioral outcomes. However, most studies on the relationship between CM and prosocial behavior focused on the overall experience of CM. Since different forms of CM exert various influences on adolescents, it is essential to find out which form of CM has the strongest link with prosocial behavior and the underlying mechanism behind it to fully understand this relationship and design a specific intervention for promoting prosocial behavior.

OBJECTIVE

Guided by internal working model theory and hopelessness theory, this study aimed to investigate the connections of multiple forms of CM with prosocial behavior, and explore the mediating mechanism of gratitude from the perspective of the broaden-and-build theory through a 14-day daily diary study.

PARTICIPANTS

A total of 240 Chinese late adolescents (217 females; M_age = 19.02, SD_age = 1.83) from a college volunteered for this study and completed questionnaires regarding CM, gratitude, and prosocial behavior.

METHODS

A multilevel regression analysis was conducted to investigate which form of CM was correlated to prosocial behavior, and a multilevel mediation analysis was applied to examine the underlying mechanism (i.e., gratitude) behind this relationship.

RESULTS

The results of the multilevel regression analysis showed that it was childhood emotional maltreatment, but not physical or sexual maltreatment that negatively predicted prosocial behavior. The results of the multilevel mediation analysis indicated that gratitude mediated the relationship between childhood emotional maltreatment and prosocial behavior.

CONCLUSIONS

Findings from the present study highlight the predictive effect of childhood emotional maltreatment on late adolescents' prosocial behavior and the mediating role of gratitude in this link.

Childhood and adolescent nutrition outcomes among girls exposed to gender-based violence: A rapid evidence assessment of quantitative research

BACKGROUND

An emerging evidence base has explored the nutritional consequences of gender-based violence (GBV) perpetrated against girls during childhood/adolescence. We conducted a rapid evidence assessment of quantitative studies describing associations between GBV and girls' nutrition.

METHODS

We adapted systematic review methods and included empirical, peer-reviewed studies, published after 2000 (until November, 2022), that were written in Spanish or English and reported quantitative associations between girls' exposure to GBV and nutrition outcomes. A variety of GBV forms were considered: childhood sexual abuse (CSA), child marriage, preferential feeding of boys, sexual IPV and dating violence. Nutrition outcomes included anemia, underweight, overweight, stunting, micronutrient deficiencies, meal frequency, and dietary diversity.

RESULTS

In total, 18 studies were included, 13 of which were conducted in high-income countries. Most sources utilized longitudinal or cross-sectional data to quantify associations between CSA, sexual assault, and intimate partner/dating violence and elevated BMI/overweight/obesity/adiposity. Findings suggest that CSA perpetrated by parents/caregivers is associated with elevated BMI/overweight/obesity/adiposity via cortisol reactivity and depression; this relationship may be compounded by additional intimate partner/dating violence in adolescence. The effects of sexual violence on BMI are likely to emerge during a sensitive period of development between late adolescence and young adulthood. Emerging evidence was found regarding the relationship between child marriage (and the related exposure: age at first pregnancy) and undernutrition. The association between sexual abuse and reduced height and leg length was inconclusive.

CONCLUSION

Given that only 18 studies were included, the relationship between girls' direct exposure to GBV and malnutrition has received little empirical attention, especially with respect to studies conducted in LMIC and fragile settings. Most studies focused on CSA and overweight/obesity, where significant associations were found. Future research should test the moderation and mediation effects of intermediary variables (depression, PTSD, cortisol reactivity, impulsivity, emotional eating) and consider sensitive periods of development. Research should also explore the nutritional consequences of child marriage.

The Prevalence of PTSD in a Forensic Psychiatric Setting: The Impact of Traumatic Lifetime Experiences

Background

Several studies have identified traumatic history among forensic patients and its association with criminal behaviors and psychiatric diagnoses. Post-traumatic stress disorder (PTSD) is highly prevalent in forensic settings causing a serious deterioration of the primary psychiatric disorder.

Aims

Our study aims to evaluate the prevalence of PTSD and the role of traumatic experiences and abuse in the development of severe psychiatric disorders in a sample of psychiatric offenders.

