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Schilling S, Wood JN, Christian CW. Struggling to Stem the Tide of Child Maltreatment. JAMA 2024; 331:918-919. [PMID: 38502084 DOI: 10.1001/jama.2024.0899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Affiliation(s)
- Samantha Schilling
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Joanne N Wood
- Safe Place: The Center for Child Protection and Health, Policy Lab, Clinical Futures and Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Cindy W Christian
- Safe Place: The Center for Child Protection and Health, Policy Lab, Clinical Futures and Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
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Kim H, Drake B. Has the relationship between community poverty and child maltreatment report rates become stronger or weaker over time? Child Abuse Negl 2023; 143:106333. [PMID: 37379728 PMCID: PMC10651183 DOI: 10.1016/j.chiabu.2023.106333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/06/2023] [Accepted: 06/22/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Poverty is among the most powerful predictors of child maltreatment risk and reporting. To date, however, there have been no studies assessing the stability of this relationship over time. OBJECTIVE To examine whether the county-level relationship between child poverty rates and child maltreatment report (CMR) rates changed over time in the United States in 2009-2018, overall and across of child age, sex, race/ethnicity, and maltreatment type. PARTICIPANTS AND SETTING U.S. Counties in 2009-2018. METHODS Linear multilevel models estimated this relationship and its longitudinal change, while controlling for potential confounding variables. RESULTS We found that the county-level relationship between child poverty rates and CMR rates had intensified almost linearly from 2009 to 2018. Per one-percentage-point increase in child poverty rates, CMR rates significantly increased by 1.26 per 1000 children in 2009 and by 1.74 per 1000 children in 2018, indicating an almost 40 % increase in the poverty-CMR relationship. This increasing trend was also found within all subgroups of child age and sex. This trend was found among White and Black children, but not among Latino children. This trend was strong among neglect reports, weaker among physical abuse reports, and not found among sexual abuse reports. CONCLUSIONS Our findings highlight the continued, perhaps increasing importance of poverty as a predictor of CMR. To the degree that our findings can be replicated, they could be interpreted as supporting an increased emphasis on reducing child maltreatment incidents and reports through poverty amelioration efforts and the provision of material family supports.
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Affiliation(s)
- Hyunil Kim
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America.
| | - Brett Drake
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States of America
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Bruzelius E, Levy NS, Okuda M, Suglia SF, Martins SS. Prescription Drug Monitoring and Child Maltreatment in the United States, 2004-2018. J Pediatr 2022; 241:196-202. [PMID: 34678247 DOI: 10.1016/j.jpeds.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To test whether a policy approach aimed at decreasing prescription drug misuse, specifically, state monitoring of controlled substance prescriptions-prescription drug monitoring programs (PDMPs)-were associated with changes in Child Protective Services-reported maltreatment prevalence. STUDY DESIGN Using a difference-in-differences design and maltreatment data (2004-2018) from 50 states and the District of Columbia, we compared the prevalence of total maltreatment incidents and total victims, in states with and without PDMPs, before and after implementation. Exploratory analyses further examined models disaggregated by maltreatment type (neglect, physical abuse, sexual abuse, psychological abuse) and among different racial/ethnic groups. Quasi-Poisson models included state-level covariates, state- and year-fixed effects, and cluster-robust standard errors. RESULTS Difference-in-differences models identified greater relative reductions in PDMP states relative to controls (total prevalence ratio, 0.87; 95% CI, 0.80, 0.940; victimization prevalence ratio, 0.92; 95% CI, 0.85-0.98) over the observation period. Decreases seemed to be driven by changes in neglect (prevalence ratio, 0.87; 95% CI, 0.80-0.93) and physical abuse (prevalence ratio, 0.78; 95% CI, 0.71-0.87) incidents, and may have been especially salient for American Indian/Alaskan Native children (prevalence ratio, 0.78; 95% CI, 0.65-0.94). CONCLUSIONS We found evidence supporting an association between prescription drug monitoring and reduced maltreatment prevalence at the state level. Policies aimed at restricting the prescribing and dispensing of controlled substances may have indirect implications for child welfare.
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Affiliation(s)
| | - Natalie S Levy
- Department of Epidemiology, Columbia University, New York, NY
| | - Mayumi Okuda
- Department of Psychiatry, Columbia University, New York, NY
| | - Shakira F Suglia
- Department of Epidemiology, Rollings School of Public Health, Emory University, Atlanta, GA
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Augusti EM, Sætren SS, Hafstad GS. Violence and abuse experiences and associated risk factors during the COVID-19 outbreak in a population-based sample of Norwegian adolescents. Child Abuse Negl 2021; 118:105156. [PMID: 34139385 PMCID: PMC9757861 DOI: 10.1016/j.chiabu.2021.105156] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 11/10/2020] [Revised: 05/25/2021] [Accepted: 06/03/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The lockdowns occurring across society because of the COVID-19 pandemic have had far-reaching consequences for children and adolescents. One immediate concern was what the impact of the comprehensive disease control measures on rates of violence and abuse against children and adolescents would be. OBJECTIVE We aimed to establish rates of child abuse and degree of family conflict during the first COVID-19 lockdown spring 2020. Additionally, we aimed to investigate associations between preexisting and concurrent risk factors and abuse during these unique times. PARTICIPANTS AND SETTING A total of 3545 Norwegian 13- to 16-year-olds participated in this study. A total of 1944 of these had provided data 1 year before the lockdown. METHODS We used a web survey format to assess abuse exposure and associated risk factors. The survey was administered in schools during school hours in June 2020, shortly after the reopening of schools after the first lockdown. RESULTS In this sample 8.2% reported psychological abuse during lockdown, 2.4% had experienced physical abuse and 1.4% sexual abuse. For online sexual abuse, the rate was 5.6% during this time period. Adolescents did not report an increase in family conflict. Concurrently perceived family affluence and family risk factors were most strongly associated with physical abuse during lockdown (OR = 11.01(95% CI 5.32-22.84); OR = 5.36 (95% CI 2.69-10.67)), but also other types of child maltreatment. Analyses across assessment points suggested that prior victimization was the most accurate predictor of abuse experiences during lockdown (OR = 3.84 (95% CI 2.85-5.20)). CONCLUSIONS The negative consequences of the COVID-19 preventative measures struck the adolescent population unevenly. The findings underscore the need for targeted measures to mitigate the negative outcomes of health-related crises for adolescents in risk groups such as those with low family affluence and prior abuse experiences.
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Affiliation(s)
- Else-Marie Augusti
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
| | - Sjur Skjørshammer Sætren
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; CAMHS Sola, Division of Psychiatry, Stavanger University Hospital, Norway
| | - Gertrud S Hafstad
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Nguyen LH. Calculating the impact of COVID-19 pandemic on child abuse and neglect in the U.S. Child Abuse Negl 2021; 118:105136. [PMID: 34098378 PMCID: PMC9757860 DOI: 10.1016/j.chiabu.2021.105136] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/31/2020] [Revised: 04/13/2021] [Accepted: 05/23/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND COVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases. OBJECTIVES To estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020. METHODS Secondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs. RESULTS Prior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S. CONCLUSIONS The COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.
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Affiliation(s)
- Loc H Nguyen
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Montgomery Ross Fisher Building, Los Angeles, CA 90089-0411, United States of America; County Welfare Directors Association of California, 925 L Street, Suite 350, Sacramento, CA 95814-3701, United States of America.
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Salt E, Wiggins AT, Cooper GL, Benner K, Adkins BW, Hazelbaker K, Rayens MK. A comparison of child abuse and neglect encounters before and after school closings due to SARS-Cov-2. Child Abuse Negl 2021; 118:105132. [PMID: 34082194 PMCID: PMC9618451 DOI: 10.1016/j.chiabu.2021.105132] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Risk factors for child abuse and neglect and commonly used reporting mechanisms were highly affected by SARS-Cov-2 pandemic; yet, little is known about the effects of SARS-Cov-2 on rates of child abuse and neglect. OBJECTIVE To compare overall rates, demographics, types of abuse and acuity of child abuse and neglect encounters seen at one university health system for the 6 months before and after school closings due to the SARS-Cov-2 pandemic. PARTICIPANTS AND SETTING Data was extracted from a database of billed ICD10 codes for child abuse and neglect including sexual abuse codes. There were 579 encounters for patients <18 years of age and 476 unique patients. METHODS In addition to ICD10 code and pre/post school closing, each encounter was identified to be inpatient, outpatient and/or emergency department. Demographic data such as age, gender, ethnicity, and race were extracted. Incident rate ratios in addition to descriptive statistics, Mann-Whitney U test, two-sample t-test, or the chi-square test of association were used in the analysis. RESULTS No significant differences were identified for total rates of child abuse and neglect encounters (p = .08), physical abuse (p = .91) nor child maltreatment (p = .86) codes or in the age (p = .46), gender (p = .58), and race/ethnicity (p = .15) of patient encounters pre- versus post-school closings. The sexual abuse incidence and inpatient encounters increased by 85% (IRR = 1.85, p < .0001; IRR = 1.85, p = .004, respectively). CONCLUSIONS Our findings provide a unique contribution to the existing literature in that we identified a significant increase in the incidence of sexual abuse and higher patient acuity as evidenced by higher rates of inpatient encounters after school closing due to SARS-Cov-2.
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Affiliation(s)
- Elizabeth Salt
- University of Kentucky, College of Nursing, 315 College of Nursing Building, 751 Rose Street, Lexington, KY 40536-0232, United States.
| | - Amanda T Wiggins
- University of Kentucky, College of Nursing, 315 College of Nursing Building, 751 Rose Street, Lexington, KY 40536-0232, United States.
| | - Gena L Cooper
- University of Kentucky, Pediatric Emergency Department, College of Medicine, 800 Rose Street, Lexington, KY 40508, United States
| | - Kalea Benner
- University of Kentucky, College of Social Work, 619 Patterson Office Tower, Lexington, KY 40506, United States
| | - Brian W Adkins
- University of Kentucky, Emergency Department, College of Medicine, 800 Rose Street, Lexington, KY 40508, United States
| | - Katherine Hazelbaker
- University of Kentucky, College of Nursing, 315 College of Nursing Building, 751 Rose Street, Lexington, KY 40536-0232, United States.
| | - Mary Kay Rayens
- University of Kentucky, College of Nursing, 315 College of Nursing Building, 751 Rose Street, Lexington, KY 40536-0232, United States.
