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Background: To investigate the educational outcomes of siblings of childhood leukemia survivors, explore determinants of school difficulties, and compare the rates of repeating grades between siblings and the general population. Methods: A cross‐sectional study of childhood leukemia survivors' siblings recruited through the Leucémies de l'Enfant et de l'Adolescent cohort, a French long‐term follow‐up program, was conducted, and education‐related data were obtained via self‐report questionnaires. Adjusted logistic regression models were used to identify variables associated with school difficulties and time since diagnosis. Rates of repeating a grade in middle school were compared between siblings and the general population of the same generation. Results: A total of 564 siblings with a mean time from diagnosis of 14.1 ± 6.4 years were included, among whom 139 (24.6%) repeated a grade, at an average of 6.4 ± 4.5 years after diagnosis. In multivariate analysis, the risk factors for repeating a grade were older siblings (odds ratio [OR] 2.3, p = 0.006), family financial difficulties (OR 2.8, p = 0.008), and history of repetition in survivors (OR, 2.5, p = 0.001). Sibling hematopoietic stem cell donors were at greater risk of repeating a grade long‐term after diagnosis (p = 0.018). Overall, siblings did not have a higher risk of educational delays at the end of middle school than the general population. Conclusion: Although the results are reassuring, socioeconomic and cancer‐related factors may have an impact on siblings' schooling long after diagnosis. Paying attention to siblings contributes to identifying the most vulnerable families, allowing more attention and appropriate resources to avoid long‐term repercussions. Additionally, supportive and targeted interventions can be developed to improve the organization of education and the health care system. [ABSTRACT FROM AUTHOR]

Child and family social workers routinely make professional judgements involving significant legal and moral questions (e.g. whether a child has been abused) and more 'everyday' issues (e.g. will the child be re‐referred again if we close the case now?) Yet the world is capricious, and we rarely know with certainty what is going to happen in future or the likely impact of our different choices. Given the consequences of their judgements and decisions, it is imperative that social workers are provided with the best possible support. This paper reports a proof‐of‐concept study of a set of interventions to improve the judgemental accuracy of social workers: (i) a survey to identify respondents with above‐average existing abilities, (ii) training sessions on cognitive debiasing and (iii) structured group working and (iv) three methods for aggregating individual judgements. Findings indicate that it is possible to measure the accuracy of social work judgements in relation to case‐study materials and retrospective questions, while the feedback about the training was largely positive. Any future studies should aim to recruit a more diverse set of respondents, test judgemental accuracy in relation to prospective judgements and explore what types of questions would be most helpful for real‐world decision‐making. [ABSTRACT FROM AUTHOR]

Self‐reported lost memory of child sexual abuse (CSA) can be mistaken for "repressed memory." Based on our longitudinal studies of memory and disclosure in child maltreatment victims who are now adults, we discuss findings relevant to "repressed memory cases." We examined relations between self‐report of temporarily lost memory of CSA (subjective forgetting) and memory accuracy for maltreatment‐related experiences (objective memory). Across two studies involving separate samples, we find evidence for memory suppression rather than repression: (1) Most adults who claimed temporary lost memory of CSA reported memory suppression and clarified that they could have remembered the event if asked; (2) subjective forgetting was positively associated with accurate objective memory for maltreatment‐related experiences. Subjective forgetting was also related to increased adult trauma symptoms and related to childhood non‐disclosure of CSA. Moreover, trauma‐related psychopathology mediated the relation between non‐disclosure and subjective forgetting. Implications for psychological theory and repressed memory cases are discussed. Self‐reported forgetting of child sexual abuse (CSA) may be misattributed to repressed memory. Using evidence from two longitudinal studies with separate maltreatment samples, we identify memory suppression as a more viable explanation than repression for CSA memory that has been reportedly lost and then retrieved. Important relations between self‐reported lost memory of CSA, accuracy of abuse‐related memory, childhood non‐disclosure of CSA, and adult trauma symptoms emerged, with significant legal implications. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma‐related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families. [ABSTRACT FROM AUTHOR]

Background: Prior studies have established an association between a history of abuse and more severe migraine presentation. Objectives: This cross‐sectional, observational study of a clinic‐based migraine population used validated measures to elucidate migraine‐specific and migraine‐related burdens among patients with a history of abuse. Methods: Patients with migraine (n = 866) from the American Registry for Migraine Research self‐reported if they had a history of emotional, physical, and/or sexual abuse and completed questionnaires assessing migraine‐related burden: Migraine Disability Assessment, Subjective Cognitive Impairment Scale for Migraine Attacks, Work Productivity and Activity Impairment, Patient‐Reported Outcomes Measurement Information System Pain Interference, Patient Health Questionnaire‐2, and Generalized Anxiety Disorder‐7. Migraine‐related burden in patients with versus without a history of abuse was compared. Subsequently, a mediation analysis evaluated the impact of depression and anxiety symptoms in the relationship between abuse history and migraine burden. Results: A history of abuse was reported by 36.5% (n = 316/866) of participants. After controlling for patient age, sex, years lived with headache, and headache frequency, a history of abuse was significantly associated with more severe migraine‐related disability. The combined burden of depression and anxiety symptoms mediated the relationship. Conclusion: A history of abuse is associated with greater migraine‐related disability. Future studies should determine if identification and management of the psychological and physical sequelae of abuse reduce migraine burden. Plain Language Summary: In this study, we found that patients with migraine who participated in the American Registry for Migraine Research and self‐reported a history of emotional, physical, or sexual abuse had worse migraine‐related burden than patients with migraine without a history of abuse. For example, patients who are survivors of abuse described a greater impact of migraine on their work, day‐to‐day living, and cognition. This increased migraine burden may be because of depression and anxiety, and we wonder if treating the underlying causes of these mental health difficulties might reduce their migraine burden. [ABSTRACT FROM AUTHOR]

Objectives: Recovery from sexual trauma can be complex and multi‐faceted. Most current psychological treatment protocols for trauma use a cognitive model of post‐traumatic stress disorder (PTSD). However, sexual trauma may include specific complexities beyond that of a cognitive model of PTSD, such as relational factors. The distress experienced after sexual abuse may involve variables not exclusive to a PTSD model. Compassion focused therapy (CFT) is an approach that incorporates evolutionary, relational and social perspectives. This study explored the relationships between variables associated with CFT, PTSD and distress in survivors of sexual abuse to determine the role of CFT‐related variables. Methods: 155 adults who had experienced sexual abuse or any unwanted sexual experience at any point in their lives completed online questionnaires pertaining to various CFT variables (self‐compassion, receiving compassion from others, having a fear of compassion from others, having a fear of compassion from the self, shame and self‐criticism) and questionnaires measuring global distress as the outcome of sexual abuse and PTSD symptoms. Results: An exploratory model involving CFT‐related variables explained significantly more of the variance (4.4%) in global distress than PTSD symptomology alone. Self‐criticism was found to be the variable with significant contribution. Conclusions: That CFT treatments, targeting self‐criticism, should be developed alongside the standard cognitive model of PTSD based treatments for survivors of sexual abuse was supported. Future research may explore experimental designs utilizing CFT in this population, as well as further investigations on the roles of these specific CFT variables. [ABSTRACT FROM AUTHOR]