Methods

Fifty-three patients admitted in Italian high intensity therapeutic facilities-the Residenze per l'Esecuzione delle Misure di Sicurezza (REMS)-were evaluated with the Trauma Experience Checklist (TEC) and the Millon Clinical Multiaxal Inventory (MCMI-III) to study lifetime traumatic memories and general psychopathology, respectively.

Results

Preliminary findings show that about 41% (N = 22) of psychiatric offenders were affected by PTSD, often not due to a single episode but to multiple lifetime traumas. Therefore, lifetime traumatic experiences and specifically sexual abuse are significant risk factors for the development of a personality disorder, which is present in the 38% (N = 20) of the sample.

Conclusions

The high PTSD prevalence and the strong association found between trauma and abuse with the development of a personality disorder emphasizes the importance of an early evaluation and intervention on traumatic experiences in this difficult population of psychiatric patients; in fact, the treatment of psychiatric offenders is actually vague and devoid of scientific evidence. Our results open up the perspective on the use of known and specific interventions for trauma, such as EMDR and Mindfulness.

Child maltreatment in the time of the COVID-19 pandemic: A proposed global framework on research, policy and practice

BACKGROUND

Child protection is and will be drastically impacted by the COVID-19 pandemic. Comprehending this new reality and identifying research, practice and policy paths are urgent needs.

OBJECTIVE

The current paper aims to suggest a framework for risk and protective factors that need to be considered in child protection in its various domains of research, policy, and practice during and after the COVID-19 pandemic.

STRATEGY

From an international collaboration involving researchers and child protection professionals from eight countries, the current paper examines various factors that were identified as playing an important role in the child protection system.

THE INITIAL SUGGESTED FRAMEWORK

Through the use of an ecological framework, the current paper points to risk and protective factors that need further exploration. Key conclusions point to the urgent need to address the protection of children in this time of a worldwide pandemic. Discussion of risk and protective factors is significantly influenced by the societal context of various countries, which emphasizes the importance of international collaboration in protecting children, especially in the time of a worldwide pandemic.

CONCLUSION

The COVID-19 pandemic has stressed the urgent need to advance both theory and practice in order to ensure children's rights to safety and security during any pandemic. The suggested framework has the potential to advance these efforts so that children will be better protected from maltreatment amidst a pandemic in the future.

Implications of Severe Polyvictimization for Cardiovascular Disease Risk Among Female Survivors of Violence

In this study, we examined the impact of severe polyvictimization on 30-year cardiovascular disease (CVD) risk among female survivors of intimate partner violence (IPV). Data were collected from 34 participants in the "Leave it on the Mat" pilot study. The study was conducted in an urban city in a Midwestern state from August 2012 to April 2014. Severe polyvictimization was considered present if participants reported a history of three or more forms of victimization (childhood exposure to domestic violence, being psychologically or physically abused in childhood, and lifetime sexual assault) in addition to IPV. CVD risk factors included smoking, body mass index (BMI), and systolic blood pressure (SBP). A Framingham-based prediction model was used to estimate 30-year CVD risk. A linear regression model, adjusted for age, education, race/ethnicity, and family history of CVD, was calculated. Fifty percent (n = 17) of the study participants reported severe polyvictimization and the average 30-year risk of CVD in the full sample was 22.3. Participants who experienced severe polyvictimization had higher 30-year CVD risk scores when compared to participants who experienced two or fewer forms of victimization. The findings revealed that severe polyvictimization was prevalent among survivors of IPV and was associated with increased scores on the 30-year CVD risk model. Screening for abuse history could aid identification of individuals at high CVD risk.

Co-occurrence of Dating Violence Victimization Subtypes: Assessing the Influence of Family Factors, Dating Attitudes, Risky Behaviors, and the Moderating Effect of Gender Among School-Aged Teens

