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Mori C, Park J, Racine N, Ganshorn H, Hartwick C, Madigan S. Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis. Child Abuse Negl 2023; 143:106255. [PMID: 37343427 DOI: 10.1016/j.chiabu.2023.106255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/10/2023] [Accepted: 05/20/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children. OBJECTIVE To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention. PARTICIPANTS AND SETTING Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa. METHODS A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies. RESULTS Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females. CONCLUSIONS Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.
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Affiliation(s)
- Camille Mori
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 28 Oki Dr NW, Calgary, Alberta T3B 6A8, Canada.
| | - Julianna Park
- Department of Psychology, Queen's University, 99 University Ave, Kingston, ON K7L 3N6, Canada.
| | - Nicole Racine
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier 4087, Ontario K1N 6N5, Canada.
| | - Heather Ganshorn
- Libraries and Cultural Resources, Taylor Family Digital Library, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
| | - Cailey Hartwick
- Child Abuse Service, Luna Child and Youth Advocacy Centre, 400-3820 24 Ave NW, Calgary, Alberta T3B 2X9, Canada.
| | - Sheri Madigan
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 28 Oki Dr NW, Calgary, Alberta T3B 6A8, Canada.
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Racine N, Madigan S, Cardinal S, Hartwick C, Leslie M, Motz M, Pepler D. Community-based research: Perspectives of psychology researchers and community partners. Canadian Psychology/Psychologie canadienne 2022. [DOI: 10.1037/cap0000318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Racine N, Dimitropoulos G, Hartwick C, Eirich R, van Roessel L, Madigan S. Characteristics and Service Needs of Maltreated Children Referred for Mental Health Services at a Child Advocacy Centre in Canada. J Can Acad Child Adolesc Psychiatry 2021; 30:92-103. [PMID: 33953761 PMCID: PMC8056957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE There is a dearth of Canadian-based literature on children referred to treatment services following maltreatment exposure. In order to inform assessment, intervention, and program development to improve outcomes, insight into the demographics and mental health needs of this population is required. METHODS A retrospective file review of 176 children and youth who were referred for assessment and treatment at a mental health partner agency within a Canadian Child Advocacy Centre was conducted from January 2016 to June 2017. A standardized protocol was developed to extract data on family and child demographic characteristics, type of maltreatment, other adversity exposure, presenting concerns of the child, and mental health service utilization. RESULTS The majority of children were female (66.5%), 4.5% were 0 to <5 years, 66.5% were 5 to <13 years, and 29.0% were 13 to <18 years of age. More than half of the children (53.4%) had multiple forms of maltreatment, with 67% exposed to sexual abuse. Exposure to other forms of adversity was also common, including domestic violence (53.4%) and parental mental health difficulties (52.3%). Most children had more than five presenting concerns at the time of referral, and most went on to receive intervention services. Sixty-nine percent of families had not previously received child mental health treatment, although 41.5% had prior child welfare involvement. Thirty percent of families ended treatment prematurely. CONCLUSIONS The current study illustrates the complex profile and mental health needs of children referred for treatment following maltreatment exposure. Results may have implications for clinical care improvement that support maltreated children.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Alberta, The Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta
| | - Cailey Hartwick
- Child Abuse Service, Alberta Health Services, Calgary, Alberta
| | | | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute
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Racine N, Zhu J, Hartwick C, Madigan S. Differences in Demographic, Risk, and Protective Factors in a Clinical Sample of Children who Experienced Sexual Abuse Only vs. Poly-victimization. Front Psychiatry 2021; 12:789329. [PMID: 35095603 PMCID: PMC8791394 DOI: 10.3389/fpsyt.2021.789329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Children exposed to child sexual abuse (CSA) vary considerably with regards to their presenting concerns and treatment needs. One factor creating heterogeneity amongst children experiencing CSA is their history of experiencing other victimizations (i.e., poly-victimized or not). However, little is known about risk factors for poly-victimization as well as differences in protective factors among these two groups. Additionally, there is currently limited understanding of whether poly-victimization is associated with greater trauma symptoms in children exposed to CSA and being seen for trauma treatment. Using a clinical sample of 117 children who were sexually abused (64 CSA only and 53 poly-victimized) ranging from age 3-18 years, the current study examined demographic characteristics, abuse characteristics, trauma symptoms, and protective factors using casefile review methodology. After accounting for other risk factors, parental abuse history and protective factors were significantly associated with child poly-victimization status. Children exposed to poly-victimization were more likely to have financial concerns χ ( 1 , 115 ) 2 = 4.16, p = 0.04, parents with abuse histories χ ( 1 , 117 ) 2 = 8.93, p = 0.003, and parents with histories of mental health or substance use difficulties χ ( 1 , 117 ) 2 = 4.02, p = 0.045. Although cumulative trauma symptoms scores were higher for children who were poly-victimized compared to CSA only, t (115) = -2.24, p = 0.03, multiple regression analyses showed that poly-victimization status was not significantly associated with child trauma symptoms after accounting for other demographic and abuse characteristics. Assessing and understanding the extent to which children exposed to CSA have experienced other forms of maltreatment is critical for identifying children who may be most at risk of poor outcomes.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Cailey Hartwick
