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Background: Childhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement. Methods: This study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years. Results: Results indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis. Conclusion: The study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps. [ABSTRACT FROM AUTHOR]

This study compared borderline personality disorder (BPD) and bipolar 2 disorder (BP 2 disorder) with respect to reported childhood trauma and Five-Factor personality traits using the Childhood Trauma Questionnaire (CTQ) and the NEO Five-Factor Inventory (NEO-FFI). Participants were 50 men and women, aged 18-45, with DSM-5-diagnosed BPD and 50 men and women in the same age group with DSM-5-diagnosed BP 2 disorder. Participants could not meet criteria for both BPD and BP 2 disorder. Borderline participants had significantly higher scores on the neuroticism subscale and significantly lower scores on the agreeableness subscale of the NEO-FFI. After correction for multiple comparisons, there were no between-group differences on CTQ scores. Study results suggest that BPD and BP 2 disorder differ primarily with respect to underlying temperament/genetic architecture and that environmental factors have only a limited role in the differential etiologies of the two disorders. [ABSTRACT FROM AUTHOR]

This article addresses the differences between girls and boys in the disclosure of sexual violence. The dataset combines data from the Finnish Child Victim Survey (FCVS) of 2008 (N = 13,459) and 2013 (N = 11,364), focusing on victims of sexual violence, ages 11 to 17 years, from the perspectives of disclosure and gender. Frequency and percentage analysis, cross tabulation, and a Chi-square test were used in the analysis. In the FCVS for both years, around 85% of the victims were girls. In almost two-thirds of the cases, the offender was a relative, friend, or some other known person, while in more than one-third of the cases, the offender was unknown to the victim. The second most common case was that the victim knew the offender, who was not, however, a friend. Sexual violence was found to be, in many ways, gendered. Most of the victims were girls, and most of the offenders were men. There was also a gender difference in the disclosure of experiences. Twenty-one percent of the girls and 45% of the boys reported that they had not told anyone about their experiences. Irrespective of the type of offender, the victims most often (63%) told a peer about their experiences, while 23% told parents, and only 10% told authorities. Moreover, victims reported shame and fear, distrust toward adults, and disbelief that disclosure would be helpful as reasons for not disclosing their experiences. To address this problem, raising awareness of the phenomenon, promoting an atmosphere that supports disclosing experiences of sexual violence, and improving readiness to address them are required. [ABSTRACT FROM AUTHOR]

Neighborhood violence is an adverse childhood experience which impacts millions of U.S. children and is associated with poor health outcomes across the life course. These effects may be mitigated by access to care. Yet, the ways in which exposure to neighborhood violence shapes children's health care access have been understudied. This is a cross-sectional analysis of 16,083 children (weighted N=67,214,201) ages 1 to <18 years from the 2019 and 2021 National Health Interview Survey. Guardians were asked about preventive care access, unmet health needs, and health care utilization in the last year. Changes associated with exposure to neighborhood violence were estimated using marginal effects from multivariable logistic regression models adjusted for year, age, sex, race/ethnicity, parental education, family structure, rurality, income, insurance type, insurance discontinuity, and overall reported health. Of 16,083 sample children, 863 (weighted 5.3% [95% CI 4.8–5.7]) reported exposure to neighborhood violence, representing a weighted population of ∼3.5 million. In adjusted analyses, exposure to violence was associated with forgone prescriptions (adjusted difference 1.2 percentage-points (pp) [95%CI 0.1–2.3]; weighted national population impact 42,833 children), trouble paying medical bills (7.7pp [4.4–11.0]; 271,735), delayed medical (1.5pp [0.2–2.9]; 54,063) and mental health care (2.8pp [1.1–4.6]; 98,627), and increased urgent care (4.5pp [0.9–8.1]; 158,246) and emergency department utilization (6.4pp [3.1–9.8]; 227,373). In this nationally representative study, neighborhood violence exposure among children was associated with unmet health needs and increased acute care utilization. Evidence-based interventions to improve access to care and reduce economic precarity in communities impacted by violence are needed to mitigate downstream physical and mental health consequences. [ABSTRACT FROM AUTHOR]