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Herrenkohl TI, Scott D, Higgins DJ, Klika JB, Lonne B. How COVID-19 Is Placing Vulnerable Children at Risk and Why We Need a Different Approach to Child Welfare. Child Maltreat 2021; 26:9-16. [PMID: 33025825 DOI: 10.1177/1077559520963916] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The onset of the COVID-19 pandemic brings new worries about the welfare of children, particularly those of families living in poverty and impacted other risk factors. These children will struggle more during the pandemic because of financial pressures and stress placed on parents, as well as their limited access to services and systems of support. In this commentary, we explain how current circumstances reinforce the need for systemic change within statutory child welfare systems and the benefits that would accrue by implementing a continuum of services that combine universal supports with early intervention strategies. We also focus on promising approaches consistent with goals for public health prevention and draw out ideas related workforce development and cross-sector collaboration.
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Affiliation(s)
- Todd I Herrenkohl
- 1259University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - Debbie Scott
- 2541Monash University, Richmond, Victoria, Australia
| | - Daryl J Higgins
- Institute of Child Protection Studies, 95359Australian Catholic University, Melbourne, Victoria, Australia
| | - J Bart Klika
- 141164Prevent Child Abuse America, Chicago, IL, USA
| | - Bob Lonne
- School of Health, 1319University of New England, Armidale, New South Wales, Australia
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Finkelhor D. Trends in Adverse Childhood Experiences (ACEs) in the United States. Child Abuse Negl 2020; 108:104641. [PMID: 32739600 DOI: 10.1016/j.chiabu.2020.104641] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 12/20/2019] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND It is important for those called upon to discuss major social determinants of health such as adverse childhood experiences (ACEs) to have accurate knowledge about generational trends in their prevalence. OBJECTIVE To review available trend data on major forms of ACEs. METHODS A search of academic data bases was conducted by combining the term "trend" with a variety of terms referring to childhood adversities. RESULTS Available trend data on ACEs from the 20th century show multi-decade declines in parental death, parental illness, sibling death, and poverty, but multi-decade increases in parental divorce, parental drug abuse and parental incarceration. More recent trend data on ACEs for the first fifteen to eighteen years of the 21st century show declines in parental illness, sibling death, exposure to domestic violence, childhood poverty, parental divorce, serious childhood illness, physical abuse, sexual abuse, physical and emotional bullying and exposure to community violence. Two 21st century ACE increases were for parental alcohol and drug abuse. Overall, there appear to have been more historical and recent improvements in ACEs than deteriorations. But the US still lags conspicuously behind other developed countries on many of these indicators. CONCLUSION Awareness of improvements, as well as persistent challenges, are important to motivate policy makers and practitioners and to prompt them to recognize the feasibility of success in the prevention of ACEs.
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Affiliation(s)
- David Finkelhor
- Crimes Against Children Research Center, University of New Hampshire, 125 McConnell Hall, 15 Academic Way, Durham, NH, 03824, United States.
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Makita K, Takiguchi S, Naruse H, Shimada K, Morioka S, Fujisawa TX, Shimoji K, Tomoda A. White matter changes in children and adolescents with reactive attachment disorder: A diffusion tensor imaging study. Psychiatry Res Neuroimaging 2020; 303:111129. [PMID: 32585578 DOI: 10.1016/j.pscychresns.2020.111129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/23/2020] [Accepted: 06/12/2020] [Indexed: 01/02/2023]
Abstract
Childhood maltreatment is associated with altered brain structure and function and is a major risk factor for psychopathology, including reactive attachment disorder (RAD). However, whether changes to white matter microstructural integrity are associated with RAD is unclear. We used diffusion tensor imaging (DTI) to assess group differences in fractional anisotropy (FA) in patients with RAD (n = 25; mean age = 13.2) to typically developing (TD) controls (n = 33; mean age = 13.0). To further interpret differences in FA, additional parameters such as mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were assessed. We found that FA values in the body of corpus callosum (CC) and in the projection and thalamic pathways, including the posterior limb of the internal capsule and corona radiata (anterior, posterior, and superior), were significantly higher in the RAD than in the TD group. Additionally, RAD group showed significantly lower RD values in the body of the CC and abovementioned pathways than TD group. Our findings indicate that RAD is associated with altered structure of the CC and projection and thalamic pathways, which may play a role in emotion regulation. The aberrant development of these tracts in RAD may reflect stress-related psychophysiological responses.
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Affiliation(s)
- Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shinichiro Takiguchi
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Hiroaki Naruse
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Fukui, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Shigemi Morioka
- Department of Pediatrics, Fukui Aiiku Hospital, Fukui, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Keigo Shimoji
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.
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Rodriguez CM, Wittig SMO, Silvia PJ. Refining social-information processing theory: Predicting maternal and paternal parent-child aggression risk longitudinally. Child Abuse Negl 2020; 107:104563. [PMID: 32682144 PMCID: PMC7494567 DOI: 10.1016/j.chiabu.2020.104563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/18/2020] [Accepted: 05/23/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Clarifying the pathways leading parents to engage in parent-child aggression (PCA) would benefit child abuse prevention efforts during the perinatal period. OBJECTIVE The present investigation empirically tested whether a social information processing (SIP) model could predict PCA risk from factors assessed in new mothers and fathers. PARTICIPANTS AND SETTING This study recruited a diverse sample of 201 primiparous mothers in the last trimester of their pregnancy along with 151 fathers. METHODS Using a prospective longitudinal study, the hypothesized SIP model was refined statistically using SIP factors measured prenatally to predict PCA risk when their children were 18 months. This refined model was then validated with SIP factors assessed when infants were 6 months to predict PCA risk when toddlers were 18 months. RESULTS In general, findings indicated poor empathy related to greater overreactivity and more negative child behavior attributions. Moreover, approval of PCA use, negative child attributions, less knowledge of non-physical discipline alternatives, and higher child compliance expectations predicted subsequent PCA risk. The proposed SIP model for mothers demonstrated considerable stability. Although SIP processes predicted paternal risk, several SIP relations changed over time for fathers. CONCLUSIONS Findings suggest comprehensive theoretical models like SIP theory can guide the specific processes to target for prevention and clarify how processes may be interconnected. SIP processes appear relevant and relatively stable targets for prevention and early intervention, particularly for mothers. SIP processes were applicable for fathers although the model was less consistent, suggesting work in examining paternal PCA risk remains an important research direction.
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Affiliation(s)
| | | | - Paul J Silvia
- University of North Carolina at Greensboro, United States
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Baldwin H, Biehal N, Allgar V, Cusworth L, Pickett K. Antenatal risk factors for child maltreatment: Linkage of data from a birth cohort study to child welfare records. Child Abuse Negl 2020; 107:104605. [PMID: 32590228 DOI: 10.1016/j.chiabu.2020.104605] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Understanding the risk factors for child maltreatment is critical to efforts to reduce its prevalence. OBJECTIVE This study investigated the association between characteristics and circumstances of mothers during pregnancy and the subsequent identification of concerns about child maltreatment. PARTICIPANTS AND SETTING The study drew on two data sets: (i) data from questionnaires administered to the expectant mothers of 11,332 children born in a deprived multi-ethnic local authority in England between 2007 and 2011, for a birth cohort study, and (ii) administrative data on children referred to child welfare services. METHODS The linkage of these two pre-existing data sets enabled the prospective study of risk factors for child maltreatment. RESULTS A range of factors captured during the antenatal period were associated with an increased likelihood of subsequent recorded child maltreatment concerns, including: younger maternal age (HR=0.96; p < .001), lower maternal education level (HR=1.36; p < .001), maternal mental illness (HR=1.17; p = .001), maternal smoking in pregnancy (HR=1.69; p < .001), single motherhood (HR=1.41; p = .022), larger family size (HR=1.13; p < .001), multiple deprivation (HR=1.01; p = .011), social housing (HR=1.72; p < .001), paternal unemployment (HR=1.79; p < .001), and the receipt of means-tested welfare benefits (HR=1.43; p < .001). A greater total number of risk factors during pregnancy also increased the risk of subsequent maltreatment concerns (HR=1.45; p < .001). CONCLUSIONS The identification of multiple risk factors in this study supports claims that single targeted interventions are unlikely to be successful in preventing or reducing child maltreatment due to its multifactorial nature, and that multidimensional interventions are required.
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Affiliation(s)
- Helen Baldwin
- Department of Social Policy and Social Work, University of York, York, YO10 5DD, England, United Kingdom.
| | - Nina Biehal
- Department of Social Policy and Social Work, University of York, York, YO10 5DD, England, United Kingdom.
| | - Victoria Allgar
- Department of Health Sciences, University of York, YO10 5DD, York, England, United Kingdom.
| | - Linda Cusworth
- Department of Social Policy and Social Work, University of York, York, YO10 5DD, England, United Kingdom.
| | - Kate Pickett
- Department of Health Sciences, University of York, YO10 5DD, York, England, United Kingdom.
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Schorr MT, Tietbohl-Santos B, de Oliveira LM, Terra L, de Borba Telles LE, Hauck S. Association between different types of childhood trauma and parental bonding with antisocial traits in adulthood: A systematic review. Child Abuse Negl 2020; 107:104621. [PMID: 32603957 DOI: 10.1016/j.chiabu.2020.104621] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/18/2019] [Revised: 05/16/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND ASPD describes individuals with a pervasive pattern of disregard for the rights of others that begins in childhood and continues into adulthood. The relationship between parental bonding, trauma, and ASPD is well established, however, it remains unclear what types of trauma or which patterns of bonding are more associated with ASPD. OBJECTIVES Review the literature regarding what types of trauma and bonding characteristics were related to antisocial personality traits. METHOD Systematic searches of PubMed, Embase, Web of Science, and Scielo for studies about the relationship between antisocial personality traits and the Childhood Trauma Questionnaire (CTQ) and/or the Parental Bonding Instrument (PBI). RESULTS 357 abstracts were selected, and 18 studies met the inclusion criteria. Regarding CTQ, the most consistent finding was the association between physical abuse and neglect to antisocial traits. Sexual abuse was the variable least related to antisocial traits. Regarding PBI, the most consistent finding was the inverse relationship between maternal and paternal care and antisocial traits. Concerning overprotection, the data is less consistent. Also, there was a considerable heterogenity between studies. CONCLUSIONS The literature little explores how these variables interact with each other. Thus, more studies are important to aidpolitical,educational, and public health programs to create preventive initiatives for ASPD.