- Child Abuse Service, Alberta Children's Hospital, Alberta Health Services, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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Racine N, Hartwick C, Collin-Vézina D, Madigan S. Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations. Child Abuse Negl 2020; 110:104698. [PMID: 32839022 PMCID: PMC7437482 DOI: 10.1016/j.chiabu.2020.104698] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/12/2020] [Accepted: 08/15/2020] [Indexed: 05/07/2023]
Abstract
The ongoing COVID-19 pandemic has led to unprecedented disruptions and stress in the lives of children and families internationally. Heightened family stress and turmoil can increase risk for, and exacerbate, child maltreatment. As a result, child maltreatment experts are concerned that there will be an influx of children requiring trauma assessment and treatment during and after COVID-19. As physical distancing measures have been implemented and will likely persist into 2021, organizations providing trauma treatment to children and their families have had to rapidly pivot to telemental health to maintain service delivery with clients. While the benefits of telemental health have been identified, including reduced barriers to access, increased cost effectiveness, and broad availability of services, there are unique limitations to its implementation within a child maltreatment population, such as challenges with attention and emotion regulation skills, difficulties identifying dissociative symptoms, and increased time with perpetrators of abuse due to shelter in place orders. These limitations are exacerbated for children and families who are most marginalized and facing the highest levels of social and economic barriers. Lack of access to reliable technology, lack of a private or confidential space for sessions, and reluctance to process trauma in the absence of a safe environment, are all barriers to conducting effective trauma treatment over telemental health. This article discusses both the benefits and barriers to telemental health in a child maltreatment population and offers considerations for child trauma service provision, program development, and policy during and post the COVID-19 pandemic.
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Affiliation(s)
- Nicole Racine
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada
| | - Cailey Hartwick
- Child Abuse Service, Alberta Children's Hospital, 3820 24 Avenue NW, T2P 2M5, Calgary, AB, Canada
| | - Delphine Collin-Vézina
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada; Child Abuse Service, Alberta Children's Hospital, 3820 24 Avenue NW, T2P 2M5, Calgary, AB, Canada; School of Social Work, McGill, University, 3506 University Street, Room 321A, Montreal, Quebec, H3A2A7, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada.
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Racine N, Eirich R, Dimitropoulos G, Hartwick C, Madigan S. Development of trauma symptoms following adversity in childhood: The moderating role of protective factors. Child Abuse Negl 2020; 101:104375. [PMID: 32014798 DOI: 10.1016/j.chiabu.2020.104375] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Although the buffering effect of protective factors on children's outcomes following exposure to adverse childhood experiences has been well documented, research gaps remain as to whether this buffering effect differs based on the type of adversity experienced (i.e., maltreatment versus household dysfunction). OBJECTIVE To examine whether protective factors moderate the association between cumulative adversity, as well as adversity subtypes (i.e., maltreatment and household dysfunction) and child trauma-related distress in a clinical sample referred for treatment following exposure to adversity. PARTICIPANTS AND SETTING One-hundred and seventy-six children (aged 3-18) referred to a child abuse treatment clinic and who's files were opened between January 2016 and June 2017 were included. METHODS Data were collected, extracted, and coded from clinical files using a standardized data extraction protocol. Protective factors included: using individual coping strategies, peer support, individual social skills, caregiver physical caregiving, caregiver psychological caregiving, and educational involvement. RESULTS Cumulative childhood adversity (b = .16, p = .04) positively predicted child trauma-related distress. The link between exposure to cumulative adversity and child trauma-related distress varied as a function of protective factors: there was a positive association between adversity and child trauma-related distress for children who had low levels of protective factors, but not for those with high levels of protective factors (b=-0.56, p=<.001). Similar findings were observed when data was stratified by maltreatment and household dysfunction. CONCLUSIONS Bolstering children's protective factors prior to, and during child abuse treatment, may reduce trauma-related distress following exposure to adversity.