Using a qualitative multi‐methods approach, this study explored the offence, survivor and perpetrator characteristics, and the lived experiences of child and adolescent survivors of child sexual abuse (CSA) in Ghana. We analysed the contents of local media reports of CSA cases from January 2015 to December 2020 in Ghana, after which we conducted semi‐structured interviews involving five female child and adolescent survivors of CSA. The media content analysis identified 529 eligible reports involving female (n = 516) and male (n = 13) survivors aged 11–18 years who knew the perpetrators. The perpetrators were all‐male youth and middle‐aged adults employed in low‐income status occupations. Defilement was the most reported sexual offence; the survivors were more likely to come from single‐parent families experiencing poverty and economic hardship. The perpetrators employed multiple methods to coerce and elicit compliance from their victims: confidence approaches, violence (blitz methods) and gifts. Content analysis showed that most of the survivors attributed their victimisation to family poverty and dysfunctional parent–child relationships. These findings underscore a need to develop prevention strategies that empower young females and males to identify, escape or avoid (potential) sexual predators and encourage reporting and disclosure of CSA victimisation to formal support institutions. [ABSTRACT FROM AUTHOR]

Aim: To examine how school environment, physical functioning problems, and behavioral problems explain levels of school participation (i.e. attendance and involvement) among young people with craniofacial microsomia (CFM) and other childhood‐onset disabilities, and whether participation‐focused caregiver strategies play a role in these relationships. Method: We conducted secondary analyses of a subset of data (n = 260 families: 120 with CFM and 140 with other childhood‐onset disabilities) from the second follow‐up phase of a longitudinal cohort study. We applied structural equation modeling with data collected from the Participation and Environment Measure – Children and Youth version, the Child Behavior Checklist, and the Pediatric Quality of Life Inventory physical functioning scale. Results: Model fit was acceptable to close (comparative fit index = 0.973; root mean square error of approximation = 0.055; standardized root mean squared residual = 0.043; Tucker–Lewis index = 0.958). School environmental support had a positive effect on young people's participation attendance and involvement, and physical functioning problems had a negative effect on participation involvement. The number of disclosed caregiver strategies had a significant positive effect on the relationship between school environmental support and school participation attendance. Interpretation: Findings confirm the effect of school environmental support and physical functioning problems on school participation and highlight the role of participation‐focused caregiver strategies to intensify the positive effect of school environmental support on school participation attendance. What this paper adds: Environmental support had a positive effect on participation attendance and involvement.Physical functioning problems had a negative effect on school participation involvement.Disclosed caregiver strategies intensified the impact of environmental support on participation attendance. [ABSTRACT FROM AUTHOR]

Objective: To describe young adult childhood cancer survivors' disclosure of their cancer history (i.e., disclosure behavior, difficulty, and timing), perceived partner responses, and associations with relationship status satisfaction. Methods: German long‐term survivors of childhood cancer (N = 509; response rate: 31.3%, age 21–26, 59.7% female) completed a registry‐based nationwide survey (embedded mixed methods design, including closed and open‐ended questions) on measures about disclosure history (behavior, difficulty, and timing), partner responses, and relationship status satisfaction. Statistical (χ2‐, t‐, or F‐tests) and qualitative analyses were conducted. Results: Half of all survivors always disclosed their cancer history to romantic partners. Thereby, three themes for considering (non‐)disclosure were identified: Survivors' attitudes, having integrated cancer as part of their identity, and anticipated effects on romantic relationships. About 40% indicated having no difficulties with disclosing their cancer history. The timing of disclosure varied, with most survivors disclosing after a few dates. Facilitators of disclosure were the visibility of their former illness (e.g., scars), having trust in a (potential) partner, getting older/mature, and previous positive experiences with disclosure. Few survivors (13.8%) had ever experienced negative responses from dating partners. Yet, those who had negative experiences, found it more difficult to disclose their cancer history. Survivors were overall rather satisfied with their relationship status, with partnered survivors reporting greater satisfaction than singles (Hedge's g = 1.68); and particularly partnered survivors with past positive responses being most satisfied. Conclusions: Young adult childhood cancer survivors appear rather open in disclosing their cancer history to (potential) romantic partners, and few experienced negative responses. Psycho‐educational programs may emphasize such findings in helping to prevent fear of disclosure or avoidance of dating and disclosure among survivors. [ABSTRACT FROM AUTHOR]

Objectives: Childhood cancer survivors' social reintegration may be hampered in low and middle‐income countries. The nature and extent of social challenges and prejudices that survivors encounter in such settings are largely unknown. This study explores caregivers' perspectives on social reintegration and stigmatization of Kenyan childhood cancer survivors. Methods: Caretakers of childhood cancer survivors (<18 years) were interviewed using mixed‐methods questionnaires during home or clinic visits between 2021 and 2022. Stigma was assessed with an adjusted Social Impact Scale and risk factors were investigated. Results: Caretakers of 54 survivors (median age 11 years) were interviewed. Families' income (93%) decreased since start of treatment. Caretakers (44%) often lost their jobs. Financial struggles (88%) were a burden that provoked conflicts within communities (31%). School fees for siblings became unaffordable (52%). Families received negative responses (26%) and were left or avoided (13%) by community members after cancer disclosure. Survivors and families were discriminated against because the child was perceived fragile, and cancer was considered fatal, contagious, or witchcraft. Survivors repeated school levels (58%) and were excluded from school activities (19%) or bullied (13%). Performance limitations of daily activities (p = 0.019), male sex (p = 0.032), solid tumors (p = 0.056) and a short time since treatment completion (p = 0.047) were associated with increased stigma. Caretakers recommended educational programs in schools and communities to raise awareness about cancer treatment and curability. Conclusions: Childhood cancer survivors and their families experienced difficulties with re‐entry and stigmatization in society. Increasing cancer and survivorship awareness in schools and communities should facilitate social reintegration and prevent stigmatization. [ABSTRACT FROM AUTHOR]

Cumulative childhood maltreatment (CCM) is associated with relationship difficulties including lower perceived partner responsiveness (PPR)—the degree of feeling cared for, understood, and validated by a person's partner. Attachment theory is understood via its representations of self and others and could offer a better understanding of how CCM effects continue into adulthood and affect PPR. We examined whether CCM is related to PPR via attachment in French‐speaking adolescents and young adults. A sample of 427 individuals in a romantic relationship and another sample of 159 couples completed self‐report measures. In both samples, a person's CCM was associated with their own lower PPR via their higher attachment anxiety and avoidance. In the dyadic sample, a person's CCM was associated with their partner's lower PPR via their own higher attachment anxiety. Attachment insecurities help understand the associations between CCM and PPR and may represent an important intervention target. [ABSTRACT FROM AUTHOR]