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Affiliation(s)
- Manuela Teixeira Schorr
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Research Laboratory in Psychodynamic Psychiatry, Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil.
| | - Bárbara Tietbohl-Santos
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Research Laboratory in Psychodynamic Psychiatry, Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil.
| | - Lucas Mendes de Oliveira
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Research Laboratory in Psychodynamic Psychiatry, Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil.
| | - Luciana Terra
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Research Laboratory in Psychodynamic Psychiatry, Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil.
| | - Lisieux Elaine de Borba Telles
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Forensic Psychiatric Institute 'Doutor Maurício Cardoso', Bento Gonçalves Av., 2850, Porto Alegre, Rio Grande do Sul, 90650-003, Brazil.
| | - Simone Hauck
- Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil; Research Laboratory in Psychodynamic Psychiatry, Post-Graduation Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Ramiro Barcelos Street, 2350, Rio Grande do Sul, 90035-003, Brazil.
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Antwi-Boasiako K, King B, Fallon B, Trocmé N, Fluke J, Chabot M, Esposito T. Differences and disparities over time: Black and White families investigated by Ontario's child welfare system. Child Abuse Negl 2020; 107:104618. [PMID: 32653746 DOI: 10.1016/j.chiabu.2020.104618] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 02/23/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Black-White disparities in child welfare involvement have been well-documented in the United States, but there is a significant knowledge gap in Ontario about how and when these disparities emerge. OBJECTIVE This paper compares incidence data on Black and White families investigated by Ontario's child welfare system over a 20-year period. METHODS Data from the first five cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993-2013) were used to examine trends in child maltreatment investigations involving Black and White families. Incidence rates were calculated. T-tests were conducted to assess statistically significant differences between and within cycles. Population and decision-based enumeration approaches were also used to examine child welfare disparities. RESULTS The incidence of investigations involving White families almost doubled between 1998 and 2003, but for Black families the incidence increased almost fourfold during the same period. These increases and the difference between Black and White families in 2003 were statistically significant. The results further indicate that Black families experience disparate representation in Ontario's child welfare system over time for most service dispositions. CONCLUSIONS Several possible explanations are offered for the study's outcome, including changes in risk related to social safety net, the threshold for risk of harm, and bias and racist institutional policies and practices. This study invites policy-makers and child welfare authorities to rethink service delivery in addressing the disparate representation of Black families in the child welfare system.
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Affiliation(s)
| | - Bryn King
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | - Nico Trocmé
- School of Social Work, McGill University, Canada
| | - John Fluke
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado, United States
| | - Martin Chabot
- School of Social Work, University of Montreal, Canada
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Vial A, van der Put C, Stams GJJM, Kossakowski J, Assink M. Exploring the interrelatedness of risk factors for child maltreatment: A network approach. Child Abuse Negl 2020; 107:104622. [PMID: 32663718 DOI: 10.1016/j.chiabu.2020.104622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/19/2020] [Revised: 06/03/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Theories on the etiology of child maltreatment generally focus on the interaction between multiple risk and protective factors. Moreover, the quadratic model of cumulative risk describes a threshold at which the risk of child maltreatment increases exponentially, suggesting a synergistic effect between risk factors. OBJECTIVE This study explored the interrelatedness of risk factors for child maltreatment. PARTICIPANTS AND SETTING The sample consisted of risk assessments performed for both high-risk families (n = 2,399; child protection services) and lower risk families (n = 1,904; community outreach services). METHODS Network analyses were performed on parental risk factors. Three networks were constructed: a cross-sample network, a high-risk network, and a lower risk network. The relations between risk factors were examined, as well as the centrality of each risk factor in these networks. Additionally, the networks of the two samples were compared. RESULTS The networks revealed that risk factors for child maltreatment were highly interrelated, which is consistent with Belsky's multi-dimensional perspective on child maltreatment. As expected, risk factors were generally stronger related to each other in the high-risk sample than in the lower risk sample. Centrality analyses showed that the following risk factors play an important role in the development of child maltreatment: "Caregiver was maltreated as a child", "History of domestic violence", and "Caregiver is emotionally absent". CONCLUSIONS We conclude that studying the interrelatedness of risk factors contributes to knowledge on the etiology of child maltreatment and the improvement of both risk assessment procedures and interventions for child maltreatment.
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Affiliation(s)
- Annemiek Vial
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands.
| | - Claudia van der Put
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - Geert Jan J M Stams
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
| | - Jolanda Kossakowski
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, the Netherlands
| | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands
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Abstract
Describing a maladaptive parent-child relationship wherein a parent turns to a child for the satisfaction of emotional and/or relational needs, emotional incest remains an underinvestigated phenomenon. This is partly due to a lack of an empirically based measure of childhood emotional incest, and as a result, a 2-factor, 12-item scale was created based on expert opinion and a preliminary study of 319 university students. Each consisting of 6 items, the factors were called "Surrogate Spouse" and "Unsatisfactory Childhood." A follow-up study conducted with a second sample of 415 participants supports the 2-factor structure as a good fit to the data as well as the invariance of the scale across genders. The Childhood Emotional Incest Scale (CEIS) demonstrates good convergent validity with childhood emotional neglect (r = .58) and emotional abuse (r = .52) as well as good divergent validity with early memories of warmth and safeness (r = -0.54). The CEIS has also been found to be a stronger predictor of decreased life satisfaction and increased anxiety than the Parent-Focused Parentification subscale. Based on the values of internal consistency, composite reliability, and test-retest reliability, both factor and total scores of the CEIS can also be considered reliable. Therefore, as a measure of childhood emotional experiences for the retrospective assessment of adults, the 12-item CEIS can be utilized in the research of counseling, psychology, and education, particularly with regard to expanding knowledge into the roots and consequences of emotional incest and promoting parenting practices and marital/relational dynamics that are more functional. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Elif Çimşir
- Department of Guidance and Counseling, Faculty of Education, Anadolu University
| | - Ramazan Akdoğan
- Department of Guidance and Counseling, Faculty of Education, Anadolu University
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Salem M, Dargham SR, Kamal M, Eldeeb N, Alyafei KA, Lynch MA, Mian M, Mahfoud ZR. Effect of gender on childhood maltreatment in the state of Qatar: Retrospective study. Child Abuse Negl 2020; 101:104314. [PMID: 31896531 DOI: 10.1016/j.chiabu.2019.104314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/15/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND International maltreatment studies show a range of results for overall rates of child maltreatment and gender differences. The ISPCAN Child Abuse Screening Tools (ICAST) were designed to reduce variability in data collection. OBJECTIVE To investigate the influence of gender on the experiences of discipline and maltreatment in childhood among young people in Qatar, informingpractice and policy development. PARTICIPANTS AND SETTING A representative sample of Qatari youth aged between 18 and 24 years were identified using a cross sectional random household survey. The total number of subjects was 697 of whom 46.8% were male. METHODS Participants self-administered the ICAST-R (retrospective), which includes questions about exposure below the age of 18 to potentially abusive physical, psychological and sexual behaviors. Verbal consent was obtained following an introductory explanation and assurance ofconfidentiality. RESULTS At least one form of physical abuse was reported by 22.1% of participants and was significantly higher among males (28.2%) than females (16.7%) p<0.001). A trend for greater abuse was identified among boys aged over five which become statistically significant between 10 -13 years (p=0.001). For psychological abuse the overall rates were very similar, 16.2% for girls and 15.0% for boys. Only 17 (2.5%) of participants reported sexual abuse, with no statistically significant gender difference. CONCLUSIONS Physical, psychological and sexual abuse all occur in Qatar. This study demonstrates the importance of identifying the role of gender and age when exploring the extent and nature of maltreatment in a population. It allows for better targeting of preventative action.
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Affiliation(s)
- Mansoura Salem
- Suez Canal University, Egypt & Primary Health Care Corporation, Doha, Qatar
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Zins ZP, Wheeler KK, Brink F, Armstrong M, Shi J, Groner JI, Xiang H. Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006-2014. Child Abuse Negl 2019; 98:104179. [PMID: 31704543 DOI: 10.1016/j.chiabu.2019.104179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/30/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses. METHODS Nationally estimated rates of definitive and suggestive physical abuse and neglect injuries for children <10 years were generated using the Nationwide Emergency Department Sample, the National Inpatient Sample, and census estimates. Trends over time were evaluated, including the trend in the proportion of definitive diagnoses to all diagnoses (definitive plus suggestive). Logistic regression was used to evaluate whether patient characteristics and hospital patient volumes were associated with definitive versus suggestive diagnoses. RESULTS The population rates of child physical maltreatment medically treated injuries were unchanged from 2006 to 2014; the trends were not statistically significant for ED or hospitalized patients. Over time, physician definitive diagnoses as a proportion of all physical maltreatment diagnoses (definitive plus suggestive) increased in admitted children from 17.6% in 2006 to 22.0% in 2014 (p = 0.02). Older age, white race, lower income by zip code, and public insurance as well as larger patient volumes increased the odds of definitive rather than suggestive diagnoses of physical abuse and neglect injuries. CONCLUSIONS Definitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias. The use of electronic medical records may have influenced the coding of definitive diagnoses.
