Child Maltreatment, Peer Victimization, and Mental Health: Neurocognitive Perspectives on the Cycle of Victimization

Atypical brain structural connectivity and social cognition in childhood maltreatment and peer victimisation

BACKGROUND

Childhood maltreatment (CM) is associated with neurobiological aberrations and atypical social cognition. Few studies have examined the neural effects of another common early-life interpersonal stressor, namely peer victimisation (PV). This study examines the associations between tract aberrations and childhood interpersonal stress from caregivers (CM) and peers (PV), and explores how the observed tract alterations are in turn related to affective theory of mind (ToM).

METHODS

Data from 107 age-and gender-matched youths (34 CM [age = 19.9 ± 1.68; 36%male], 35 PV [age = 19.9 ± 1.65; 43%male], 38 comparison subjects [age = 20.0 ± 1.66; 42%male] were analysed using tractography and whole-brain tract-based spatial statistics (TBSS).

RESULTS

At the whole-brain level using TBSS, the CM group had higher fractional anisotropy (FA) than the PV and comparison groups in a cluster of predominantly limbic and corpus callosal pathways. Segmented tractography indicated the CM group had higher FA in right uncinate fasciculus compared to both groups. They also had smaller right anterior thalamic radiation (ATR) tract volume than the comparison group and higher left ATR FA than the PV group, with these metrics associated with higher emotional abuse and enhanced affective ToM within the CM group, respectively. The PV group had lower inferior fronto-occipital fasciculus FA than the other two groups, which was related to lower affective ToM within the PV group.

CONCLUSION

Findings suggest that exposure to early-life stress from caregivers and peers are differentially associated with alterations of neural pathways connecting the frontal, temporal and occipital cortices involved in cognitive and affective control, with possible links to their atypical social cognition.

Childhood maltreatment and Internet addiction among Chinese adolescents: A moderated mediation model

Although childhood maltreatment has been suggested to play an important role in developing Internet addiction among adolescents, little is known about the mediating and moderating mechanisms underlying this association. The present study investigated (a) the mediating role of maladaptive cognitive emotion regulation strategy (MCERS) in the association between childhood maltreatment and Internet addiction, and (b) the moderating role of peer support in the relationship between childhood maltreatment and Internet addiction. A sample of 4163 Chinese adolescents (50.3 % females, Mage = 14.25, SD = 1.53) were recruited. The moderated mediation model showed that MCERS mediated the relationship between childhood maltreatment and Internet addiction. Furthermore, the mediating process was moderated by peer support. Interestingly, peer support can protect adolescents from being affected by higher levels of MCERS while it displays limited protective effect when adolescents suffered from higher levels of childhood maltreatment. These findings indicate that reducing the MCERS and enhancing peer support can contribute to the alleviation of negative influences of childhood maltreatment on Internet addiction.

Coping strategies in response to peer victimization: Comparing adolescents in the United States and Korea

We examined cultural specificity in how adolescents' coping strategies in response to peer victimization are associated with adjustment with a sample of 7th-8th graders from the United States (n = 292, 60% female, Mage  = 13.6, SD = 0.65) and South Korea (n = 462, 50.2% female, Mage  = 13.7, SD = 0.58). Participants read scenarios describing victimization and rated the likelihood of utilizing different coping strategies. US adolescents rated conflict resolution, cognitive distancing, and revenge higher than Korean adolescents, while Korean adolescents endorsed social support seeking more than US adolescents. Social support seeking was positively associated with global self-worth in both countries; however, social support seeking was negatively related to depression and social anxiety only for Korean youth.

Concurrent and longitudinal associations of developmental language disorder with peer victimization in adolescence: evidence from a co-twin study

BACKGROUND

Children with developmental language disorder (DLD) experience higher levels of peer victimization than their peers. However, it is not known if such associations reflect genetic and environmental confounding. We used a co-twin control design to investigate the association of language difficulties (DLD and separately poor pragmatic language) with peer victimization and compare the developmental trajectories of peer victimization across adolescence for those with and without language difficulties.

METHODS

Participants were 3,400 pairs of twins in the Twins Early Development Study (TEDS), a UK-based population birth cohort. Language abilities were assessed via online tests at age 11 and peer victimization was self-reported at ages 11, 14 and 16. Language difficulties were defined as language abilities at least -1.25 SD below the mean of the TEDS sample. We performed linear regressions and latent growth curve modeling at a population level and within monozygotic and same-sex dizygotic twin pairs.