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Affiliation(s)
- Nicole Racine
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada
| | - Rachel Eirich
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Gina Dimitropoulos
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada
| | - Cailey Hartwick
- Child Abuse Service, Alberta Children's Hospital, 3820 24 Avenue NW, T2P 2M5, Calgary, AB, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9, Calgary, AB, Canada.
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Ferris R, Boyle L, Hartwick C, Lanham-New S, Moreno L, Fielding B, Hart K. Innovating nutrition education. Promoting food appreciation and nutrition to school-aged children at an international sporting event. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mazur-Mosiewicz A, Carlson HL, Hartwick C, Dykeman J, Lenders T, Brooks BL, Wiebe S. Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge. Epilepsia 2015; 56:735-44. [DOI: 10.1111/epi.12963] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Anya Mazur-Mosiewicz
- The Chicago School of Professional Psychology; Chicago Illinois U.S.A
- Alberta Children's Hospital; Calgary Alberta Canada
| | - Helen L. Carlson
- Alberta Children's Hospital; Calgary Alberta Canada
- Alberta Children's Hospital Research Institute; Calgary Alberta Canada
| | | | | | | | - Brian L. Brooks
- Alberta Children's Hospital; Calgary Alberta Canada
- Alberta Children's Hospital Research Institute; Calgary Alberta Canada
- University of Calgary; Calgary Alberta Canada
| | - Samuel Wiebe
- Foothills Medical Centre; Calgary Alberta Canada
- University of Calgary; Calgary Alberta Canada
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Bailey HN, DeOliveira CA, Wolfe VV, Evans EM, Hartwick C. The impact of childhood maltreatment history on parenting: a comparison of maltreatment types and assessment methods. Child Abuse Negl 2012; 36:236-46. [PMID: 22444714 DOI: 10.1016/j.chiabu.2011.11.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 09/15/2011] [Accepted: 11/07/2011] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Childhood maltreatment is associated with subsequent parenting difficulties; however, most research has relied on self-reported parenting outcomes, and observational measures have revealed mixed findings. Furthermore, research has focused predominantly on histories of sexual and/or physical abuse. This study explored associations between a wide range of childhood maltreatment experiences and both observed and self-reported parenting outcomes. METHODS Mothers of 4- to 6-year-old children at moderate social risk completed the History of Maltreatment and Trauma Form (HMTF), which assesses a range of maltreatment experiences and delineates specific characteristics such as chronicity and severity. Participants completed questionnaires assessing parenting stress and competence, and their emotional availability (sensitivity, intrusiveness, hostility) toward their children was coded from videorecorded interactions. RESULTS Construct (factorial, convergent and discriminant) validity of the HMTF was demonstrated through factor analysis and a multi-trait, multi-method matrix comparing it to the Childhood Trauma Questionnaire. HMTF-assessed childhood maltreatment, specifically witnessing family violence, neglect and emotional maltreatment, were significantly associated with mothers' observed hostility toward their children, even after controlling for potentially traumatic adult experiences. In contrast, childhood sexual abuse history was associated with self-reported concerns regarding parenting competence, and this association held even after controlling for other forms of childhood maltreatment and potentially traumatic adult experiences. Self-reported parenting outcomes were unrelated to observed parenting behavior. CONCLUSIONS Findings highlight the complexity of associations between child maltreatment and subsequent parenting outcomes. Although much previous research has focused on sexual and physical abuse, other more contextual forms of maltreatment may be similarly or more strongly associated with certain parenting outcomes. Furthermore, different forms of maltreatment may be associated with perceived versus observed parenting outcomes.
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Affiliation(s)
- Heidi N Bailey
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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