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Affiliation(s)
- Zachary P Zins
- The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, USA.
| | - Krista K Wheeler
- Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Farah Brink
- The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, USA; The Center for Family Safety and Healing, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Megan Armstrong
- Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Junxin Shi
- Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Jonathan I Groner
- The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, USA; Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Trauma Program, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Henry Xiang
- The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, USA; Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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Belli H, Ural C, Akbudak M, Sagaltıcı E. Levels of childhood traumatic experiences and dissociative symptoms in extremely obese patients with and without binge eating disorder. Nord J Psychiatry 2019; 73:527-531. [PMID: 31502911 DOI: 10.1080/08039488.2019.1662085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: It has been suggested that obese patients with binge eating disorder (BED) show higher levels of dissociation and childhood trauma. Aim: This study assesses childhood trauma history and dissociative symptoms in obese patients with BED compared to obese patients without BED. Methods: The 241 patients participating in the study had to meet obesity criteria. These patients were applicants for bariatric surgery and were consulted by a psychiatry service. Patients were separated into two groups that were accompanied by BED diagnoses according to structured clinical interviews administered according to the DSM-IV (SCID-I). Patients were assessed using the Dissociation Questionnaire (DIS-Q) and the Childhood Trauma Questionnaire (CTQ). The two groups of patients were compared. Results: A total of 75 (31.1%) of the 241 obese patients were diagnosed with BED. The study showed that obese patients with BED had higher dissociative scores than those without BED (p < .05). The results showed higher total scores and two different types of childhood trauma (physical abuse and emotional abuse) in BED patients compared to non-BED patients (p < .05). Conclusions: Clinicians should be fully aware of BED, dissociative symptoms and childhood traumatic experiences. These results show that, for at least a sub-group of obese patients, BED is associated with obesity and may be connected with dissociative symptoms and childhood physical abuse and emotional abuse.
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Affiliation(s)
- Hasan Belli
- Department of Psychiatry, Bagcilar Education and Research Hospital, University of Health Sciences , Istanbul , Turkey
| | - Cenk Ural
- Department of Psychiatry, Bagcilar Education and Research Hospital, University of Health Sciences , Istanbul , Turkey
| | - Mahir Akbudak
- Department of Psychiatry, Mardin State Hospital , Mardin , Turkey
| | - Eser Sagaltıcı
- Department of Psychiatry, Bagcilar Education and Research Hospital, University of Health Sciences , Istanbul , Turkey
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Chou IJ, Kong SS, Chung TT, See LC, Kuo CF, Lin JJ, Wang HS, Lin KL, Hung PC. Evaluation of the effect of the child protection act on serious child physical abuse in Taiwan. Child Abuse Negl 2019; 95:104066. [PMID: 31284024 DOI: 10.1016/j.chiabu.2019.104066] [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: 01/02/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Few studies have examined the effects of the Child Protection Act on child maltreatment in Taiwan. OBJECTIVE This study estimated the secular trends in the incidence rate of physical abuse of children requiring hospitalization between 1996 and 2013, and the subsequent in-hospital death proportion before and after implementation of the Act in 2003. PARTICIPANTS AND SETTING The cases were children younger than 12 years old who were hospitalized due to child abuse, shaken-baby syndrome, neglect, or homicide between 1996 and 2013. A comparison group consisted of children requiring hospitalization for other reasons. We used the National Health Insurance database to identify patients. METHODS The Joinpoint Regression Program was used to estimate temporal trends in the standardized incidence rates. RESULTS Between 1996 and 2013, 2050 children required hospitalization for physical abuse. Before 2005, the annual percent change increased by 9.40 [95% confidence interval (CI), 4.98-14.00] per year, and after 2005 the annual percent change was -4.80 (95% CI, -9.53-0.17) per year. Among the 2050 physically abused children requiring hospitalization, 83 (4%) died in hospital. The in-hospital death proportion was 2.62% before 2003 and 4.90% after 2003, and the ratio of these two proportions was 1.43 (95% CI, 0.80-2.58). CONCLUSIONS The trend in the incidence of hospitalization of children due to physical-abuse-related injuries started to decline 2 years after implementation of the Child Protection Act. However, the proportion of children who died in hospital as a result of physical abuse requiring hospitalization did not change.
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Affiliation(s)
- I-Jun Chou
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan
| | - Shu-Sing Kong
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan
| | - Ting-Ting Chung
- Big Data Research Office, Chang Gung Memorial Hospital, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine and Biostatistics Core Laboratory, Molecular Medicine Research Centre, Chang Gung University, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK; Big Data Research Office, Chang Gung Memorial Hospital, Taiwan
| | - Jainn-Jim Lin
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan
| | - Huei-Shyong Wang
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan
| | - Kuang-Lin Lin
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan
| | - Po-Cheng Hung
- Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan.
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20
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Tonmyr L, Shields M, Asokumar A, Hovdestad W, Laurin J, Mukhi S, Burnside L. Can coders abstract child maltreatment variables from child welfare administrative data and case narratives for public health surveillance in Canada? Child Abuse Negl 2019; 92:77-84. [PMID: 30933833 DOI: 10.1016/j.chiabu.2019.03.020] [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: 11/07/2018] [Revised: 03/17/2019] [Accepted: 03/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Public health surveillance is essential to inform programs that aim to eradicate child maltreatment (CM) and to provide services to children and families. However, collection of CM data imposes a burden on child welfare workers (CWWs). This study assesses the feasibility of hiring coders to abstract the required information from administrative records and case narratives. METHODS Based on a convenience sample of child welfare data from Manitoba, Canada, two coders abstracted information on 181 alleged CM cases. The coders completed a short web-based questionnaire for each case to identify which of five types of CM had been investigated, level of substantiation for each type, and risk of future CM. The CWWs responsible for each case completed the same questionnaire. Percentages of the occurrence of CM by the three sources were compared. The validity of the coders' classifications was assessed by calculating sensitivity, specificity, and positive and negative predictive values, against the CWWs' classifications as the "gold standard." Cohen's kappa was also calculated. RESULTS The coders' classifications of physical abuse, sexual abuse and neglect generally matched those of CWWs; for exposure to intimate partner violence, agreement was weak for one coder. Coding of emotional maltreatment and risk investigations could not be evaluated. CONCLUSION Results were promising. Abstraction was not time-consuming. Differences between coders and CWWs can be largely explained by the administrative data system, child welfare practice, and legislation. Further investigation is required to determine if additional training could improve coders' classifications of CM.
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Affiliation(s)
- Lil Tonmyr
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada.
| | - Margot Shields
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Ajani Asokumar
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Wendy Hovdestad
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Jessica Laurin
- Public Health Agency of Canada, 785 Carling Ave, AL 6807B, Ottawa, ON, K1A 0K9, Canada
| | - Shamir Mukhi
- Canadian Network for Public Health Intelligence, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Linda Burnside
- Birch Wellness Centre, 34 Carlton St, Winnipeg, MB, R3C 1N9, Canada
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Funkhouser CJ, Correa KA, Carrillo VL, Klemballa DM, Shankman SA. The time course of responding to aversiveness in females with a history of non-suicidal self-injury. Int J Psychophysiol 2019; 141:1-8. [PMID: 31028756 DOI: 10.1016/j.ijpsycho.2019.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/27/2019] [Accepted: 04/24/2019] [Indexed: 01/26/2023]
Abstract
Non-suicidal self-injury is a risk factor for suicidal behavior, particularly in females. Two prominent theories of suicide suggest that habituation to the psychophysiological aversiveness of NSSI is a mechanism by which NSSI exposure may lead to increased risk for suicide. Several laboratory studies examining the relationship between physiological habituation and suicide attempt history have yielded mixed results, potentially due to their use of broad measures of physiological arousal and/or focus on specific psychopathologies. However, no studies have examined the association between the time course (e.g., habituation, initial reactivity) of responding to aversiveness and NSSI, which may help to elucidate psychophysiological mechanisms of NSSI. Therefore, we examined habituation and initial reactivity to aversiveness (indexed by the time course of acoustic startle reflex, a well-validated measure of defensive responding) in three groups of young adult females - those with a history of NSSI, psychiatric controls matched on potential confounds (e.g., psychopathology, trauma history, demographics), and healthy controls. Results indicated that individuals with a history of NSSI exhibited blunted initial reactivity and marginally slower habituation to aversiveness relative to the two control groups. The NSSI group's insensitivity to aversiveness may reflect prior psychophysiological habituation, and may be a mechanism through which prior NSSI exposure leads to increased risk for suicidal behavior.
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Affiliation(s)
- Carter J Funkhouser
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Kelly A Correa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Vivian L Carrillo
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - David M Klemballa
- Department of Psychology, University of Illinois at Chicago, United States of America
| | - Stewart A Shankman
- Department of Psychology, University of Illinois at Chicago, United States of America; Department of Psychiatry, University of Illinois at Chicago, United States of America; Department of Psychiatry and Behavioral Sciences, Northwestern University, United States of America.
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Atiqul Haque M, Janson S, Moniruzzaman S, Rahman AKMF, Islam SS, Mashreky SR, Eriksson UB. Children's exposure to physical abuse from a child perspective: A population-based study in rural Bangladesh. PLoS One 2019; 14:e0212428. [PMID: 30779784 PMCID: PMC6380542 DOI: 10.1371/journal.pone.0212428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/02/2019] [Indexed: 01/14/2023] Open
Abstract
Background Although child physical abuse (CPA) is considered as a major global public health problem, it has not yet been recognized as such in Bangladesh. Very few studies have assessed the prevalence and victims’ characteristics of multiple forms of CPA. Objective This population-based study assessed the prevalence of CPA committed by adults in a rural area of Bangladesh and examined its association with demographic and socio-contextual factors. Methods Data were obtained using ISPCAN Child Abuse Screening Tool for Children (ICAST-C) in a random sample of 1416 children (49% girls, 51% boys) aged 11 to 17 years by face-to-face interviews during March-April 2017. The response rate was 91.5%. To estimate predictors of CPA, physical abuse was categorized into frequent and less frequent groups. Results The prevalence of at least one form (≥ 1), two forms (≥2) and three or more forms (≥ 3) of CPA were estimated approximately to 99%, 95% and 83% in their lifetime and 93%, 79%, and 57% in the past year respectively. Hitting (except on buttocks), standing/kneeling and slapping were the most common physical abuse whereas given drugs or alcohol, pinched, burned or scalded, beaten-up and locked up were less reported. Female children were faced severe forms of CPA more than that of males. Male children, younger age groups, witnessing adults using weapons at home, bullied by siblings and low level of maternal education were found to be significant risk factors for both ≥ 1 form and ≥ 2 forms of frequent CPA whereas adding also adult shouting in a frightening way was found as a significant risk factor for ≥ 2 forms of frequent CPA. Conclusion Self-reported prevalence of CPA is extremely common in the Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children such as being younger, witnessing domestic violence and maternal low education. The findings provide evidence to support parents and policy-makers to take effective measures to implement policy and programme on alternative up-bringing methods and creating awareness of negative effects of CM which in turn help Bangladesh to line up with UN Convention on the Rights of the Child, which the country signed in 1990.