RESULTS

At population level, youth with DLD experienced higher levels of peer victimization at ages 11 (β = 0.27, 95% Confidence Interval (CI) 0.20-0.35), 14 (β = 0.15, 95% CI 0.03-0.27) and 16 (β = 0.17, 95% CI 0.03-0.32) and a sharper decline in peer victimization between ages 11 and 16 compared to their peers without DLD. The associations between DLD and peer victimization were reduced in strength and not statistically significant in within-twin models. Moreover, there was no difference in the rate of change in peer victimization between twin pairs discordant for DLD. Results were similar for the association of poor pragmatic language with peer victimization.

CONCLUSIONS

Associations between language difficulties (DLD and separately, poor pragmatic language) and peer victimization were confounded by genetic and shared environmental factors. Identifying specific factors underlying these associations is important for guiding future work to reduce peer victimization among adolescents with language difficulties.

Heightened response to positive facial cues as a potential marker of resilience following childhood adversity

Background: Childhood maltreatment profoundly influences social and emotional development, increasing psychiatric risk. Alterations in the implicit processing of threat-related cues following early abuse and neglect represent a marker of mental health vulnerability. Less is known about how early adversity influences the perception of positive social cues, despite their central role in establishing and maintaining social interactions and their association with better mental health outcomes.Methods: The sample consisted of 42 children and adolescents with substantiated childhood maltreatment experiences and 32 peers (mean age 13.3), matched on age, pubertal status, gender, socioeconomic status, ethnicity, and cognitive ability. A computerised experimental task assessed the perceived emotional intensity of positive (happy) and negative (fearful) facial expressions. Mental health symptoms were measured via self- and parental reports, and perceived social support was self-reported.Results: The experience of abuse and neglect was associated with heightened perceived intensity of positive facial cues. Cross-sectional post-hoc moderation and mediation analyses, employing a model-building approach, revealed that in maltreatment-exposed participants: (i) their increased response to positive facial cues was associated with lower symptoms; (ii) the presence of social support accounted for their heightened perceived intensity of positive facial cues; (iii) the presence of social support putatively contributed to lower symptoms by increasing the perceived intensity of positive facial cues. No group differences in perceived intensity of negative expressions were observed.Conclusions: These findings provide fresh insight into how positive faces are processed following maltreatment experience in childhood. Maltreatment experience was found to be associated with heightened perceived intensity of happy faces, which in turn was associated with better mental health and greater levels of social support. This suggests that heightened saliency of positive emotions acts protectively in children with maltreatment experience.

Atypical Interpersonal Problem-Solving and Resting-state Functional Connectivity in Adolescents with Maltreatment Experience

BACKGROUND

Childhood maltreatment is associated with altered neurocognitive functioning, which is thought to reflect, in part, adaptation to early adverse environmental experiences. However, we continue to lack a precise mechanistic understanding linking atypical neurocognitive processing with social functioning and psychiatric outcomes following early adversity.

OBJECTIVE

The present work investigated interpersonal problem-solving, resting-state functional connectivity (rsFC), and mental health symptoms in adolescents with documented maltreatment experience and explored whether altered neural function contributes in part to poorer social functioning.

METHODS

Forty adolescents (aged 12-17) with documented experiences of abuse or neglect and a carefully matched group of 42 non-maltreated peers participated in this study that measured task-based interpersonal problem-solving skills and rsFC.

RESULTS

Adolescents with maltreatment experience showed poorer interpersonal problem-solving performance, which partly accounted for their elevated mental health symptoms. Resting-state seed-based analyses revealed that adolescents with maltreatment experience showed a significant increase in rsFC between medial Default Mode Network (DMN) hubs, the medial prefrontal cortex (mPFC), with a posterior cluster, including the posterior cingulate cortex (PCC), precuneus (PCu), retrosplenial cortex (RSC), and lingual gyrus (LG). Moderation analyses revealed that maltreatment-related increased DMN rsFC partly accounted for poorer performance in interpersonal problem-solving.

CONCLUSION

Poorer interpersonal problem-solving, partly accounted for by atypical coupling between DMN medial hubs, was associated with maltreatment exposure. Interventions tailored to enhance interpersonal problem-solving represents a promising avenue to promote resilience and reduce the likelihood of mental health disorder following maltreatment experience.