Using data from a nationally representative sample of school-aged teens (n = 795), this study examined covariates associated with three subtypes of dating violence victimization (physical violence, emotional abuse, and imposed isolation). We asked the research questions: What were the family factors, dating attitudes, and risky behaviors associated with three subtypes of dating violence victimization across two time points? Second, were these relationships moderated by gender? Overall, we found widespread co-occurrence of victimization. Contrary to our predictions, not all earlier experiences with dating violence victimization worsened or persisted overtime. Regarding family factors, we did not find substantial statistically significant effects on victimization, with the exception that greater openness with parents was associated with increased occurrence of emotional abuse at Wave 1. In terms of dating attitudes, we found that when respondents condoned violence against a girlfriend, they were more likely to experience physical violence victimization at both waves. Respondents who believed that it is okay to use violence to control a boyfriend's behavior were more likely to report emotional abuse at Wave 1. Similarly, respondents who believed that it is okay to date more than one person, as well as those who condoned sexual intercourse outside of a romantic relationship, were more susceptible to emotional abuse. Regarding risky behaviors, we found that the respondents' victimization experience did not increase with a greater sexual partner acquisition; rather, it exerted the opposite effect on their experience with physical violence victimization. These risky behaviors, however, were only statistically significant at Wave 1. Finally, the moderating effect of gender is noted in the study. Implications from the study are discussed.

Violence against children in Latin America and the Caribbean: What do available data reveal about prevalence and perpetrators?

OBJECTIVE

To describe the prevalence of recent physical, sexual, and emotional violence against children 0 - 19 years of age in Latin America and the Caribbean (LAC) by age, sex, and perpetrator.

METHODS

A systematic review and analysis of published literature and large international datasets was conducted. Eligible sources from first record to December 2015 contained age-, sex-, and perpetrator-specific data from LAC. Random effects meta-regressions were performed, adjusting for relevant quality covariates and differences in violence definitions.

RESULTS

Seventy-two surveys (2 publications and 70 datasets) met inclusion criteria, representing 1 449 estimates from 34 countries. Prevalence of physical and emotional violence by caregivers ranged from 30% - 60%, and decreased with increasing age. Prevalence of physical violence by students (17% - 61%) declined with age, while emotional violence remained constant (60% - 92%). Prevalence of physical intimate partner violence (IPV) ranged from 13% - 18% for girls aged 15 - 19 years. Few or no eligible past-year estimates were available for any violence against children less than 9 years and boys 16 - 19 years of age; sexual violence against boys (any age) and girls (under 15 years); IPV except for girls aged 15 - 19 years; and violence by authority figures (e.g., teachers) or via gangs/organized crime.

CONCLUSION

Past-year physical and emotional violence by caregivers and students is widespread in LAC across all ages in childhood, as is IPV against girls aged 15 - 19 years. Data collection must be expanded in LAC to monitor progress towards the sustainable development goals, develop effective prevention and response strategies, and shed light on violence relating to organized crime/gangs.

Ongoing Pediatric Health Care for the Child Who Has Been Maltreated

Pediatricians provide continuous medical care and anticipatory guidance for children who have been reported to state child protection agencies, including tribal child protection agencies, because of suspected child maltreatment. Because families may continue their relationships with their pediatricians after these reports, these primary care providers are in a unique position to recognize and manage the physical, developmental, academic, and emotional consequences of maltreatment and exposure to childhood adversity. Substantial information is available to optimize follow-up medical care of maltreated children. This new clinical report will provide guidance to pediatricians about how they can best oversee and foster the optimal physical health, growth, and development of children who have been maltreated and remain in the care of their biological family or are returned to their care by Child Protective Services agencies. The report describes the pediatrician's role in helping to strengthen families' and caregivers' capabilities and competencies and in promoting and maximizing high-quality services for their families in their community. Pediatricians should refer to other reports and policies from the American Academy of Pediatrics for more information about the emotional and behavioral consequences of child maltreatment and the treatment of these consequences.

Relationship between Child Maltreatment and Adolescent Body Mass Index Trajectories