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Affiliation(s)
- M. Atiqul Haque
- Public Health Sciences, Department of Health Sciences, Karlstad University, Karlstad, Sweden
- * E-mail: ,
| | - Staffan Janson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Syed Moniruzzaman
- Risk and Environmental Studies, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden
| | - A. K. M. Fazlur Rahman
- Center for Injury Prevention and Research, Bangladesh, New DOHS, Mohakhali, Dhaka, Bangladesh
- Bangladesh University of Health Sciences, Darus Salam, Mirpur, Dhaka, Bangladesh
| | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Center for Injury Prevention and Research, Bangladesh, New DOHS, Mohakhali, Dhaka, Bangladesh
- Bangladesh University of Health Sciences, Darus Salam, Mirpur, Dhaka, Bangladesh
| | - Ulla-Britt Eriksson
- Public Health Sciences, Department of Health Sciences, Karlstad University, Karlstad, Sweden
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Abstract
BACKGROUND There is ample evidence showing that childhood maltreatment (CM) is a risk factor for the development of depression in adulthood. However, little is known about the psychological processes mediating this relationship. This study used a large community sample to investigate the mediating role of emotional, cognitive and/or interpersonal dysfunctions on the one hand and posttraumatic stress disorder symptoms on the other hand. METHODS One thousand twenty seven participants of a community sample filled out an online survey. Mediation analyses were computed via linear structural equation modelling. RESULTS Results showed a significant mediation of the association between CM and adult depression via emotional impairments, depressogenic attribution style and symptoms of posttraumatic stress disorder. Our study design was cross-sectional and therefore did not allow testing temporal precedence of mediators and causality. Data was collected retrospectively, a confounding effect of current depressive symptoms on retrospective recall of CM therefore cannot be ruled out. CONCLUSIONS The a priori mediation model showed a good fit with the data. The model suggests promising objectives for further research on CM-related depression and potential treatment targets in the future.
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Affiliation(s)
- Anne Klumparendt
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
- Christoph-Dornier-Foundation for Clinical Psychology, Münster, Germany
| | - Janna Nelson
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
- Christoph-Dornier-Foundation for Clinical Psychology, Münster, Germany
| | - Jens Barenbrügge
- Department of Psychology, University of Münster, Fliednerstr. 21, 48149 Muenster, Germany
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
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Hogarth L, Martin L, Seedat S. Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents. Drug Alcohol Depend 2019; 194:69-74. [PMID: 30412899 PMCID: PMC6327152 DOI: 10.1016/j.drugalcdep.2018.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND In adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role. METHODS Secondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13-23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect. RESULTS The three types of childhood abuse measured by the CTQ - emotional, physical and sexual - were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates. CONCLUSIONS These data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Lindi Martin
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
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25
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Hsin YC, Chang YC, Lee EP, Chiu CH, Chou I.J, Hsia SH, Lin KL, Lee J, Huang JL, Wang CJ, Wu HP. Risk factors for child maltreatment by the utilization of medical service and socioeconomic environment in Taiwan. Medicine (Baltimore) 2018; 97:e13728. [PMID: 30593145 PMCID: PMC6314714 DOI: 10.1097/md.0000000000013728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Child maltreatment is complicated by cultural, welfare, and socioeconomic factors. However, the relationship between child maltreatment and socioeconomic factors has not been completely understood. We investigated risk factors for child abuse and neglect in Taiwan.The data in our study was obtained from Taiwan National Statistics at county level from 2004 to 2015. We included 4 areas (eastern, western, southern, northern) involving 20 cities and counties. The trends of child maltreatment rate based on different years and different areas were surveyed. In addition, panel data analysis was used to analyze the links between child maltreatment rate and socioeconomic factors.An increasing trend of child maltreatment rate in Taiwan was observed. During the past decade, child maltreatment rate increased from 14.5 in 2004 to 23.4 cases per 10000 children in 2014. The peak, which was 43 cases per 10000 children, occurred in 2012. Significant geographical differences were observed, and the highest child maltreatment rate was seen in eastern Taiwan. Panel data analysis revealed a lag effect of the unemployment rate on child maltreatment rate at the county level: the child maltreatment rate increased by 7 percent, while the prior unemployment rate increased by one percent. In addition, the medical personnel density was related to the child maltreatment rate within the county.Previous unemployment rate had a lag impact on child maltreatment occurrence. Unemployment rate has not only a direct impact on the economy but also sequential effects on child maltreatment.
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Affiliation(s)
- Yi-Chen Hsin
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan
- College of Medicine, Chang Gung University
- Division of Pediatric Allery, Asthma, and Rheumatology, Department of Pediatrics
| | - Yu-Ching Chang
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan
- College of Medicine, Chang Gung University
| | - En-Pei Lee
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan
- College of Medicine, Chang Gung University
- Division of Pediatric Critical Care Medicine
| | - Cheng-Hsun Chiu
- College of Medicine, Chang Gung University
- Division of Pediatric Infectious Diseases
| | - I.-.Jun Chou
- College of Medicine, Chang Gung University
- Division of Pediatric Neurology
| | - Shao-Hsuan Hsia
- College of Medicine, Chang Gung University
- Division of Pediatric Critical Care Medicine
| | - Kuang-Lin Lin
- College of Medicine, Chang Gung University
- Division of Pediatric Neurology
| | - Jung Lee
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan
- College of Medicine, Chang Gung University
| | - Jing-Long Huang
- College of Medicine, Chang Gung University
- Division of Pediatric Allery, Asthma, and Rheumatology, Department of Pediatrics
| | - Chao-Jan Wang
- College of Medicine, Chang Gung University
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan
| | - Han-Ping Wu
- Department of Pediatric Emergency Medicine
- Department of Medical Research, Children's Hospital
- Department of Medicine, College of Medicine, China Medical University, Taichung
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26
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Affiliation(s)
- Megan R Gerber
- Women's Health Program , VA Boston Healthcare System, 150 South Huntington Avenue, PC 11/WHC, Boston, MA, 02130, USA.
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Kristina M Bogdan
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Erica R Scioli
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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27
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Li XB, Bo QJ, Tian Q, Yang NB, Mao Z, Zheng W, Wen YJ, Wang CY. Impact of childhood trauma on sensory gating in patients with first-episode schizophrenia. BMC Psychiatry 2018; 18:258. [PMID: 30115023 PMCID: PMC6097339 DOI: 10.1186/s12888-018-1807-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 07/05/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Childhood trauma (CT) has been found to contribute to the onset of schizophrenia and auditory sensory gating deficit is a leading endophenotype for schizophrenia. However, the association between the CT and sensory gating in first-episode schizophrenia remains elusive. METHODS Fifty-six patients and 49 age and sex-matched healthy controls were assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF) for CT and Positive and Negative Syndrome Scale (PANSS) for symptoms severity. Sensory gating was tested using the modified paradigm, perceived spatial separation-induced prepulse inhibition (PSS-PPI), and the perceived spatial co-location PPI (PSC-PPI or classical PPI). RESULTS Comparing with healthy controls, the patients had significantly higher score on sexual abuse (t = 2.729, p < 0.05), lower PSS- PPI, % (ISI = 120 ms and ISI = 60 ms) (t = - 3.089, - 4.196, p < 0.05). Univariate analysis revealed the absence of a significant correlation among CT, PPI paradigms and symptoms. However, multiple linear regression analyses demonstrated the CTQ-SF total was negatively associated with PSS PPI (ISI = 120 ms) (p = 0.018). CONCLUSION The current study illustrates that the impact of CT on sensory gating in patients with first-episode schizophrenia, and thus we conclude that CT may be a risk factor to the occurrence of schizophrenia through its impact on sensory gating.
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Affiliation(s)
- Xian-Bin Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Qi-Jing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Qing Tian
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Ning-Bo Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yu-Jie Wen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
| | - Chuan-Yue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China
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28
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Spilsbury JC, Gross-Manos D, Haas BM, Bowdrie K, Richter F, Korbin JE, Crampton DS, Coulton CJ. Change and consistency in descriptions of child maltreatment: A comparison of caregivers' perspectives 20 years apart. Child Abuse Negl 2018; 82:72-82. [PMID: 29870865 PMCID: PMC6589824 DOI: 10.1016/j.chiabu.2018.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/15/2018] [Accepted: 05/23/2018] [Indexed: 06/02/2023]
Abstract
Although approximately one-fifth of child maltreatment reports originate with family members, friends, neighbors, or community members, their efforts to identify and report child maltreatment are still not well understood. Nor is it well understood how these individuals' perceptions of what constitutes maltreatment may change over time. This study examined descriptions of behavior perceived as maltreatment by caregivers of minors in Cleveland, Ohio, USA neighborhoods. Data were obtained from two neighborhood-based cross-sectional surveys of caregivers of minors: one conducted in 1995-1996 and the other in 2014-2015. The sample consisted of 400 caregivers living in 20 census tracts with varying profiles of maltreatment risk in the 1995-1996 study, and 400 caregivers living in the same 20 census tracts surveyed in 2014-2015. Each time point, participants were asked to provide three examples of behaviors they considered to be child abuse and neglect. All responses were categorized using the 1995-1996 coding scheme. Logistic regression analyses including all 800 participants, adjusted for individual and neighborhood characteristics, and accounting for residential clustering in neighborhoods, showed that participating in the 2014-2015 survey was associated with 51% increased odds of mentioning an act of neglect and a 39% decreased odds of mentioning an act of physical abuse. No significant temporal changes were observed for inadequate supervision, emotional or verbal abuse, sexual abuse, and parental misbehavior. Associations between specific types of maltreatment and individual and neighborhood characteristics were observed. Potential practice implications and future research directions include seeking greater familiarity with caregivers' perceptions of maltreating behaviors to better understand how these perceptions might "translate" into child maltreatment reports and investigations.