Developmental Pathway from Childhood Abuse to Adolescent Peer Victimization: The Role of Rejection Sensitivity and Aggression

Despite the well-established relationship between early experiences of victimization and later re-victimization, little is known about the exact mechanism of this cycle of victimization. The present study examined whether the route from rejection sensitivity to aggression mediates the associations between different forms of childhood abuse and later peer victimization longitudinally. A total of 3525 adolescents (56.6% male; Mage = 13.21 ± 0.85) participated in this three-wave study, with a 6-month lag and a 9-month lag respectively. The results indicated that the association between childhood emotional abuse and peer victimization were independently mediated by aggression, and sequentially mediated by rejection sensitivity and aggression in both sexes. Sex differences existed regarding the association between childhood physical abuse and aggression, such that only in adolescent boys did physical abuse show significant effect on aggression, resulting in later peer victimization. In general, these findings suggest that maladaptive social-cognitive processes and behavioral patterns are crucial for understanding the mechanism of the vicious cycle of victimization, and sex differences must be considered when examining different types of childhood abuse.

Longitudinal correlates of bullying victimization among Chinese early adolescents: A cross-lagged panel network analysis

BACKGROUND

Bullying victimization is a major public health issue often faced by adolescents. This highlights the need to identify the relevant risk factors to inform intervention. Based on the ecological systems theory and applied cross-lagged panel network analysis, this study explored the longitudinal correlates of bullying victimization among Chinese early adolescents.

METHODS

A total of 1686 early adolescents (60.4 % were boys) from the Chinese Early Adolescent Cohort study were included in this study. Bullying victimization and its associated factors were assessed using the self-report questionnaires, which was administered from 2019 (T1), 2021 (T2), and 2022 (T3). The longitudinal relationships between bullying victimization and its correlates were examined using a cross-lagged panel network analysis.

RESULTS

27.0 %, 14.9 %, and 13.2 % of the participants reported being bullied by peers at T1, T2, and T3, respectively. The temporal network suggested that individual-level (sex, depression, and anxiety), family-level (child abuse), school-level (satisfaction with classmates), and social-level (satisfaction with society) factors were associated with bullying victimization. The node with the greatest centrality strength was anxiety. Notably, relationship with teachers and classmates were the unique nodes in the T2 → T3 replication network.

LIMITATIONS

The sample is unrepresentative, as it is from only one middle school.

CONCLUSIONS

The findings provide important insights into bullying victimization prevention and intervention among Chinese early adolescents: 1) highlighting the importance of joint interventions across multiple departments; 2) focusing on the most central factors of bullying victimization; and 3) considering the effect of time when exploring the correlates of bullying victimization.

Pathways from Polyvictimization to Offline and Online Sexual Harassment Victimization Among South Korean Adolescents

This study aimed to investigate the association between polyvictimization and offline and online sexual harassment and whether the association might be mediated by internalizing problems, low school satisfaction, and dropping out of school. The analytic sample was derived from the Children and Youth Rights Survey in South Korea. It consisted of 6353 adolescents' responses to the sexual harassment question and a set of other questions in the middle and high school questionnaires. The findings showed a direct association between polyvictimization and offline and online sexual harassment. Adolescents who were polyvictimized were more likely to be victims of both forms of sexual harassment. Furthermore, polyvictimization was positively related to dropping out of school, which was positively associated with offline sexual harassment. The findings from the study have significant implications for future research and practice.

Relationship between Harsh Parenting and Aggressive Behaviors in Male Juvenile Delinquents: Potential Mediating Roles of Peer Victimization and Hostile Attribution Bias

Harsh parenting can be regarded as a harsh behaviors, feelings, and attitudes toward children in the process of parenting. According to the theory of intergenerational transmission of violence, harsh parenting is an important factor affecting children's aggressive behavior, but the theory does not clarify the specific action path between harsh parenting and aggressive behavior. In order to reveal the relationship between harsh parenting and the aggressive behavior of juvenile delinquents, 604 male juvenile delinquents (N = 604; M_age = 16.57 years; SD = 0.612 years) were investigated using the Harsh Parenting Questionnaire, the Buss-Perry Aggression Questionnaire, the Multidimensional Peer Victimization Scale, and the Word Sentence Association Paradigm for Hostility in Chinese. Analysis using structural equation modeling procedures showed that (a) all variables were positively associated with each other; (b) the partial indirect effect of harsh parenting on aggressive behaviors was determined through the mediators of peer victimization and hostile attribution bias independently; and (c) the partial indirect effect was determined through the mediators of peer victimization and hostile attribution bias sequentially. The results suggest that harsh parenting can explain the highly aggressive behavior of male juvenile delinquents. Moreover, harsh parenting may also predict the risk of peer victimization and hostile attribution bias, thereby predicting the development of highly aggressive behaviors.