This study examines the relationship between childhood maltreatment experiences and body mass index (BMI) over time. Using data from the National Longitudinal Study of Adolescent to Adult Health, we use latent profile analysis to create child maltreatment experience classes and latent growth modeling to understand how classes relate to BMI trajectories from adolescence to early adulthood. The best-fitting model suggests four child maltreatment experience classes: 1) poly-maltreatment (n=607); 2) physical abuse (n=1,578); 3) physical abuse and neglect (n=345); and 4) no childhood maltreatment (n=4,188). Class membership differentially predicts BMI trajectories, such that individuals in the no maltreatment, physical abuse, and physical abuse plus neglect classes exhibit the most stable BMI, and individuals in the poly-maltreatment class increase most rapidly (Χ2[9]=149.9, p < 0.001). Individuals in the poly-maltreatment class experience significantly higher BMI over time compared to the other three classes. In addition to overall growth differing between classes, there is substantial inter-individual variability in BMI trajectories within each class. Because BMI trajectories differ across different childhood maltreatment experiences-and substantial variability in BMI trajectories exists within these different experiences-future analyses should investigate mediators and moderators of this relationship to inform trauma-based therapies and interventions.

Recent intimate partner violence against women and health: a systematic review and meta-analysis of cohort studies

OBJECTIVE

We reviewed cohort studies to determine the magnitude and temporal direction of the association between recent intimate partner violence (IPV) and a range of adverse health outcomes or health risk behaviours.

DESIGN

Systematic review and meta-analysis.

METHODS

Medline, EMBASE and PsycINFO were searched from the first record to November 2016. Recent IPV was defined as occurring up to and including the last 12 months; all health outcomes were eligible for inclusion. Results were combined using random-effects meta-analysis.

RESULTS

35 separate cohort studies were retrieved. Eight studies showed evidence of a positive association between recent IPV and subsequent depressive symptoms, with a pooled OR from five estimates of 1.76 (95% CI 1.26 to 2.44, I²=37.5%, p=0.172). Five studies demonstrated a positive, statistically significant relationship between depressive symptoms and subsequent IPV; the pooled OR from two studies was 1.72 (95% CI 1.28 to 2.31, I²=0.0%, p=0.752). Recent IPV was also associated with increased symptoms of subsequent postpartum depression in five studies (OR=2.19, 95% CI 1.39 to 3.45, p=0.000), although there was substantial heterogeneity. There was some evidence of a bidirectional relationship between recent IPV and hard drug use and marijuana use, although studies were limited. There was no evidence of an association between recent IPV and alcohol use or sexually transmitted infections (STIs), although there were few studies and inconsistent measurement of alcohol and STIs.

CONCLUSIONS

Exposure to violence has significant impacts. Longitudinal studies are needed to understand the temporal relationship between recent IPV and different health issues, while considering the differential effects of recent versus past exposure to IPV. Improved measurement will enable an understanding of the immediate and longer term health needs of women exposed to IPV. Healthcare providers and IPV organisations should be aware of the bidirectional relationship between recent IPV and depressive symptoms.

PROSPERO REGISTRATION NUMBER

CRD42016033372.

Who perpetrates violence against children? A systematic analysis of age-specific and sex-specific data

OBJECTIVE

The epidemiology of violence against children is likely to differ substantially by sex and age of the victim and the perpetrator. Thus far, investment in effective prevention strategies has been hindered by lack of clarity in the burden of childhood violence across these dimensions. We produced the first age-specific and sex-specific prevalence estimates by perpetrator type for physical, sexual and emotional violence against children globally.

DESIGN

We used random effects meta-regression to estimate prevalence. Estimates were adjusted for relevant quality covariates, variation in definitions of violence and weighted by region-specific, age-specific and sex-specific population data to ensure estimates reflect country population structures.

DATA SOURCES

Secondary data from 600 population or school-based representative datasets and 43 publications obtained via systematic literature review, representing 13 830 estimates from 171 countries.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Estimates for recent violence against children aged 0-19 were included.

RESULTS

The most common perpetrators of physical and emotional violence for both boys and girls across a range of ages are household members, with prevalence often surpassing 50%, followed by student peers. Children reported experiencing more emotional than physical violence from both household members and students. The most common perpetrators of sexual violence against girls aged 15-19 years are intimate partners; however, few data on other perpetrators of sexual violence against children are systematically collected internationally. Few age-specific and sex-specific data are available on violence perpetration by schoolteachers; however, existing data indicate high prevalence of physical violence from teachers towards students. Data from other authority figures, strangers, siblings and other adults are limited, as are data on neglect of children.