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Affiliation(s)
- James C Spilsbury
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
| | - Daphna Gross-Manos
- Department of Social Work, Tel-Hai College, Upper Galilee, 1220800, Israel
| | - Bridget M Haas
- Center for Child Health and Policy, Case Western Reserve University School of Medicine, 11100 Euclid Avenue MS 6036, Cleveland, OH, 44106, United States
| | - Kristina Bowdrie
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Rd, Columbus, OH, 43210, United States
| | - Francisca Richter
- Center on Urban Poverty and Community Development, Jack, Joseph and Morton Mandel School of Applied Social Sciences Room 212, Case Western Reserve University, 11402 Bellflower Court, Cleveland, OH, 44106, United States
| | - Jill E Korbin
- College of Arts and Sciences, Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH, 44106, United States
| | - David S Crampton
- Center on Urban Poverty and Community Development, Jack, Joseph and Morton Mandel School of Applied Social Sciences Room 212, Case Western Reserve University, 11402 Bellflower Court, Cleveland, OH, 44106, United States
| | - Claudia J Coulton
- Center on Urban Poverty and Community Development, Jack, Joseph and Morton Mandel School of Applied Social Sciences Room 212, Case Western Reserve University, 11402 Bellflower Court, Cleveland, OH, 44106, United States
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29
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Affiliation(s)
- D M B Hall
- Institute of General Practice and Primary Care, ScHARR, University of Sheffield, Sheffield, UK.
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30
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Bilson A, Cant RL, Harries M, Thorpe DH. Accounting for the increase of children in care in western Australia: What can a client information system tell us? Child Abuse Negl 2017; 72:291-300. [PMID: 28865400 DOI: 10.1016/j.chiabu.2017.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/04/2016] [Revised: 07/25/2017] [Accepted: 08/07/2017] [Indexed: 06/07/2023]
Abstract
This paper analyses a fourteen-year period of Western Australian data from the client information system of the Department for Child Protection and Family Support. Western Australia saw a large increase in the number of children in state care similar to trends across Australia as a whole. The study shows the following trends: changes in response to 'referrals' with particular increases in the number of findings of neglect and increasing proportions of these followed swiftly by entry to care; changes in patterns of entry to care with more children under one-year-old entering; increased length of stay of children in care; and, the high incidence of Aboriginal children entering and remaining in care. The data demonstrate unequivocally that increased 'referrals' are not associated with increased substantiations of harm or 'acts of commission with dangerous intent', but that neglect assessed early in the lives of children was the major precipitant for entry to care and particularly so for Aboriginal infants.
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Affiliation(s)
- Andy Bilson
- School of Social Work, University of Central Lancashire, Preston PR1 2HE, United Kingdom; School of Population Health, Faculty of Medicine, Dentistry and Heath Sciences M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
| | - Rosemary L Cant
- School of Population Health, Faculty of Medicine, Dentistry and Heath Sciences M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
| | - Maria Harries
- School of Population Health, Faculty of Medicine, Dentistry and Heath Sciences M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Western Australia.
| | - David H Thorpe
- Department of Sociology, University of Lancaster, Lancaster LA1 4YD, United Kingdom.
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31
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Mattheij M, Venstermans C, de Veuster I, Vanderstraete I, Menovsky T, Jorens P, Ceulemans B. Retinal haemorrhages in a university hospital: not always abusive head injury. Acta Neurol Belg 2017; 117:515-522. [PMID: 28160241 DOI: 10.1007/s13760-017-0748-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/13/2017] [Indexed: 11/26/2022]
Abstract
Retinal haemorrhages (RH) and subdural haematomas (SDH) are frequently seen in abusive head trauma (AHT). The aim of our study is to show that they are suggestive, but not pathognomonic for AHT. We performed an observational retrospective study on children, aged 1-18 months old, admitted to the Antwerp University Hospital with RH. History, physical examination, medical course, coagulation and metabolic tests, skeletal survey, head circumference, retinal findings, cerebral imaging, and evaluation reports by social services or civil/criminal courts were collected. Twenty-nine children with RH were included. Twenty three of them were found suspect of AHT. Three children of this group showed intraparenchymal haematomas/infarctions, 5 interhemispheric blood, 6 cerebral oedema, 7 ventricle compression, and 4 papilloedema. Seven of the 16 children with diffusion-weighted MRI images showed diffuse lesions. In 2 of the 6 children not suspect for AHT, an aetiology was found. None of the 4 remaining children showed the above-mentioned abnormalities. Three of these 4 cases showed an accelerated growth of the head circumference months before presentation. The majority of the children in all groups showed 'too numerous to count' (>20) RH (12 of the 23 'suspect' children, and 4 of the 6 'non-suspect' children). Results showed no differences between the groups concerning the location, distribution, or size of the RH. Infants with RH and/or SDH are not necessarily victims of AHT. Cerebral imaging and retinal findings can help differentiate suspect from non-suspect cases. Infants with a large head circumference could be predisposed to RH or SDH.
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Affiliation(s)
- M Mattheij
- Department of Neurology - Paediatric Neurology, Antwerp University Hospital, University of Antwerp, Wijlrijkstraat 10, 2610, Edegem, Belgium.
| | - C Venstermans
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - I de Veuster
- Department of Ophthalmology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - I Vanderstraete
- Vertrouwenscentrum Kindermishandeling (Confidentiality center), Prof. Claraplein 1, 2018, Antwerp, Belgium
| | - T Menovsky
- Department of Neurosurgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - P Jorens
- Intensive Care Unit, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - B Ceulemans
- Department of Neurology - Paediatric Neurology, Antwerp University Hospital, University of Antwerp, Wijlrijkstraat 10, 2610, Edegem, Belgium
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32
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Abstract
BACKGROUND AND OBJECTIVE Child maltreatment (abuse and neglect) has established effects on mental health. Less is known about its influence on adult economic circumstances. We aimed to establish associations of child maltreatment with such outcomes and explore potential pathways. METHODS We used 1958 British birth cohort data (N = 8076) to examine associations of child neglect and abuse with adult (50 years) long-term sickness absence, not in employment, education or training (NEET), lacking assets, income-related support, poor qualifications, financial insecurity, manual social class, and social mobility. We assessed mediation of associations by 16-year cognition and mental health. RESULTS Abuse prevalence varied from 1% (sexual) to 10% (psychological); 16% were neglected. A total of 21% experienced 1 maltreatment type, 10% experienced ≥2 types. Sexual and nonsexual abuse were associated with several outcomes; eg, for sexual abuse, adjusted odds ratio (aOR) of income-related support was 1.75 (95% confidence interval [CI], 1.12-2.72). Associations were little affected by potential mediating factors. Neglect was associated with several adult outcomes (eg, aOR of NEET was 1.43 [95% CI, 1.10-1.85]) and associations were mediated by cognition and mental health (primarily by cognition): percent explained varied between 4% (NEET) to 70% (poor qualifications). In general, the risk of poor outcome increased by number of maltreatment types (eg, aOR for long-term sickness absence increased from 1.0 [reference] to 1.76 [95% CI, 1.32-2.35] to 2.69 [95% CI, 1.96-3.68], respectively, for 0, 1, and ≥2 types of maltreatment. CONCLUSIONS Childhood maltreatment is associated with poor midadulthood socioeconomic outcomes, with accumulating risk for those experiencing multiple types of maltreatment. Cognitive ability and mental health are implicated in the pathway to outcome for neglect but not abuse.
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Affiliation(s)
- Snehal M Pinto Pereira
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Leah Li
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Chris Power
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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33
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Quinn K, Boone L, Scheidell JD, Mateu-Gelabert P, McGorray SP, Beharie N, Cottler LB, Khan MR. The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use. Drug Alcohol Depend 2016; 169:190-198. [PMID: 27816251 PMCID: PMC5728665 DOI: 10.1016/j.drugalcdep.2016.09.021] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/28/2016] [Accepted: 09/29/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND We examined associations between childhood trauma and adulthood prescription pain reliever misuse (PPRM) and injection drug use (IDU) in a nationally-representative U.S. sample to further understanding of factors associated with these epidemics. METHODS National Longitudinal Study of Adolescent to Adult Health data (N=12,288) yielded nine childhood traumas: neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, and experienced violence. We estimated adjusted odds ratios (AOR) and 95% confidence intervals for the association of each trauma and cumulative trauma and drug initiation in emerging and later adulthood. RESULTS Outcome prevalences were 20% (PPRM) and 1% (IDU) in emerging adulthood and 10% PPRM in adulthood. We observed dose-response relationships that varied across outcomes. Cumulative trauma (referent=none) was associated with 34-79% greater odds of PPRM (emerging adulthood) across one to five+ trauma categories. The gradient was most consistent and associations strongest for adulthood PPRM: one trauma AOR=1.46(1.12, 1.91); two AOR=1.71(1.23, 2.36); three AOR=2.16(1.43, 2.36); four AOR=2.70(1.42, 5.62); five+ AOR=3.09(1.52, 6.30). Dose-response was less consistent for IDU, but 4 and 5+ traumas were associated with approximately seven and five times the odds of IDU. Neglect, emotional abuse, and parental incarceration and binge drinking were associated with 25-55% increased odds of PPRM. Sexual abuse and witnessed violence were associated with nearly 3 and 5 times the odds of IDU. CONCLUSIONS Associations between childhood trauma and PPRM/IDU highlight the need for trauma-informed interventions for drug users and early trauma screening and treatment for prevention of drug misuse over the life course.