Maternal Impaired Cognition and Infant Neglect: Exploring the Independent and Combined Effects of Maternal Executive Function and Reflective Function

Infant neglect is a common type of child maltreatment. According to the Social Information Processing theory, maternal executive function (EF) and reflective function (RF) are assumed to be important contributing factors to infant neglect. However, empirical evidence about this assumption is sparse. This was a cross-sectional study. A total of 1010 eligible women participated. The Behavior Rating Inventory of Executive Function-Adult Version, Parental Reflective Function Questionnaire, and Signs of Neglect in Infants Assessment Scale (SIGN) were used to assess maternal EF, RF, and infant neglect, respectively. Random forest was used to assess the relevant importance of maternal EF and RF. K-means clustering was used to identify the profiles of maternal EF and RF. Multivariable linear regression and generalized additive models were used to examine the independent and combined effects of maternal EF and RF on infant neglect. Each dimension of EF was linearly related to infant neglect. The associations between each dimension of RF and infant neglect were nonlinear. The inflection point for each dimension of RF was indicated. Random forest showed EF was more closely related to infant neglect. EF and RF had accumulative effects on infant neglect. Three profiles were identified. Among them, those with globally impaired EF had the highest level of infant neglect compared with those who had normal cognition or only impaired RF. Maternal EF and RF had independent and combined effects on infant neglect. Interventions with maternal EF and RF as targets are promising for reducing infant neglect.

Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance

BACKGROUND

Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown.

OBJECTIVE

Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings.

METHODS

Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation).

RESULTS

The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings.

CONCLUSIONS

The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f² = .16 for evaluation; f² = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.

A pilot randomized controlled trial comparing a novel compassion and metacognition approach for schizotypal personality disorder with a combination of cognitive therapy and psychopharmacological treatment

BACKGROUND

Schizotypal personality disorder is characterized by a pervasive pattern of maladaptive behavior that has been associated with the liability for schizophrenia. Little is known about effective psychosocial interventions. This pilot non-inferiority randomized controlled trial aimed to compare a novel form of psychotherapy tailored for this disorder and a combination of cognitive therapy and psychopharmacological treatment. The former treatment - namely, Evolutionary Systems Therapy for Schizotypy-integrated evolutionary, metacognitively oriented, and compassion focused approaches.

METHODS

Thirty-three participants were assessed for eligibility, twenty-four randomized on a 1:1 ratio, nineteen included in the final analysis. The treatments lasted 6 months (24 sessions). The primary outcome was change across nine measurements in personality pathology, the secondary outcomes were remission from diagnosis and pre-post changes in general symptomatology and metacognition.

RESULTS

Primary outcome suggested a non-inferiority of the experimental treatment in respect to control condition. Secondary outcomes reported mixed results. There was no significant difference in terms of remission, but experimental treatment showed a larger reduction of general symptomatology (η² = 0.558) and a larger increase in metacognition (η² = 0.734).

CONCLUSIONS

This pilot study reported promising results about the effectiveness of the proposed novel approach. A confirmatory trial on large sample size is needed to provide evidence about relative effectiveness of the two treatment conditions.

TRIAL REGISTRATION

ClinicalTrials.gov; NCT04764708; Registration day 21/02/2021.