Maltreatment survivors may be at risk for parenting challenges, although the previous literature is inconsistent, has focused on individual maltreatment forms, and has overlooked posttraumatic stress symptoms (PTSS) and other trauma exposure. The current study, thus, aimed to expand this research in four key ways by (a) examining all five maltreatment forms; (b) controlling for other nonmaltreatment trauma exposure to better isolate the role of maltreatment; (c) investigating maltreatment types and PTSS simultaneously; and (d) exploring novel parenting factors, specifically four types of parenting beliefs and developmental knowledge. Trauma‐exposed parents (N = 301; Mage = 26.49 years, SD = 8.34, range: 18–69 years; 66.8% female; 59.8% White) participated in the study. A path analytic model indicated that, surprisingly, none of the maltreatment types nor cumulative trauma exposure corresponded with parental beliefs related to one's child, self, partner, or social relationships. PTSS, however, were tied to all four parenting belief types as well as developmental knowledge, βs = −.05—.40. Physical and emotional abuse were linked to less accurate developmental knowledge, β =.02, and maladaptive parenting practices, β =.03. Sexual abuse, neglect, and witnessing domestic violence were not associated with any of the parenting factors. Thus, current trauma symptoms are likely a more critical intervention focus than maltreatment experiences, although physical and emotional abuse may also play a role in parenting knowledge and behaviors. These findings also signal the importance of including all five maltreatment forms and PTSS when conducting research on the interaction between trauma and parenting. [ABSTRACT FROM AUTHOR]

Intrafamilial child sexual abuse (IFCSA) is perceived as a crime perpetrated without witnesses. Nevertheless, researchers have explored two main aspects of the others present during abusive incidents: bystanders in extra‐familial child sexual abuse and bystanders' decisions of whether to become involved. However, there is a lack of knowledge regarding how children and survivors perceive and experience the presence of others during abusive incidents. The current study examined survivors' experiences and perceptions concerning the presence of others during IFCSA based on their written testimonies for an independent inquiry. Of the more than 500 written testimonies sent to an independent Israeli inquiry, 16 addressed IFCSA and the others present. Inductive thematic analysis was conducted, and four main themes were identified: survivors' perceptions of others, others' responses to the abuse, familial dynamics with others during abuse, and acceptance. The discussion addresses the phenomenon of the presence of others during IFCSA and related theories of trauma and family dynamics. The findings challenge the social perception of IFCSA as a secret, highlighting the awareness that characterizes it in reality, as illustrated in the survivors' testimonies. This emphasizes the urgent need for policy‐makers and professionals to promote the publicness of IFCSA instead of maintaining its secrecy. [ABSTRACT FROM AUTHOR]

Introduction: Childhood abuse could potentially cause negative health consequences later in life, where they influence individuals' physiological, psychological, and behavioral health. Screening for ACEs is not widely incorporated during routine primary healthcare. The information about past childhood abuse screening among adult patients is elusive. The aim of the study was to investigate healthcare providers (HCPs) practices, skills, attitudes, and perceived barriers related to past childhood abuse screening among adult patients in Saudi Arabia. Design: Cross‐sectional study. Methods: Data were collected from healthcare facilities in the Riyadh and Madinah regions of Saudi Arabia using a self‐reported questionnaire. Results: A total of 126 HCPs completed the survey. Less than one‐third of the HCPs reported routinely (usually or always) screening for childhood abuse. HCPs were more concerned that they would offend their patients by examining history of adversities. HCP practice location, the extent to which they think it is part of their responsibilities to screen for history of adversities, and their self‐reported of adverse childhood experiences were significantly associated with screening practices for childhood abuse. Four perceived barriers were significantly associated with HCP screening. Conclusion: Screening for past adversities is vital for identifying childhood trauma among the public; therefore, we might participate in reducing childhood trauma and further controlling consequences in the future. Developing a screening form for childhood abuse or adversities and providing this form in healthcare settings are appropriate at this stage. Clinical Relevance: Early screening for ACEs is recommended, which prioritizes health promotion and disease prevention. It is highly needed to increase HCP awareness toward childhood abuse, screening for it, and reflection on it. [ABSTRACT FROM AUTHOR]

In creating a situation in which Camila has no reasonable choice but to infringe Jacqueline's right against deception, has Jacqueline thereby violated Camila's I privacy i ? 36 You might think that if Jacqueline tells this story I with the intention i of extracting private information from Camila, then Jacqueline clearly I would i violate Camila's privacy rights. Nor need we say that Camila has a right that Jacqueline not perform I any i action that results in Jacqueline acquiring the information that Camila has cancer. We needn't say that if Jacqueline tells a story about her cousin's cancer diagnosis, and Camila turns white, and Jacqueline realizes that her hunch about Camila's diagnosis is correct, then Jacqueline, in telling the story, violates Camila's rights. We only need to say that Camila has a right that Jacqueline not take certain actions that will, if not almost certainly, then very likely foreclose Camila's capacity to choose whether to reveal her diagnosis to Jacqueline. [Extracted from the article]

Men who have sex with men (MSM) report childhood sexual abuse (CSA) at higher rates than heterosexual men. The literature has established a clear association between CSA and sexual risk taking. Biomedical HIV preventative approaches are effective tools for reducing HIV acquisition. Since many studies are conducted on MSM broadly, the objective of this review was to examine outcomes of studies on MSM with CSA histories and HIV biomedical approaches. The PRISMA checklist was used to extract data from the included studies. Of 124 studies retrieved, seven articles (n = 7) met the inclusion criteria. Studies included in the review were predominately correlational. Four themes were identified which were sexual behaviour, mental health, drug use/polydrug abuse and intimate partner violence. All identified variables impacted biomedical adherence either directly or indirectly. However, negative childhood experiences were not the dominant priority in the studies reviewed. In addition, there were confusion over how some variables were operationalized. This systematic review highlights the need for further research and intervention development based on past experiences and trauma, especially among MSM of colour. Approaches that incorporate past trauma should be the future focus of HIV prevention and management. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether women's exposure to multiple types of violence during childhood and pregnancy was associated with children's BMI trajectories and whether parenting quality moderated those associations. Methods: A cohort of 1288 women who gave birth between 2006 and 2011 self‐reported their exposure to childhood traumatic events, intimate partner violence (IPV), and residential address (linked to geocoded index of violent crime) during pregnancy. Children's length/height and weight at birth and at age 1, 2, 3, 4 to 6, and 8 years were converted to BMI z scores. Observed mother–child interactions were behaviorally coded during a dyadic teaching task. Results: Covariate‐adjusted growth mixture models identified three trajectories of children's BMI from birth to 8 years old: Low‐Stable (17%), Moderate‐Stable (59%), and High‐Rising (22%). Children whose mothers experienced more types of IPV during pregnancy were more likely to be in the High‐Rising than the Low‐Stable (odds ratio [OR] = 2.62; 95% CI: 1.27–5.41) trajectory. Children whose mothers lived in higher crime neighborhoods were more likely to be in the High‐Rising than the Low‐Stable (OR = 1.11; 95% CI:1.03–1.17) or Moderate‐Stable trajectories (OR = 1.08; CI: 1.03–1.13). Main effects of childhood traumatic events and moderation by parenting were not detected. Conclusions: Maternal experiences of violence during pregnancy increase children's risk for developing overweight, highlighting intergenerational transmission of social adversity in children's health. [ABSTRACT FROM AUTHOR]

Contemporary Developments in the Area of Non-recent Child Sexual Abuse: Moving from What Is Wrong with You and What Happened to You, to What Are We Going To Do About It Now? It found that one in 13 adults reported experiencing CSA, with 9% in total reporting contact CSA and 3% non-contact CSA. The knowledge of child sexual abuse (CSA) - the recognition of its prevalence and the reality of its impact - has been lost and found in repeated cycles within society and perhaps particularly within the field of mental health. [Extracted from the article]