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Affiliation(s)
- Kelly Quinn
- Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States.
| | - Lauren Boone
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Joy D Scheidell
- Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States
| | - Pedro Mateu-Gelabert
- National Development and Research Institutes, Inc., 71 West 23rd Street, New York, NY 10010, United States
| | - Susan P McGorray
- Department of Biostatistics, College of Public Health & Health Professions, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32611, United States
| | - Nisha Beharie
- National Development and Research Institutes, Inc., 71 West 23rd Street, New York, NY 10010, United States
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, United States
| | - Maria R Khan
- Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States
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34
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Horikawa H, Suguimoto SP, Musumari PM, Techasrivichien T, Ono-Kihara M, Kihara M. Development of a prediction model for child maltreatment recurrence in Japan: A historical cohort study using data from a Child Guidance Center. Child Abuse Negl 2016; 59:55-65. [PMID: 27517122 DOI: 10.1016/j.chiabu.2016.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 02/27/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 06/06/2023]
Abstract
To develop a prediction model for the first recurrence of child maltreatment within the first year after the initial report, we carried out a historical cohort study using administrative data from 716 incident cases of child maltreatment (physical abuse, psychological abuse, or neglect) not receiving support services, reported between April 1, 1996 through March 31, 2011 to Shiga Central Child Guidance Center, Japan. In total, 23 items related to characteristics of the child, the maltreatment, the offender, household, and other related factors were selected as predictive variables and analyzed by multivariate logistic regression model for association with first recurrence of maltreatment. According to the stepwise selection procedure six factors were identified that include 9-13year age of child (AOR=3.43/95%CI=1.52-7.72), <40year age of the offender (AOR=1.65/95%CI=1.09-2.51), offender's history of maltreatment during childhood (AOR=2.56/95%CI=1.31-4.99), household financial instability or poverty (AOR=1.64/95%CI=1.10-2.45), absence of someone in the community who could watch over the child (AOR=1.68/95%CI=1.16-2.44), and the organization as the referral source (AOR=2.21/95%CI=1.24-3.93). Using these six predictors, we generated a linear prediction model with a sensitivity and specificity of 45.2% and 82.4%, respectively. The model may be useful to assess the risk of further maltreatment and help the child and family welfare administrations to develop preventive strategies for recurrence.
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Affiliation(s)
- Hiroyuki Horikawa
- Shiga Prefectural Mental Health and Welfare Center, Mureyama-so House, Kasayama 8-Chome 5-130, Kusatsu City, Shiga, 525-0072, Japan; Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - S Pilar Suguimoto
- Center for Medical Education, Graduate School of Medicine, Kyoto University, Faculty of Medicine Building E Room 109, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan; Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Patou Masika Musumari
- Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Teeranee Techasrivichien
- Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Masako Ono-Kihara
- Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Masahiro Kihara
- Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Science Frontier Laboratory Room 204, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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Abrahams N, Mathews S, Martin LJ, Lombard C, Nannan N, Jewkes R. Gender Differences in Homicide of Neonates, Infants, and Children under 5 y in South Africa: Results from the Cross-Sectional 2009 National Child Homicide Study. PLoS Med 2016; 13:e1002003. [PMID: 27115771 PMCID: PMC4846035 DOI: 10.1371/journal.pmed.1002003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 03/15/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Homicide of children is a global problem. The under-5-y age group is the second largest homicide age group after 15-19 y olds, but has received little research attention. Understanding age and gender patterns is important for assisting with developing prevention interventions. Here we present an age and gender analysis of homicides among children under 5 y in South Africa from a national study that included a focus on neonaticide and infanticide. METHODS AND FINDINGS A retrospective national cross-sectional study was conducted using a random sample of 38 medico-legal laboratories operating in 2009 to identify homicides of children under 5 y. Child data were abstracted from the mortuary files and autopsy reports, and both child and perpetrator data data were collected from police interviews. We erred towards applying a conservative definition of homicide and excluded sudden infant death syndrome cases. We estimated that 454 (95% CI 366, 541) children under the age of 5 y were killed in South Africa in 2009. More than half (53.2%; 95% CI 46.7%, 59.5%) were neonates (0-28 d), and 74.4% (95% CI 69.3%, 78.9%) were infants (under 1 y), giving a neonaticide rate of 19.6 per 100,000 live births and an infanticide rate of 28.4 per 100,000 live births. The majority of the neonates died in the early neonatal period (0-6 d), and abandonment accounted for 84.9% (95% CI 81.5%, 87.8%) of all the neonates killed. Distinct age and gender patterns were found, with significantly fewer boy children killed in rural settings compared to urban settings (odds ratio 0.6; 95% CI 0.4, 0.9; p = 0.015). Abuse-related killings and evidence of sexual assault were more common among older girls than in all other age and gender groups. Mothers were identified as the perpetrators in all of the neonaticides and were the most common perpetrators overall (71.0%; 95% CI 63.9%, 77.2%). Abandoned neonates were mainly term babies, with a mean gestational age of 38 wk. We did not have information on abandonment motives for all newborns and did not know if babies were abandoned with the intention that they would die or with the hope that they would be found alive. We therefore considered all abandoned babies as homicides. CONCLUSIONS Homicide of children is an extreme form or consequence of violence against children. This national study provides one of the first analyses of neonaticide and infanticide by age and gender and shows the failure of reproductive and mental health and social services to identify and help vulnerable mothers. Multi-sectoral prevention strategies are needed.
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Affiliation(s)
- Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- * E-mail:
| | - Shanaaz Mathews
- Children’s Institute, University of Cape Town, Cape Town, South Africa
| | - Lorna J. Martin
- Forensic Pathology Services, Western Cape Government, Cape Town, South Africa
- Division of Forensic Medicine and Toxicology, University of Cape Town, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nadine Nannan
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
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Abstract
CONTEXT Evidence confirms associations between childhood violence and major causes of mortality in adulthood. A synthesis of data on past-year prevalence of violence against children will help advance the United Nations' call to end all violence against children. OBJECTIVES Investigators systematically reviewed population-based surveys on the prevalence of past-year violence against children and synthesized the best available evidence to generate minimum regional and global estimates. DATA SOURCES We searched Medline, PubMed, Global Health, NBASE, CINAHL, and the World Wide Web for reports of representative surveys estimating prevalences of violence against children. STUDY SELECTION Two investigators independently assessed surveys against inclusion criteria and rated those included on indicators of quality. DATA EXTRACTION Investigators extracted data on past-year prevalences of violent victimization by country, age group, and type (physical, sexual, emotional, or multiple types). We used a triangulation approach which synthesized data to generate minimum regional prevalences, derived from population-weighted averages of the country-specific prevalences. RESULTS Thirty-eight reports provided quality data for 96 countries on past-year prevalences of violence against children. Base case estimates showed a minimum of 50% or more of children in Asia, Africa, and Northern America experienced past-year violence, and that globally over half of all children-1 billion children, ages 2-17 years-experienced such violence. LIMITATIONS Due to variations in timing and types of violence reported, triangulation could only be used to generate minimum prevalence estimates. CONCLUSIONS Expanded population-based surveillance of violence against children is essential to target prevention and drive the urgent investment in action endorsed in the United Nations 2030 Sustainable Development Agenda.
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Affiliation(s)
- Susan Hillis
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | | | - Adaugo Amobi
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Chen CT, Yang NP, Chou P. Child maltreatment in Taiwan for 2004-2013: A shift in age group and forms of maltreatment. Child Abuse Negl 2016; 52:169-176. [PMID: 26726760 DOI: 10.1016/j.chiabu.2015.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 05/07/2015] [Revised: 10/11/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Abstract
Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment.
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Affiliation(s)
- Chih-Tsai Chen
- Department of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Child and Adolescent Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan; Department of Family Studies and Child Development, Shih Chien University, Taipei, Taiwan
| | - Nan-Ping Yang
- Department of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Keelung Hospital, Ministry of Health and Welfare, Keelung City, Taiwan
| | - Pesus Chou
- Department of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
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38
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Sergentanis TN, Sakelliadis EI, Vlachodimitropoulos D, Goutas N, Sergentanis IN, Spiliopoulou CA, Papadodima S. Does history of childhood maltreatment make a difference in prison? A hierarchical approach on early family events and personality traits. Psychiatry Res 2014; 220:1064-70. [PMID: 25468626 DOI: 10.1016/j.psychres.2014.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 10/19/2014] [Accepted: 10/22/2014] [Indexed: 11/29/2022]
Abstract
This study attempts to assess childhood maltreatment in prison through a hierarchical approach. The hierarchical approach principally aims to disentangle the independent effects of childhood maltreatment upon psychiatric morbidity/personality traits, if any, from the burden that the adverse family conditions have already imposed to the mental health of the maltreated individual-prisoner. To this direction, a conceptual framework with five hierarchical levels was constructed, namely: immutable demographic factors; family conditions; childhood maltreatment (physical abuse, neglect and sexual abuse); personality traits, habits and psychiatric morbidity; prison-related variables. A self-administered, anonymous set (battery) of questionnaires was administered to 173 male prisoners in the Chalkida prison, Greece; 26% of prisoners disclosed childhood maltreatment. Psychiatric condition in the family, parental alcoholism and parental divorce correlated with childhood maltreatment. After adjustment for immutable demographic factors and family conditions, childhood maltreatment was associated with aggression (both in terms of Lifetime History of Aggression and Buss–Perry Aggression Questionnaire scores), illicit substance use, personal history of psychiatric condition, current smoking, impulsivity and alcohol abuse. In conclusion, childhood maltreatment represents a pivotal, determining factor in the life course of male prisoners. Delinquents seem to suffer from long-term consequences of childhood maltreatment in terms of numerous mental health aspects.
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Taillieu TL, Afifi TO, Mota N, Keyes KM, Sareen J. Age, sex, and racial differences in harsh physical punishment: results from a nationally representative United States sample. Child Abuse Negl 2014; 38:1885-1894. [PMID: 25466426 PMCID: PMC4402223 DOI: 10.1016/j.chiabu.2014.10.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 10/17/2014] [Accepted: 10/23/2014] [Indexed: 05/29/2023]
Abstract
The purpose of this research was to examine age, sex, and racial differences in the prevalence of harsh physical punishment in childhood in a nationally representative sample of the United States. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) collected in 2004 and 2005 (n=34,653). Logistic regression analyses were conducted to examine age, sex, and racial differences in the prevalence of harsh physical punishment. Results suggest that the prevalence of harsh physical punishment has been decreasing among more recently born age groups; however, there appear to be sex and racial differences in this trend over time. The magnitude of the decrease appears to be stronger for males than for females. By race, the decrease in harsh physical punishment over time is only apparent among Whites; Black participants demonstrate little change over time, and harsh physical punishment seems to be increasing over time among Hispanics. Prevention and intervention efforts that educate about the links of physical punishment to negative outcomes and alternative non-physical discipline strategies may be particularly useful in reducing the prevalence of harsh physical punishment over time.