Social thinning and stress generation after childhood maltreatment: a neurocognitive social transactional model of psychiatric vulnerability

Childhood maltreatment is associated with significant, enduring risk of psychiatric disorder. In this paper, we review how neurocognitive alterations after maltreatment might indirectly increase the risk of psychiatric disorder via their impact on social functioning. We propose a neurocognitive social transactional model, within which the neurocognitive sequelae of maltreatment are postulated to affect how an individual's social architecture is constructed across development, including the quality and quantity of relationships in an individual's social network. We review extant evidence in two areas in relation to maltreatment: stress generation (a process by which individuals are more likely to experience interpersonal stressor events) and social thinning (an attenuation in the number and quality of relationships over time). We consider how neurocognitive alterations could contribute to these interactive and autocatalytic social processes, which gradually impoverish an individual's actual or potential social environment and ultimately increase psychiatric risk. We conclude by considering the implications of this neurocognitive social transactional model for the prevention of psychiatric disorder after childhood maltreatment.

Early life adverse experiences and loneliness among young adults: The mediating role of social processes

Loneliness has been described as endemic among young people. Such feelings of social isolation 'even in a crowd' are likely linked to adverse early life experiences that serve to diminish perceptions of social support and intensify negative social interactions. It was suggested in the present series of survey studies that childhood abuse, which compromises a child's sense of safety in relationships, may affect social processes that contribute to loneliness in young adulthood. Study 1 assessed different adverse childhood and adult experiences in relation to loneliness among young adults (N = 171). Linear regression analyses indicated that childhood abuse was uniquely associated with greater loneliness, and this relationship was partially mediated by the perceived availability of social support. Study 2 (N = 289) assessed different forms of childhood abuse and demonstrated that early life emotional abuse was a unique predictor of loneliness, and this relationship was fully mediated by lower perceived support or value in social connections (social connectedness) and more frequent unsupportive interactions with friends. Study 3 evaluated the implications of the age of occurrence of abuse (N = 566). Both emotional and sexual abuse predicted young adult loneliness regardless of age; abuse that was recalled to have occurred at very early ages (0-5 years) was not predictive of loneliness over and above consideration of events that happened in older childhood. These relationships were at least partially mediated by perceived social support, social connectedness, and in the case of emotional abuse, unsupportive interactions with friends. Our results add to mounting evidence pointing to the prevalence of loneliness among young adults and the links to adverse early life experiences that may serve to shape appraisals of safety, value, and personal worth in social relationships.

Working with Goals and Trauma in Youth Mental Health

There is good evidence of the value of working with goals in youth mental health services and settings. As such, goal-oriented practice is seen as a core component of good mental health interventions. Yet, there is debate among clinicians and academics about whether working with goals is a valid approach with clients who have experienced trauma. In this paper, I will explore the impacts of trauma and argue that working with goals, including the use of tools that facilitate these practices, such as the Goal-Based Outcome (GBO) tool, is as vital when working in trauma-informed interventions, as with any other mode of practice or client group.

Examining the common and specific grey matter abnormalities in childhood maltreatment and peer victimisation

BACKGROUND

Early-life interpersonal stress, particularly childhood maltreatment, is associated with neurobiological abnormalities. However, few studies have investigated the neural effects of peer victimisation.

AIMS

This study examines common and specific associations between childhood maltreatment, peer victimisation and brain structural alterations in youths.

METHOD

Grey matter volume (GMV) and cortical thickness data were collected from 105 age- and gender-matched youths (age range: 17-21 years). Region-of-interest and whole-brain analyses were conducted.

RESULTS

For the region-of-interest analyses, the childhood maltreatment group had smaller GMV than controls in left inferior frontal gyrus, bilateral anterior insula, postcentral and lingual regions, which were associated with greater emotional abuse, along with smaller insular GMV than the peer victimisation group, who had smaller left lingual and postcentral GMV than controls. At the whole-brain level, both childhood maltreatment and peer victimisation groups had smaller GMV than controls in a cluster comprising left post/precentral, inferior frontal gyrus, insula, superior parietal and supramarginal gyri. The peer victimisation group alone had increased cortical thickness in a cluster comprising left superior frontal, anterior cingulate and medial orbitofrontal gyri, which was related to greater cyberbullying.

CONCLUSIONS

Early-life interpersonal stress is associated with common structural alterations of the inferior frontal-limbic, sensory and lingual regions involved in cognitive control, emotion and sensory processing. The findings of childhood-maltreatment-related reduced anterior insular GMV and peer-victimisation-related increased cortical thickness in the left medial prefrontal-anterior cingulate cluster underscore the distinctive negative effects of childhood maltreatment and peer victimisation, and suggest that peer victimisation, particularly cyberbullying, could be as detrimental as childhood maltreatment.