Objective: Eating disorders (EDs) are associated with a high prevalence of childhood maltreatment (CM). We aimed to experimentally assess if people with EDs and history of CM show altered biological, emotional and behavioural responses to the Trier Social Stress Test (TSST). Methods: According to Childhood Trauma Questionnaire cut‐off scores, 29 participants (14 with anorexia nervosa [AN] and 15 with bulimia nervosa [BN]) were classified as maltreated (Mal) ED participants while 19 participants (11 with AN and eight with BN) without CM were identified as no maltreated (noMal) ED participants. Cortisol, anxiety and hunger responses to TSST and post‐stress body dissatisfaction were measured. Results: Mal ED people showed heightened emotional reactivity, lower levels of hunger and more severe post‐stress body dissatisfaction in comparison with noMal ones. Higher cortisol production was observed in people with AN, regardless of CM history, and in those with BN and emotional CM. Emotional trauma was the main CM type contributing to the experimental differences observed in Mal ED people. Conclusions: This is the first study providing experimental and multi‐level support to the maltreated ecophenoptype hypothesis in people with EDs. These findings may promote new insights into the biological bases of EDs and provide novel therapeutic implications. Highlights: Childhood maltreatment affects psychological and biological responses to acute psychosocial stress in people with eating disorders (EDs)Emotional trauma is the main childhood maltreatment type contributing to the observed experimental differencesExperimental and multi‐level data support the identification of a maltreated ecophenoptype in people with EDs [ABSTRACT FROM AUTHOR]

Although it is well established that intimate partner violence (IPV) is detrimental to women's mental health, it remains unclear to what extent symptoms can be attributed to the proximal effects of IPV exposure itself as opposed to more stable scarring effects or co‐occurring risk factors. Heterogeneity in the magnitude of IPV effects further suggests that IPV‐exposed individuals are differentially susceptible to disorder, and an investigation of moderating factors that may make women more vulnerable is warranted. We used a prospective longitudinal study of low‐income mothers followed from 3 to 18 months postpartum to distinguish the concurrent mental health effects of IPV exposure from overall person‐level IPV‐mental health associations, as well as to test the moderating role of prior relational traumatic experiences in the form of childhood maltreatment. Multilevel modeling results demonstrated a unique concurrent association between increasing IPV and women's posttraumatic symptoms over time, even after controlling for an overall association between mean IPV and symptom levels. The effects of concurrent IPV were heightened in women who reported a history of childhood maltreatment. Model effects were medium to large, R2 =.27–.35. The implications of these findings for the identification of and intervention with women at the highest risk for relational trauma‐related mental health difficulties are discussed. [ABSTRACT FROM AUTHOR]

When young people are sexually exploited, parents and professionals alike can feel uncertain about how to balance the need to protect the child's rights to agency and autonomy while also reducing the risk of harm. Despite the shared interest in keeping young people safe, there remains a substantial gap in the research literature about how practitioners engage parents to increase capacity to safeguard their children, particularly within the context of a child protection system ill‐equipped to address forms of extrafamilial harm such as child sexual exploitation. This paper aims to contribute to understanding how professionals effectively engage parents by drawing upon evidence from research evaluations of two programmes in rural/urban North and urban South locations in England, both providing specialist support to parents/carers of sexually exploited children and young people. Through interrogating elements of effective support work evidenced across both programmes, a set of emerging key themes are presented, proposing that parent support and engagement can create a 'virtuous' cycle, whereby families are strengthened and are better able to protect their children from sexual exploitation and other forms of extrafamilial harm. [ABSTRACT FROM AUTHOR]

Research demonstrates that relationships are key when working to support young people affected by sexual violence. Within these relationships, young people show a preference for non‐judgemental, flexible, consistent and informal support. Peer support – defined here as support provided by those with similar experiences – is however an uncharted area for assisting young people affected by sexual violence. This paper draws on interviews with 25 respondents with knowledge and experience of setting up, supervising and/or participating in peer support initiatives for young people impacted by different forms of sexual violence in Europe and North America. The article highlights how one form of peer support, peer or 'survivor' mentoring, can provide emotional and social support; create space for 'normality'; and give choices to young people. It outlines three unique dimensions to the support provided by peers more generally: relatability, credibility and translatability. The discussion reflects on what this might mean for traditional support provided by professionals. It also draws attention to the significance of recognising both the variety of experience and identity of young survivors of sexual trauma and the impact this may have on promoting relatability within relationships. [ABSTRACT FROM AUTHOR]

Expressive flexibility is the ability to express or suppress one's emotions to meet the demands of the situation. Recent work suggests that expressive flexibility is associated with better adjustment. However, few studies have focused on expressive flexibility in children. In addition, there is a dearth of research on possible correlates, such as culture, parental emotion socialization, and socioeconomic status, that may be associated with expressive flexibility competencies in children. The purpose of this study was to investigate cultural differences in children's expressive flexibility, maternal emotion control values (ECVs), and their relations to family socioeconomic status (SES) during middle childhood in a sample of European American (N = 31, M age = 9.61 years; 54.8% males), Korean American (N = 38, M age = 9.16 years; 55.3% males) and South Korean children (N = 77, M age = 9.74 years; 51.9% males). Mothers reported on demographics and their emotion control values. Children's expressive flexibility ability was assessed using a lab‐based observational measure. Multivariate analyses of covariance controlling for SES, child age, and gender suggested significant cultural differences in expressive flexibility, with the U.S. children (both European and Korean Americans) scoring higher on expressive flexibility compared to their South Korean counterparts. Results also suggested significant cultural differences regarding maternal ECVs; Korean Americans were more similar to South Koreans, both scoring higher on ECVs than European Americans. Socioeconomic status, but not maternal ECVs, were associated with children's expressive flexibility, independent of child age, sex, and culture. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence in Australia of each type of child maltreatment; to identify gender‐ and age group‐related differences in prevalence. Design, setting: Cross‐sectional national survey; mobile telephone interviews using random digit dialling (computer‐generated), Australia, 9 April – 11 October 2021. Retrospective self‐report data using validated questionnaire (Juvenile Victimisation Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study). Participants: People aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from five further age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures: Proportions of respondents reporting physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence to age 18 years, assessed with the Juvenile Victimization Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study), overall and by gender and age group, and weighted to reflect characteristics of the Australian population aged 16 years or more in 2016. Results: Complete survey data were available for 8503 eligible participants (14% response rate). Physical abuse was reported by 32.0% of respondents (95% confidence interval [CI], 30.7–33.3%), sexual abuse by 28.5% (95% CI, 27.3–29.8%), emotional abuse by 30.9% (95% CI, 29.7–32.2%), neglect by 8.9% (95% CI, 8.1–9.7%), and exposure to domestic violence by 39.6% (95% CI, 38.3–40.9%). The proportions of respondents who reported sexual abuse, emotional abuse, or neglect were each statistically significantly larger for women than men. The reported prevalence of physical abuse by respondents aged 16–24 years was lower than for those aged 25–34 years, and that of sexual abuse was lower than for those aged 35–44 years, suggesting recent declines in the prevalence of these maltreatment types. Conclusions: Child maltreatment is common in Australia, and larger proportions of women than men report having experienced sexual abuse, emotional abuse, and neglect during childhood. As physical and sexual abuse may have declined recently, public health policy and practice may have positive effects, justifying continued monitoring and prevention activities. [ABSTRACT FROM AUTHOR]