CONCLUSIONS

Without further investment in data generation on violence exposure from multiple perpetrators for boys and girls of all ages, progress towards Sustainable Development Goals 4, 5 and 16 may be slow. Despite data gaps, evidence shows violence from household members, peers in school and for girls, from intimate partners, should be prioritised for prevention.

TRIAL REGISTRATION NUMBER

PROSPERO 2015: CRD42015024315.

Violence exposure and adolescents' same-day obesogenic behaviors: New findings and a replication

OBJECTIVE

To test whether exposure to violence is associated with same-day increases in obesogenic behaviors among young adolescents, including unhealthy food and beverage consumption, poor quality sleep, and lack of physical activity.

METHODS

Young at-risk adolescents between 12 and 15 years of age were recruited via telephone screening from low-income neighborhoods. Adolescents and their parents completed in-person assessments, followed by Ecological Momentary Assessment (EMA) delivered to 151 adolescents' mobile phones three times a day for 30 days (4329 person days). Three obesogenic behaviors - unhealthy food consumption, poor sleep quality, and lack of physical activity - and violence exposure were assessed daily. Adolescents' body mass index (BMI) was assessed prior to the EMA and 18 months later. A replication was performed among 395 adolescents from a population-representative sample (with 5276 EMA person days).

RESULTS

On days that at-risk adolescents were exposed versus not exposed to violence, they were more likely to consume unhealthy foods and beverages (b = 0.12, p = 0.01), report feeling tired the next morning (OR = 1.58, p < 0.01), and to be active (OR = 1.61, p < 0.01). At-risk adolescents who reported higher consumption of soda and caffeinated beverages during the 30-day EMA were more likely to experience increases in BMI in later adolescence. Findings related to sleep and activity were supported in the population-based replication sample; however, no significant same-day associations were found between violence exposure and unhealthy dietary consumption.

CONCLUSIONS

This study provides evidence that exposure to violence is associated with same-day unhealthy dietary consumption among at-risk adolescents and next-day tiredness related to sleep quality among adolescents from both at-risk and normative populations. Findings also point to unhealthy soda consumption during early adolescence as an important predictor of weight gain among at-risk adolescents.

Intimate Partner Violence and 5-Year Weight Change in Young Women: A Longitudinal Study

BACKGROUND

Intimate partner violence (IPV) and obesity are national public health problems that are potentially associated. We examined the association between IPV exposure and 5-year weight gain in young women. We also examined whether depressive mood conferred additional increases in weight gain.

MATERIALS AND METHODS

Analyses were conducted among women in Project EAT, a longitudinal cohort study of weight-related health, which has collected data at three 5-year survey waves: "EAT I" (mean age 15 years), "EAT II" (mean age 19 years), and "EAT III" (mean age 25 years). Height and body weight were self-reported at each survey wave. IPV victimization and depressive mood were assessed on the EAT II survey. The study comprised women with data on IPV and body mass index (BMI) (N = 619). Linear regression analyses examined (1) 5-year (EAT II to EAT III) BMI change as a function of IPV exposure and (2) 5-year BMI change as a function of depressive mood at EAT II in women with and without IPV exposure.

RESULTS

Almost 20% of the study sample reported IPV. Women exposed to both physical and sexual IPV at EAT II gained 1.1 kg/m2 (95% CI -0.2 to 2.4) more, over 5 years, than women unexposed to IPV, although this did not reach statistical significance. Among those with IPV exposure, depressive mood at EAT II was associated with an additional increase in BMI of 1.8 kg/m2 (95% CI 0.2-3.4) relative to no depressive mood.

CONCLUSION

Survivors of IPV with depressive mood may have accelerated weight gain. Trauma-informed obesity prevention strategies may be warranted in this group.