Canada's Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes

The policies and actions that were enacted to colonize Indigenous Peoples in Canada have been described as constituting cultural genocide. When one considers the long-term consequences from the perspective of the social and environmental determinants of health framework, the impacts of such policies on the physical and mental health of Indigenous Peoples go well beyond cultural loss. This paper addresses the impacts of key historical and current Canadian federal policies in relation to the health and well-being of Indigenous Peoples. Far from constituting a mere lesson in history, the connections between colonialist policies and actions on present-day outcomes are evaluated in terms of transgenerational and intergenerational transmission processes, including psychosocial, developmental, environmental, and neurobiological mechanisms and trauma responses. In addition, while colonialist policies have created adverse living conditions for Indigenous Peoples, resilience and the perseverance of many aspects of culture may be maintained through intergenerational processes.

Don't get too close to me: depressed and non-depressed survivors of child maltreatment prefer larger comfortable interpersonal distances towards strangers

BACKGROUND

Childhood maltreatment (CM) is frequently linked to interpersonal problems such as difficulties in social relationships, loneliness, and isolation. These difficulties might partly stem from troubles regulating comfortable interpersonal distance (CIPD).

OBJECTIVE

We experimentally investigated whether CM manifests in larger CIPD and whether all subtypes of CM (i.e., physical, emotional, or sexual abuse and physical or emotional neglect) affect CIPD.

METHODS

Using the stop-distance method (i.e. a team member approached participants until the latter indicated discomfort), we assessed CIPD in 84 adults with a self-reported history of CM (24 with depressive symptoms) and 57 adult controls without a history of CM (without depressive symptoms).

RESULTS

Adults with CM showed a larger CIPD (Mdn = 86 cm) than controls (Mdn = 68 cm), and CIPD was largest for those with CM combined with current depressive symptoms (Mdn = 145 cm) (p's < .047). In the latter group, all subtypes of CM were associated with a larger CIPD compared to controls (p's < .045). In the CM group without depressive symptoms, only those with emotional abuse (p = .040) showed a larger CIPD than controls.

CONCLUSIONS

These results add to findings of differential socio-emotional long-term consequences of CM, depending upon the subtype of CM. Future research should explore whether a larger CIPD has a negative impact on social functioning in individuals exposed to CM, particularly in those with depressive symptoms.

HIGHLIGHTS

Adults with child maltreatment (CM) prefer larger physical distances.• This effect is more pronounced in those with CM and depressive symptoms.• Troubled regulation of physical distance might contribute to interpersonal problems.

A Gap Between Children's Rights and Curricular Content in Health, Social Care, and Teacher Education Programs: An Exploratory Cross-Sectional Study

INTRODUCTION

Exposure to child maltreatment is a social and public health challenge that will require interprofessional collaboration to overcome. Evidence indicates that professional students in health, social care, and teacher education programs receive inadequate training in recognizing and responding to child maltreatment. The aims are to 1) assess the extent to which these students found that their uniprofessional education and a large-scale interprofessional learning (IPL) course had taught them about children in general, children's rights, and vulnerable/at-risk children; and 2) explore differences in student responses according to age and educational background.

METHODS

A cross-sectional study. Students (n=2811) completed questionnaires prior to or after IPL courses held in 2019 and 2020 (hybrid case-based, small-group, on-campus courses targeting children, young people, and their families as end users).

FINDINGS

The majority (>90%) agreed that it was important to learn about child-related topics. Only 4.3% disagreed that it was important to learn about vulnerable/at-risk children. Health and social care students enhanced their insight into all the child-related topics (p<0.001) after the IPL course. Teacher education and child welfare students reported decreased insight into children in general (p<0.001 in 2019 and p=0.008 in 2020) but increased insight into vulnerable/at-risk children in 2020 (p=0.001). According to stratified analyses, there was a significantly increased insight into all child-related topics among physiotherapy and Mensendieck physiotherapy students (p<0.001), decreased insight into children in general among teacher education students (p<0.02), and increased insight into vulnerable/at-risk children among teacher education students (p ≤ 0.001) in both 2019 and 2020. Age was of minor importance. The response rates ranged from 16.0% to 36.0%.

CONCLUSION

After the IPL course, the health and social care students significantly enhanced their insight into child-related topics, whereas the students in teacher education and child welfare gained increased insight into vulnerable/at-risk children.