Objectives: To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Design, setting: Cross‐sectional, retrospective survey using the Juvenile Victimization Questionnaire‐R2: Adapted Version (Australian Child Maltreatment Study); computer‐assisted mobile telephone interviews using random digit dialling, Australia, 9 April – 11 October 2021. Participants: Australians aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from the five age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures: Self‐reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission; and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio‐economic status, financial hardship (childhood and current), and geographic remoteness. Results: A total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.16–1.66), particularly admission with a mental disorder (aOR, 2.4; 95% CI, 1.03–5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37; 95% CI, 1.87–3.02) or of a consultation with a mental health nurse (aOR, 2.67; 95% CI, 1.75–4.06), psychologist (aOR, 2.40; 95% CI, 2.00–2.88), or psychiatrist (aOR, 3.02; 95% CI, 2.25–4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use. Conclusions: Child maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer term wellbeing and reducing their health system use throughout life. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is an issue of epidemic proportions in the United Kingdom (UK) and an international public health problem. Evidence suggests that in the UK one in 20 children have been sexually abused, with one in three not telling anyone about it at the time of the abuse. Conservative estimates suggest that around one in six men have experienced sexual abuse before the age of 18. CSA has been correlated with the development of numerous mental health problems, abused men often displaying externalizing behaviours, including substance misuse, 'risky' sexual behaviours, anti‐social behaviour, and offending. This article reports on one aspect of a research study focusing specifically on male survivors of CSA and its effect on their mental health. Using narrative research, face‐to‐face interviews were used to collect the stories of four men who participated in the research. Interviews were audio‐recorded and transcribed verbatim. Analysis used a two‐phase approach; initially, each narrative was analysed as a whole, with an across transcripts analysis then being carried out identifying shared themes emerging from the individual stories. Whilst findings from the second phase of the analysis identify four themes, it is the theme of 'Blocking the Memories' that is the focus for this article. Making a valuable contribution to existent knowledge regarding the experiences of men who were sexually abused as children, this article will help to inform mental health practitioners who are likely to deliver care to male survivors of CSA. [ABSTRACT FROM AUTHOR]

Issue addressed: In Australia, one in four (24.9%) children live with overweight or obesity (OW/OB). Identifying infants at risk of developing childhood OW/OB is a potential preventive pathway, but its acceptability is yet to be investigated in Australia. This study aimed to (1) investigate the acceptability of predicting childhood OW/OB with parents of infants (aged 0‐2 years) and clinicians and (2) explore key language to address stigma and maximise the acceptability of predicting childhood OW/OB in practice. Methods: This was a cross‐sectional and qualitative design, comprising individual semi‐structured interviews. Participants were multidisciplinary paediatric clinicians (n = 18) and parents (n = 13) recruited across public hospitals and health services in Queensland, Australia. Data were analysed under the Framework Method using an inductive, thematic approach. Results: Five main themes were identified: (1) Optimism for prevention and childhood obesity prediction, (2) parent dedication to child's health, (3) adverse parent response to risk for childhood obesity, (4) language and phrasing for discussing weight and risk and (5) clinical delivery. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child's health that superseded potential feelings of judgement or blame. When discussing weight in a clinical setting, the use of sensitive (ie, "overweight", "above average", "growth" versus "obesity") and positive, health‐focused language was mostly supported. Conclusions: Multidisciplinary paediatric clinicians and parents generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. So what?: Clinicians, public health and health promotion professionals and policymakers can act now to implement sensitive communication strategies concerning weight and obesity risk. [ABSTRACT FROM AUTHOR]

Aim: To describe the cumulative incidence of child protection (CP) system contact, maltreatment type, source of reports to age 7 years, and socio‐demographic characteristics for culturally and linguistically diverse (CALD) Australian children. Methods: We used CP, education, health, and birth registrations data for children followed from birth up to age 7 from the South Australian Better Evidence, Better Outcomes, Linked Data (SA BEBOLD) platform. Participants: SA born children enrolled in their first year of school from 2009 to 2015 (n = 76 563). CALD defined as non‐Aboriginal or Torres Strait Islander, spoken language other than English, Indigenous or Sign, or had at least one parent born in a non‐English speaking country. Outcomes measures: For CALD and non‐CALD children, we estimated the cumulative incidence (risk) of CP contacts up to age 7, relative risk and risk differences for all levels of CP contact from notification to out‐of‐home care (OOHC), primary maltreatment type, reporter type, and socio‐economic characteristics. Sensitivity analyses explored different population selection criteria and CALD definitions. Results: By age 7, 11.2% of CALD children had 'screened‐in' notifications compared to 18.8% of non‐CALD (risk difference [RD] 7.6 percentage points (95% confidence interval: 6.9–8.3)), and 0.6% of CALD children experienced OOHC compared to 2.2% of non‐CALD (RD 1.6 percentage points (95% confidence interval: 1.3–1.8)). Emotional abuse was the most common substantiated maltreatment type for CALD and neglect for non‐CALD. Among both groups, the most common reporter sources were police and education sector. Socio‐economic characteristics were broadly similar. Sensitivity analyses results were consistent with primary analyses. Conclusion: By age 7, CALD children had lower risk of contact with all levels of CP. Estimates based on primary and sensitivity analyses suggested CALD children were 5–9 percentage points less likely to have a report screened‐in, and from 1.0 to 1.7 percentage points less likely to have experienced OOHC. [ABSTRACT FROM AUTHOR]

Global estimates suggest 5% to 10% of men report experience of childhood sexual abuse (CSA). However, male CSA is significantly underreported, with men being reluctant to disclose due to vulnerability, stigmatisation, homophobic responses and fearing a loss of masculinity. A lack of research and service provision targeted towards men suggests male survivors of CSA are marginalised. This qualitative study, using a narrative approach, focussed on four adult male survivors of CSA. The aim of the study was to explore their experiences of engaging in counselling and support services for CSA from nonstatutory and voluntary organisations. Face‐to‐face narrative interviews were audio‐recorded and transcribed verbatim. Analysis was undertaken using a two‐phase approach; first, each narrative was analysed as a whole; second, an across‐transcripts analysis was carried out to identify shared themes and divergences that emerged from the individual stories. In this paper, findings from the second phase of the analysis are presented. Three themes regarding male survivors' experiences of specialist counselling services were identified: "Trust Me, I'm a Doctor," "Trust me, I'm a Counsellor" and "Counsellor or Mother?" This is the first academic study focussing specifically on men's experience of support for CSA in the UK from a service user perspective. Making an original contribution to the knowledge base regarding counselling experiences and the effectiveness of therapy for male CSA survivors, it will help to inform professional counselling services which are likely to come into contact with male survivors of CSA. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) has serious short‐term and long‐term effects, including non‐suicidal self‐injury (NSSI) and suicidal ideation (SI). One possible thread linking CSA to NSSI and suicide risk is emotion dysregulation. The current study assessed whether facets of emotion dysregulation mediated relations of NSSI behaviours and functions, and SI. Participants (N = 121; Mean age = 18.69, age‐range 18–22; 78 per cent female), college students with a history of childhood trauma, completed an online survey. Results indicated that facets of emotion dysregulation (i.e. clarity, non‐acceptance) mediated the relationship between CSA and SI. CSA was associated with automatic negative reinforcement, social negative and social positive reinforcement NSSI functions, but was not associated with NSSI behaviours. Emotion dysregulation facets did not mediate the relationship between CSA and NSSI functions. Findings highlight the need to help CSA survivors have clarity and acceptance of emotional experiences to reduce SI risk. This research did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors. [ABSTRACT FROM AUTHOR]