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Affiliation(s)
- Tamara L Taillieu
- Applied Health Sciences Program, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Tracie O Afifi
- Departments of Community Health Sciences, Psychiatry, and Family Social Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Natalie Mota
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Katherine M Keyes
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Jitender Sareen
- Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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40
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Maneff C, Jeannot E, Mpinga EK, Lazarevic CAW, Chastonay P. [School-detected child abuse in Geneva: outlook on the past 10 years]. Rev Med Suisse 2014; 10:1517-1521. [PMID: 25199228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Child and youth health service of the Canton of Geneva is an important actor in support of abused children attending school. Incidence of child abuse is stable at around 3.5 per 1,000 school children. Physical, psychological abuse and neglect are the types most frequently encountered. The main risk factors for abuse are precarious socio-economic situations, parenting issues and finally issues related to young people themselves. Although the incidence of abuse is stable in recent years, with respect to the growing number of children attending school, we can conclude that the absolute number of children at risk increases, confirming the need to develop and maintain common policies and prevention actions in this area.
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41
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Koen N, Wyatt GE, Williams JK, Zhang M, Myer L, Zar HJ, Stein DJ. Intimate partner violence: associations with low infant birthweight in a South African birth cohort. Metab Brain Dis 2014; 29:281-99. [PMID: 24729207 PMCID: PMC4300125 DOI: 10.1007/s11011-014-9525-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 03/05/2014] [Indexed: 11/28/2022]
Abstract
Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2 = 0.14 (adjusted r2 = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.
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Affiliation(s)
- Nastassja Koen
- Department of Psychiatry, Groote Schuur Hospital (J2), University of Cape Town, Cape Town, South Africa,
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42
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Syal S, Ipser J, Phillips N, Thomas KGF, van der Honk J, Stein DJ. The effect of childhood trauma on spatial cognition in adults: a possible role of sex. Metab Brain Dis 2014; 29:301-10. [PMID: 24553877 DOI: 10.1007/s11011-014-9497-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
Abstract
Although animal evidence indicates that early life trauma results in pervasive hippocampal deficits underlying spatial and cognitive impairment, visuo-spatial data from adult humans with early childhood adversity are lacking. We administered 4 tests of visuo-spatial ability from the Cambridge Neuorpsychological Test Automated Battery (CANTAB) to adults with a history of childhood trauma (measured by the Childhood Trauma Questionnaire) and a matched sample of healthy controls (trauma/control = 27/28). We observed a significant effect of trauma history on spatial/pattern learning. These effects could not be accounted for by adverse adult experiences, and were sex-specific, with prior adversity improving performance in men but worsening performance in women, relative to controls. Limitations include the small sample size and reliance of our study design on a retrospective, self report measure. Our results suggest that early adversity can lead to specific and pervasive deficits in adult cognitive function.
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Affiliation(s)
- Supriya Syal
- Department of Psychiatry and Mental Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa,
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43
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Benbenishty R, Jedwab M, Chen W, Glasser S, Slutzky H, Siegal G, Lavi-Sahar Z, Lerner-Geva L. Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services. Child Abuse Negl 2014; 38:11-24. [PMID: 23948314 DOI: 10.1016/j.chiabu.2013.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 03/25/2013] [Revised: 06/11/2013] [Accepted: 06/25/2013] [Indexed: 06/02/2023]
Abstract
This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement.
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Affiliation(s)
| | | | - Wendy Chen
- The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Israel
| | - Saralee Glasser
- Women & Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research (Ltd), Israel
| | - Hanna Slutzky
- Protective Services, Ministry of Welfare and Social Services, Israel
| | - Gil Siegal
- Gertner Institute for Epidemiology & Health Policy Research (Ltd), USA; UVA Law School, USA; Kiryat Ono College, Israel
| | | | - Liat Lerner-Geva
- Women & Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research (Ltd), Israel; The Sackler Faculty of Medicine, Tel Aviv University, Israel
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Brooks-Gunn J, Schneider W, Waldfogel J. The Great Recession and the risk for child maltreatment. Child Abuse Negl 2013; 37:721-9. [PMID: 24045057 PMCID: PMC3811916 DOI: 10.1016/j.chiabu.2013.08.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/02/2013] [Accepted: 08/08/2013] [Indexed: 05/18/2023]
Abstract
This study draws on the Fragile Families and Child Wellbeing Study (N=2,032), a birth cohort study of families with children from 20 U.S. cities. Interviews occurred between August 2007, and February 2010, when the children were approximately 9 years old. Macro-economic indicators of the Great Recession such as the Consumer Sentiment Index and unemployment and home foreclosure rates were matched to the data to estimate the links between different measures of the Great Recession and high frequency maternal spanking. We find that the large decline in consumer confidence during the Great Recession, as measured by the Consumer Sentiment Index, was associated with worse parenting behavior. In particular, lower levels of consumer confidence were associated with increased levels of high frequency spanking, a parenting behavior that is associated with greater likelihood of being contacted by child protective services.
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Affiliation(s)
- Jeanne Brooks-Gunn
- College of Physicians and Surgeons and Teacher�s College, Columbia University, New York, NY
| | | | - Jane Waldfogel
- Columbia University School of Social Work, New York, NY
- London School of Economics, London, UK
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45
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Damashek A, Nelson MM, Bonner BL. Fatal child maltreatment: characteristics of deaths from physical abuse versus neglect. Child Abuse Negl 2013; 37:735-744. [PMID: 23768940 DOI: 10.1016/j.chiabu.2013.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 10/19/2012] [Revised: 04/12/2013] [Accepted: 04/25/2013] [Indexed: 06/02/2023]
Abstract
This study examined victim, family, and alleged perpetrator characteristics associated with fatal child maltreatment (FCM) in 685 cases identified by child welfare services in the state of Oklahoma over a 21-year period. Analyses also examined differences in child, family, and alleged perpetrator characteristics of deaths from abuse versus neglect. Case information was drawn from child welfare investigation records for all FCM cases identified by the state Department of Human Services. Fatal neglect accounted for the majority (51%) of deaths. Children were primarily younger than age 5, and parents were most frequently the alleged perpetrators. Moreover, most victims had not been the subject of a child welfare report prior to their death. A greater number of children in the home and previous family involvement with child welfare increased children's likelihood of dying from neglect, rather than physical abuse. In addition, alleged perpetrators of neglect were more likely to be female and biologically related to the victim. These results indicate that there are unique family risk factors for death from neglect (versus physical abuse) that may be important to consider when selecting or developing prevention efforts.
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46
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Katz C. The narratives of abused children who have survived attempted filicide. Child Abuse Negl 2013; 37:762-770. [PMID: 23735872 DOI: 10.1016/j.chiabu.2013.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 01/27/2013] [Revised: 04/04/2013] [Accepted: 04/23/2013] [Indexed: 06/02/2023]
Abstract
Child abuse is a social problem that receives much attention from policy makers, practitioners, and researchers. This alarming phenomenon generates many consequences for children, their families, and society as a whole; one tragic consequence of child abuse is filicide. Because of the unfortunate circumstances surrounding such events, children are hushed by their perpetrators, whether abusers or killers, and we are thus denied the opportunity to hear their voices and to promote understanding of the phenomenon. The aim of the current study is to explore in depth the patterns and themes that can be found in the narratives of children who survived a murder attempt by one of their parents. Content analysis was performed on seven investigative interviews with children using thematic analysis. Five key categories were determined based on the children's narratives: (a) many bad things have happened to me, (b) this was not the first time I was abused by my parent, (c) I am concerned about my parent, (d) I am alive thanks to my siblings, and (e) it is hard to remember what exactly happened. This study contributes to the understanding of child physical abuse and filicide. The discussion integrated conclusions for policy makers and practitioners who seek methods of addressing child abuse as well as determining whether and how filicide can be prevented.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel
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47
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Scribano PV, Makoroff KL, Feldman KW, Berger RP. Association of perpetrator relationship to abusive head trauma clinical outcomes. Child Abuse Negl 2013; 37:771-777. [PMID: 23735871 DOI: 10.1016/j.chiabu.2013.04.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 07/23/2012] [Revised: 04/22/2013] [Accepted: 04/25/2013] [Indexed: 06/02/2023]
Abstract
The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥ 1 year (77% vs. 23%, p<0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted.
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Affiliation(s)
- Philip V Scribano
- The Children's Hospital of Philadelphia, 34th and Civic Center Blvd., Philadelphia, PA 19104, USA
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Garbarino J. Socioeconomic forces and the problem of counting in understanding child abuse and neglect: commentary on "The great recession and the risk for child maltreatment". Child Abuse Negl 2013; 37:730-734. [PMID: 24045058 DOI: 10.1016/j.chiabu.2013.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Katz C. The narratives of abused children who have survived attempted filicide. Child Abuse Negl 2013; 37:762-770. [PMID: 23735872 DOI: 10.1016/j/chiabu.2013.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 04/04/2013] [Accepted: 04/23/2013] [Indexed: 05/27/2023]
Abstract
Child abuse is a social problem that receives much attention from policy makers, practitioners, and researchers. This alarming phenomenon generates many consequences for children, their families, and society as a whole; one tragic consequence of child abuse is filicide. Because of the unfortunate circumstances surrounding such events, children are hushed by their perpetrators, whether abusers or killers, and we are thus denied the opportunity to hear their voices and to promote understanding of the phenomenon. The aim of the current study is to explore in depth the patterns and themes that can be found in the narratives of children who survived a murder attempt by one of their parents. Content analysis was performed on seven investigative interviews with children using thematic analysis. Five key categories were determined based on the children's narratives: (a) many bad things have happened to me, (b) this was not the first time I was abused by my parent, (c) I am concerned about my parent, (d) I am alive thanks to my siblings, and (e) it is hard to remember what exactly happened. This study contributes to the understanding of child physical abuse and filicide. The discussion integrated conclusions for policy makers and practitioners who seek methods of addressing child abuse as well as determining whether and how filicide can be prevented.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel
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Abstract
The constantly changing nature of social care practice necessitates continuous development of educational programs to prepare current practitioners. Basing social work practice on methodologically sound research evidence is an appealing prospect for the child protection services. However, Romania, once considered an Eastern European model for child welfare policy and practice, is somehow lagging behind. In this article the author gives a short overview of where the Romanian Child Protection System currently stands in terms of evidence-based practice.
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Affiliation(s)
- Mihai-Bogdan Iovu
- a School of Sociology and Social Work, Babeş-Bolyai University Cluj-Napoca , Cluj-Napoca , Romania
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