Patterns of Dating Violence Perpetration and Victimization in U.S. Young Adult Males and Females

Dating violence (DV) is frequently reported by young adults in intimate relationships in the United States, but little is known about patterns of DV perpetration and victimization. In this study, we examined sexual and physical violence perpetration and victimization reported by young adults to determine how the violence patterns differ by sex and race/ethnicity. Data from non-Hispanic White, non-Hispanic Black, and Hispanic participants in Wave 3 of the National Longitudinal Study of Adolescent to Adult Health were analyzed. DV was assessed using responses to four questions focused on perpetration and four questions focused on victimization. The information on DV was taken from the most violent relationship reported by participants prior to Wave 3. Latent class analysis was first conducted separately by sex, adjusting for age, race/ethnicity, and financial stress, then by race/ethnicity, adjusting for age and financial stress. Relative model fit was established by comparing Bayesian Information Criteria (BIC), adjusted BIC, entropy, interpretability of latent classes, and certainty of latent class assignment for covariate-adjusted models. The results indicate that patterns of violence differed by sex and for females, by race/ethnicity. A three-class model was the best fit for males. For females, separate four-class models were parsimonious for White, Black, and Hispanic females. Financial stress was a significant predictor of violence classification for males and females and age predicted membership in White and Black female models. Variations in DV patterns by sex and race/ethnicity suggest the need for a more nuanced understanding of differences in DV.

Parental responses to youths' reports of teen dating violence: Recommendations from parents and youth

Parental responses to teen dating violence (TDV) can influence children's behaviors. This qualitative study presents findings from focus groups analyzing parental responses to TDV. Thirty-one parents and 55 teens, recruited from local family service agencies located in southwestern part of the country, participated in separate focus groups that presented dating violence scenarios. Focus group results indicated that parents and teens both urge communication that included parents asking questions, educating the teen, sharing their personal experiences, and giving teens advice. Parental and teens' comments also focused on the importance of protecting teens, providing support for teens, refraining from overreacting and offering counseling services. Parents, more than teens, stressed the importance of educating teens; teens, more than parents, stressed the importance of parents supporting and providing comfort to teens while refraining from overreacting and yelling. Implications for programming with parents and future research are included.

Intimate partner violence in late adolescence and young adulthood and subsequent cardiovascular risk in adulthood

BACKGROUND

Childhood maltreatment has been linked to adulthood cardiovascular disease (CVD). Little is known about the relationship between intimate partner violence (IPV) in late adolescence and young adulthood and CVD risk later in adulthood.

PURPOSE

To examine whether IPV perpetration and victimization experienced in late adolescence and young adulthood are associated with CVD risk among adults in the United States and whether this relationship differs by sex.

METHODS

Data include 9976 participants (50% female) in the National Longitudinal Study of Adolescent to Adult Health. Physical and sexual IPV were measured at wave 3 (2001/02) with items from the revised Conflict Tactics Scales. Participants'30-year risk of CVD was calculated at wave 4 (2008/09) using a Framingham prediction model. Linear regression models adjusted for confounders and IPV by sex interaction terms were tested to examine the relationship.

RESULTS

The mean CVD risk score was 13.18% (95% CI: 12.71, 13.64). Aone-standard deviation increase in the victimization score was associated with a 0.28% (95% CI: 0.03, 0.54) increase in CVD risk. Perpetration was similarly positively associated with CVD risk (beta: 0.33, 95% CI: 0.03, 0.62). When measured as a composite, all violence types were associated with increased CVD risk but only prior exposure to both victimization and perpetration reached statistical significance (0.62%, 95% CI: 0.01, 1.22). No differences by sex were detected.

CONCLUSIONS

Effect sizes are not large, but early detection of increased CVD risk in this relatively young population is notable and worthy of further study to inform the clinical response.

Relationship between abuse and neglect in childhood and diabetes in adulthood: differential effects by sex, national longitudinal study of adolescent health

INTRODUCTION

Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults.

METHODS

We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate.

RESULTS

Although the prevalence of diabetes was similar for men and women (7.0% vs 6.7%), men were more likely than women to have prediabetes (36.3% vs 24.6%; omnibus P < .001). Among men, recurrent sexual abuse (≥3 lifetime incidents) was significantly associated with diabetes (OR, 3.66; 95% CI, 1.31-10.24), but not with prediabetes. There was no evidence of mediation by BMI. No forms of child abuse or neglect were associated with diabetes or prediabetes among women.

CONCLUSIONS

Recurrent sexual abuse is robustly associated with diabetes in young adult men, independently of other forms of child abuse or neglect and BMI. Future research should explore other potential mechanisms for this association to identify avenues for prevention of diabetes among men who have experienced sexual abuse.