Childhood trauma is associated with poor health outcomes in adulthood. Mechanisms for these associations are not well understood because past studies have focused predominantly on populations that have already developed physical and mental health problems. The present study examined the association between childhood trauma and stress‐related vulnerability factors in a healthy adult sample (n = 79; 68% female, mean age = 27.5, SD = 6.5). Emotion regulation difficulties were examined as a potential mediator. Participants completed baseline laboratory assessments of reported childhood trauma, emotion regulation difficulties, prior month sleep quality, baseline impedance cardiography and behavioural tests of executive functioning (EF) and a three‐day experience sampling assessment protocol that included sleep diary, reported and objective pre‐sleep arousal, daily hassles and reported EF difficulties. Reported history of childhood abuse was significantly associated with difficulties in emotion regulation, self‐report and objective pre‐sleep arousal, diary‐assessed sleep quality, daily hassles and reported EF difficulties. Reported history of childhood neglect was associated with greater pre‐sleep arousal and poorer EF‐behavioural control. Emotion regulation difficulties mediated the relationship between childhood abuse and reported pre‐sleep arousal, daily hassles and reported EF difficulties. In conclusion, history of childhood trauma is associated with a variety of stress‐related vulnerability factors in healthy adults that may be viable early intervention targets. [ABSTRACT FROM AUTHOR]

Attention biases toward unpleasant information are evident among children and adults with a history of abuse and have been identified as a potential pathway through which abused children develop psychopathology. Identifying whether a history of childhood abuse affects the time course of attention biases in adults is critical, as this may provide intervention targets. The present study examined the time course of attention bias during an emotion‐word Stroop task using event‐related potentials (ERPs) in a sample of adults with a range of child abuse histories using a categorical approach (comparing adults with or without a history of moderate‐to‐severe childhood abuse) and a dimensional approach (analyzing the range from no abuse to severe abuse in a continuous manner). Although behavioral performance did not vary as a function of abuse history, adults with a history of moderate‐to‐severe childhood abuse showed ERP evidence of early reduced processing of emotional stimuli (smaller N200) and later reduced processing of emotional and nonemotional stimuli (smaller P300), followed by later increased processing of unpleasant stimuli (larger slow wave [SW]). Results suggest that early disengagement from emotional stimuli may help individuals with moderate‐to‐severe abuse histories to achieve normal behavioral performance on the emotion‐word Stroop task. Additionally, regardless of analytic approach, adults with elevated levels of childhood abuse exhibited prolonged engagement (larger SW) specifically with unpleasant stimuli. Present results demonstrate attention bias patterns in adults with a history of childhood abuse and clarify the time course of attention bias. Results are discussed in the context of potential treatment implications. The present study evaluated the impact of a history of childhood abuse on the time course of attentional processing of emotional information in adults using ERPs. Although the effect of abuse on attention to emotional information has been examined extensively in children, it has been understudied in adults. The present study identified that adults with an abuse history showed earlier disengagement with emotional information followed by later prolonged engagement with unpleasant information. This is a pattern of processing that differs from children with a history of abuse. Results highlight the important potential avenues of intervention. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to explore child sexually abused survivors' experiences of dental treatment in order to obtain a deeper understanding of them as dental patients. Methods: Data were drawn from qualitative semi‐structured interviews with 16 adult informants recruited from four different Centres against Sexual Abuse in Norway. Data analysis was developed according to the principles of grounded theory suggested by Charmaz. Results: A conceptual framework was generated, and a core concept was constructed from the informants' reports of their experiences of dental treatment: Preparing for attack and recovering from battle based on four main categories: (a) Expecting danger, (b) Battling anxiety, (c) Reliving abuse and (d) Struggling with the aftermath. Conclusions: The analyses increase the understanding of how child sexual abuse survivors prepare before—battle during—and recover after dental treatment. This study revealed child sexual abuse survivors' experiences of extensive anxiety, triggered by sensory stimuli such as sensations, movement, muscles, touch, sight, sound, smell and taste, associated with dental procedures per se, but also sensory stimuli similar to previous traumatic experiences. The findings suggest that child sexual abuse survivors' dental anxiety is primarily trauma‐driven and possibly being one of the long‐term effects of child sexual abuse. This may be an important contribution to the understanding of CSA survivors and should affect the approach of clinicians treating dental patients with such a history. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) can have long‐term impacts on a person's mental health, which extend into adulthood. There is a high prevalence of ACEs among service members. Further, service members also report frequently experiencing disrupted sleep. We hypothesized that disrupted sleep may serve a mechanistic function connecting ACEs to functional impairment and poorer mental health. In a cross‐sectional sample (n = 759), we found evidence for an indirect effect of ACEs on mental health outcomes through disrupted sleep. In a different sample using two time‐points (n = 410), we found evidence for an indirect effect of ACEs on changes in mental health outcomes and functional impairment during a reset period, through changes in disrupted sleep during the same period. Implications, limitations and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Parenting very young children in the context of military service, deployment separations, and war‐related trauma can be challenging for many families. Female active duty personnel represent one of the fastest growing segments of the military, and recent policy changes have led women to pursue serving in combat positions at much higher rates. While not much is known about service member mothers, some studies have shown that they experience significant symptoms of distress, depression, and anxiety during the deployment cycle, feelings of disconnection from family during reintegration, and higher rates of childhood trauma histories than their male counterparts. Service member mothers who experience the combined stressors of deployment separation, combat exposure, and adverse childhood experiences—a triple threat—may be at serious risk of posttraumatic stress and depressive symptomatology, which can negatively influence the quality and nature of their parenting and parent–child relationships. This case report describes the participation of a young single service member mother and her preschool‐aged daughter in a home‐based, reintegration program designed for military families with very young children (ages 0–5). The paper illustrates how this relationship‐based, reflective parenting intervention was effective in increasing the mother's sense of competence in her parenting and strengthening the parent–child relationship. [ABSTRACT FROM AUTHOR]

Childhood trauma is a key modifiable risk factor for psychopathology. Despite significant scientific advances, traumatised children still have poorer long‐term outcomes than nontraumatised children. New research paradigms are, thus, needed. To this end, the review examines three dominant assumptions about measurement, design and analytical strategies. Current research warns against using prospective and retrospective measures of childhood trauma interchangeably; against interpreting cross‐sectional differences in putative mediating mechanisms between adults with or without a history of childhood trauma as evidence of longitudinal changes from pre‐trauma conditions; and against directly applying explanatory models of resilience or vulnerability to psychopathology in traumatised children to forecast individual risk in unseen cases. The warnings equally apply to research on broader measures of adverse childhood experiences (ACEs). Further research examining these assumptions can generate new insights on how to prevent childhood trauma and its detrimental effects. Read the Commentary on this article at doi: 10.1111/jcpp.13195 [ABSTRACT FROM AUTHOR]

This qualitative study aimed to obtain a deeper understanding of what makes adult dentistry possible for child sexual abuse survivors. Sixteen adult informants were recruited from four Centres against Sexual Abuse and interviewed. Qualitative analysis of the transcribed interviews was conducted consecutively until thematic saturation was reached at 16 informants. A conceptual framework was generated, and informants' experiences of what makes dental treatment achievable were summed as the dentist working in a trauma‐sensitive way, captured by the core category: Being considerate every step of the way. The underlying categories are: (i) offering a good start; (ii) being competent; (iii) being aware of the influence of staff behaviour; (iv) building a safe relationship; (v) arranging a secure treatment situation; and (vi) exploring individual triggers. The findings revealed that dental staff should have adequate competence to build secure relationships and explore individual triggers in dental treatment situations when treating child sexual abuse survivors. Dentists should have a trauma‐sensitive approach to all patients. When treating child sexual abuse survivors, dentists should demonstrate utmost consideration every step of the way, building long‐term solid relationships, and discussing and testing coping strategies individually adapted to the specific needs of the child sexual abuse survivors, in a safe environment. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) is a chronic T‐cell‐mediated mucocutaneous inflammatory disease, largely recognized in adults. It is uncommon in children, and the literature present still lacks comprehensive understanding mainly due to underreporting of such cases. LP shows atypical clinical features, when seen in children, mainly affecting the flexor aspect of the wrists, legs, and the oral and genital mucosae. It is largely considered an autoimmune response of the body with various etiologic factors. Its association with vaccination is still an interesting field for research. The focus of the present systematic review was to discover the link of vaccine in the pathogenesis of juvenile LP. An electronic search was carried out using MEDLINE by PubMed, Google Scholar, and Web of Science databases. Articles that reported LP in children with prior records for vaccination were selected for the present systematic review. Twenty‐three published articles in the English language were included for the quantitative and qualitative syntheses. The demographic data, specific vaccine history, and clinical details of the lesions were recorded. The existing evidence supports that vaccines could play an important role in etiopathogenesis of pediatric LP. [ABSTRACT FROM AUTHOR]

This study outlines the relationships among childhood psychological maltreatment (CPM), an understudied form of maltreatment, sense of self (SOS), a developmental construct negatively impacted by trauma, and post‐traumatic stress disorder (PTSD) symptoms in emerging adults. Results from regression analysis on a sample of emerging adults (N = 358) indicated CPM to be the greatest predictor of a weaker SOS, even when considered alongside other types of child maltreatment. Among those exposed to CPM, SOS was a significant predictor of PTSD symptoms, explaining 34.1% of the variance in the outcome. Counseling interventions that focus on SOS during emerging adulthood are recommended as one important consideration for survivors of CPM who experience PTSD symptoms. Specific counseling practice and research implications are included. [ABSTRACT FROM AUTHOR]

Although trauma exposure is a recognized risk factor for alcohol use, research on military populations has emphasized combat exposure, with minimal consideration of exposure to other potentially traumatic events (PTEs). We aimed to (a) identify, characterize, and quantify subgroups of service members based on PTE patterns; (b) examine associations between trauma exposure subgroups and alcohol use; and (c) examine these associations longitudinally. Data were drawn from Operation: SAFETY, a longitudinal study of health and well‐being among U.S. Army Reserve/National Guard soldiers (N = 478). Exposure to 15 PTEs, including childhood maltreatment, noninterpersonal events (e.g., natural disasters, accidents), interpersonal trauma, and military‐related exposures, was assessed at baseline. Latent profile analysis was conducted to characterize mutually exclusive trauma profiles; profile membership was used to longitudinally predict alcohol use in generalized estimating equation models. Four exposure profiles were identified: intimate partner violence (IPV)/combat trauma (8.4%, n = 40), combat trauma (24.7%, n = 118), childhood trauma (8.4%, n = 40), and low trauma (58.6%, n = 280). In adjusted models, compared to the low trauma profile, IPV/combat profile membership was longitudinally associated with alcohol problems, OR = 2.44, p =.005. Membership in other trauma profiles was not associated with alcohol use. Within the IPV/combat profile, men had a higher risk of frequent heavy drinking than women. Results suggest a need to comprehensively screen for lifetime PTE exposure, particularly IPV, in military populations. Given the high prevalence of nonmilitary PTEs, an inclusive, trauma‐informed approach to health care and service provision is warranted. [ABSTRACT FROM AUTHOR]

Secondary traumatization (ST) is a topical area among trauma‐exposed employees, where many are at risk of occupational mental health problems due to their work with trauma survivors. Challenges related to the accurate operationalization of ST symptoms persist, and there is no valid method for identifying employees at risk of clinically significant symptom levels. This study aimed to test the applicability of latent class analysis (LCA) to identify employees at risk for clinically relevant ST symptoms. LCA was used to identify patterns of ST symptom endorsement using the Professional Quality of Life Scale–5 (ProQoL) in a national sample of Danish child protection workers (CPW; N = 545). Predictors and associated levels of distress and functional impairment across the symptom presentations were tested using regression analysis, and three classes were identified. A total of 3.8% (n = 21) of participants were at high risk of endorsing symptoms of ST that were associated with significant levels of distress and increased functional impairment. The LCA approach outperformed existing scoring procedures in differentiating between employees with varying levels of distress, impairment, and well‐being. A minority of Danish CPWs are at risk for levels of ST that may be considered clinically significant for their associations with anxiety and social and cognitive impairment. Although the ProQoL is not a diagnostic tool, per se, a revised scoring procedure may render the measure useful when screening for employees who are at risk for levels of distress and impairment that require intervention. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to examine Native American children and caregivers' perspectives of family and cultural strengths using photovoice and to identify lessons learned from the first‐ever implementation of intergenerational photovoice with Native Americans. Participants were Native American, low‐income caregivers (n = 6) and their children (n = 12) between the ages of 10 and 15 who participated in six photovoice sessions. The themes that emerged from photos and group discussion included myriad challenges faced by Native American families including exposure to community violence, substance abuse, and criminal offending and incarceration. Themes also emerged that highlighted the strengths of Native families that were used to overcome identified challenges, including religion/spirituality, engagement in traditional cultural practices (e.g., prayer, song, dance), healthy activities (e.g., running, meditation). These data provided foundational information that is currently being used, along with other data, to develop a culturally grounded, strengths‐focused, family‐based program (Tiwahe Wicagwicayapi [Strengthening/Growing Families in Lakota]) to prevent adverse childhood experiences. We also discuss the challenges of intergenerational photovoice and lessons learned to inform future intergenerational photovoice projects. [ABSTRACT FROM AUTHOR]

Background: Childhood sexual abuse (CSA) has widespread and long‐lasting impact on women's lives and health. Increased knowledge and deeper understanding are needed of survivors' experiences of the childbearing process, health and motherhood. Methods: In this phenomenological study, 16 in‐depth interviews were conducted with nine female CSA survivors. The interviews were recorded, transcribed verbatim and thematically analysed. Results: The overarching theme of the study is: 'more understanding is needed', which refers to the participants' experience that greater understanding is needed from health professionals of the long‐term effects of CSA on childbearing women. Most of the women had suffered from poor health, especially chronic pain associated with fibromyalgia and gynaecological diseases. All of them had suffered mental health consequences particularly anxiety, depression and PTSD. The majority had experienced flashbacks to the violence and disassociation. Many had experienced miscarriages, had deviations from normal pregnancies and births, such as prolonged labour, caesarean sections, induction of labour, vacuum extraction, bleeding and exaggerated pregnancy problems, such as great nausea and pelvic pain. All but one had a negative experience in one of their births. All of them had experienced a lack of understanding in the healthcare system, perceived abuse of power and felt vulnerable in those situations. All of them had a strong need for a sense of control and participation in decision‐making in the childbearing process. Most of them had experienced problems in bonding with their children and some have had difficulties touching them. All of them were in dire need of protecting their children from potential violence and many expressed a tendency to overprotect them. Conclusions: Healthcare professionals need to have more knowledge and greater understanding of how healthcare services can be improved so that CSA survivors can have a better experience of the childbearing process. [ABSTRACT FROM AUTHOR]

Objectives: Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study examined the impact of brooding on the association of functional impairment with burdensomeness and belongingness among trauma‐exposed undergraduates (N = 262). Method: Trauma was assessed via clinical interview with questionnaires for study variables. Regression models examined the unique and interactive effects of physical impairment, emotional impairment, and brooding on burdensomeness and thwarted belongingness. Results: An interaction of brooding and impairment due to emotional difficulties was observed for burdensomeness with impairment linked to elevated burdensomeness at high (β = −0.46; p < 0.001), but not low (β = −0.07; p = 0.476) brooding. Impairment due to emotional difficulties (β = −0.38; p < 0.001) and brooding (β = 0.25; p < 0.001) were associated with belongingness. Conclusions: Findings identify brooding as a potential target for assessment and intervention in trauma‐exposed individuals. [ABSTRACT FROM AUTHOR]

Background: Sexual violence against children is a major clinical, public health and human rights concern globally. Specifically, child sexual violence (CSV) is one of the world's leading causes of trauma in children. In extreme cases, victims of CSV grow up with a plethora of maladaptive behaviours, which may be salient in the course of growth but later present in adulthood as severe cases of comorbid psychopathologies. It is expected therefore that CSV cases be treated with urgency and policies/laws against perpetrators be translated into visible outcomes. However, many CSV cases go unreported; and where there are attempts at reporting, the manner and approach of handling these cases is discouraging and futile. In this study, we explored the lived experiences of CSV survivors in Nigeria who tried reporting and opening up their experiences. Method: Using the hermeneutic phenomenological approach, responses from 11 girls aged 15 to 17 years at the time of the study and 8 to 16 years at onset of abuse were obtained. Data were gathered through interviews, and the victims' experiences were aggregated using content analysis. Results: The major findings were summarized under the following themes: (a) silent screams, (b) trauma and the search for a therapeutic ear, (c) stigma and (d) withdrawal: our last resort. Respondents reported crying out and begging perpetrators to stop the act. They also reported experiencing trauma and related physical/mental health issues after the act. As they sought whom to disclose to, they reported feeling stigmatized and eventually having to withdraw and recoil. Conclusions: Implications of the study cut across medical practice, social work, therapeutics and policy formation/implementation for the prevention of CSV and attending to CSV victims in hospitals, homes and schools. The importance of empathic therapeutic processes was discussed. The need for a multisectoral and multistakeholder approach in tackling CSV was also highlighted. [ABSTRACT FROM AUTHOR]

The developing brain in utero and during the first years of life is highly vulnerable to environmental influences. Experiences occurring during this period permanently modify brain structure and function through epigenetic modifications (alterations of the DNA structure and chromatin function) and consequently affect the susceptibility to mental disorders. In this review, we describe evidence linking adverse environmental variation during early life (from the fetal period to childhood) and long-term changes in brain volume, microstructure, and connectivity, especially in amygdala and hippocampal regions. We also describe genetic variations that moderate the impact of adverse environmental conditions on child neurodevelopment, such as polymorphisms in brain-derived neurotrophic factor and catechol-O-methyltransferase genes, as well as genetic pathways related to glutamate and monoaminergic signaling. Lastly, we have depicted positive early life experiences that could benefit childhood neurodevelopment and reverse some detrimental effects of adversity in the offspring. WHAT THIS PAPER ADDS: Prenatal, peripartum, and postnatal adversities influence child behavior and neurodevelopment. Exposure to environmental enrichment and positive influences may revert these effects. Putative mechanisms involve alterations in neurotrophic factors and neurotransmitter systems. New tools/big data improved the understanding on how early adversity alters neurodevelopment. This permits better translation/application of the findings from animal models to humans. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) during and prior to pregnancy has been linked to higher rates of pregnancy complications and early labor and delivery. However, to our knowledge, no studies have examined prenatal mental health problems and relational resilience as parallel mechanisms by which past-year IPV exposure impacts pregnancy and labor. The current study aimed to (a) examine the contribution of IPV exposure to pregnancy complications and early labor and delivery, controlling for childhood adversity, and (b) assess prenatal mental health and relational resilience as mediators of the effect of IPV exposure on pregnancy complications and early labor and delivery. We hypothesized that IPV would predict higher levels of mental health problems and lower levels of relational resilience, each of which would contribute to women's risk of labor complications such that fewer mental health problems and higher levels of relational resilience would each be associated with fewer pregnancy complications and early labor and delivery. Participants were (n = 76) interviewed during pregnancy and 6 weeks postdelivery. No direct effect of IPV exposure on either pregnancy complications or labor complications was found. Parallel indirect effects of IPV on labor via prenatal mental health, indirect effect size = -.09; 95% CI [-.224, -.011]; and relational resilience, indirect effect size = .13, 95% CI [.036, .329] were found. Brief, empirically tested IPV screens at prenatal clinics may help healthcare providers better identify IPV-exposed patients. Clinical interventions targeting prenatal mental health and relational resilience may help improve labor outcomes for IPV-exposed mothers. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs), defined as traumatic events in childhood that range from various forms of abuse to household challenges and dysfunction, have devastating consequences on adult health. Epidemiological studies in humans and animal models of early life stress (ELS) have revealed a strong association and insight into the mechanistic link between ACEs and increased risk of cardiovascular disease (CVD). This review focuses on the mechanistic links of ACEs in humans and ELS in mice and rats to vasoactive factors and immune mediators associated with CVD and hypertension risk, as well as sex differences in these phenomena. Major topics of discussion in this review are as follows: (a) epidemiological associations between ACEs and CVD risk focusing on hypertension, (b) evidence for association of ACE exposures to immune-mediated and/or vasoactive pathways, (c) rodent models of ELS-induced hypertension risk, (d) proinflammatory mediators and vasoactive factors as mechanisms of ELS-induced hypertension risk. We also provide some overall conclusions and directions of further research. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc. [ABSTRACT FROM AUTHOR]

The article offers suggestions on how to help children to tell about their experiences of sexual abuse. Topics discussed include an importance of increasing awareness about child sexual abuse, need of creating opportunities for children to tell about their sexual abuse and challenges for professionals to promote children's resilience and agency during child protection processes.