Childhood abuse can have long-term adverse outcomes in adulthood. These outcomes may pose a particular threat to the health and well-being of perinatal women; however, to date, this body of knowledge has not been systematically collated and synthesized. This systematic review examined the child abuse literature and a broad range of perinatal outcomes using a comprehensive search strategy. The aim of this review was to provide a clearer understanding of the distinct effect of different abuse types and areas where there may be gaps in our knowledge. Following PRISMA guidelines, EBSCO, PsychInfo, Scopus, Medline, CINAHL, PubMed, and Google Scholar databases and gray literature including preprints, dissertations and theses were searched for literature where childhood abuse was associated with any adverse perinatal outcome between 1969 and 2022. Exclusion criteria included adolescent samples, abuse examined as a composite variable, editorials, letters to the editor, qualitative studies, reviews, meta-analyses, or book chapters. Using an assessment tool, two reviewers extracted and assessed the methodological quality and risk of bias of each study. From an initial 12,384 articles, 95 studies were selected, and the outcomes were categorized as pregnancy, childbirth, postnatal for the mother, and perinatal for mother and child. The prevalence of childhood abuse ranged from 5–25% with wide variability (physical 2–78%, sexual 2–47%, and emotional/psychological 2–69%). Despite some consistent findings relating to psychological outcomes (i.e., depression and PTSD), most evidence was inconclusive, effect sizes were small, or the findings based on a limited number of studies. Inconsistencies in findings stem from small sample sizes and differing methodologies, and their diversity meant studies were not suitable for a meta-analysis. Research implication include the need for more rigorous methodology and research in countries where the prevalence of abuse may be high. Policy implications include the need for trauma-informed care with the Multi-level Determinants of Perinatal Wellbeing for Child Abuse Survivors model a useful framework. This review highlights the possible impacts of childhood abuse on perinatal women and their offspring and areas of further investigation. This review was registered with PROSPERO in 2021 and funded by an internal grant from Charles Sturt University. [ABSTRACT FROM AUTHOR]

Previous research has found that childhood maltreatment predicts increased risk for violence and partner violence and there is some evidence for poorer executive functioning and low self-esteem. To date, there have been no longitudinal studies that have examined the extent to which executive functioning and self-esteem play a role in the relationship between child maltreatment and intimate partner violence (IPV) perpetration. This study aims to fill this gap by utilizing data from a prospective longitudinal study of children with documented court cases of abuse and neglect (ages 0–11 years) from a metropolitan county area in the Midwest (during the years 1967–1971) and demographically matched controls. Both maltreated individuals and matched controls were followed up and assessed over several waves of the study in young and middle adulthood. At mean age 39 years, inhibition and cognitive control were evaluated, while cognitive flexibility and nonverbal reasoning were assessed at mean age 41. Self-esteem was also assessed at mean age 41. Physical IPV perpetration was evaluated at age 47 using two different scoring strategies in separate models: the number of acts and variety of acts, ensuring avoidance of potential score skewness. Childhood maltreatment predicted lower executive functioning and self-esteem, and both independently predicted intimate partner violence perpetration. Lower executive functioning and self-esteem mediated the relationship between childhood maltreatment and physical IPV perpetration in midlife, irrespective of the scoring method. Findings suggest that executive functioning and self-esteem play a role in the cycle of violence. Implications and suggestions for future directions are discussed. • Little is known about whether childhood maltreatment, executive function, and self-esteem predict IPV perpetration. • Individuals with documented childhood maltreatment had lower executive function and self-esteem than matched controls. • Executive function and self-esteem mediated the link between childhood maltreatment and IPV. • New evidence suggests that executive functioning and self-esteem play a role in the cycle of violence. [ABSTRACT FROM AUTHOR]

Objective: Childhood maltreatment has been consistently linked to posttraumatic stress disorder (PTSD) symptoms among college students and yoga may buffer the effects. The current study examined the frequency of college student's yoga practice over the past year as a moderator of childhood maltreatment and PTSD symptoms in the past 30 days. Participants: A sample of 177 college students from a southern university. Methods: Participants competed an online survey in exchange for extra credit or entry into a gift card raffle. Results: Moderation analysis indicated that a more frequent yoga practice buffered the relationship between maltreatment and PTSD symptoms. Conclusion: Clinicians working with college students with a history of maltreatment are encouraged to make referrals to yoga classes. Universities are encouraged to adopt trauma-sensitive yoga programs. [ABSTRACT FROM AUTHOR]

Purpose: Children exposed to domestic violence are at risk of adverse short- and long-term psychosocial effects and of being abused themselves. However, mothers and children face systemic gaps when seeking safety from domestic violence services and police. Safety planning typically focuses on women, overlooking their multiple social identities and excluding their children. We explored safety strategies used by mothers and children coping together with severe domestic violence. Method: Interviews with 30 mothers who experienced severe or potentially life-threatening domestic violence and 5 adults who experienced domestic violence in childhood were qualitatively analyzed using thematic analysis, revealing five major themes: ongoing communication, appeasing the abuser, soothing activities, exposure reduction, and fostering independence. Results: Interpreting participants' experiences in terms of the mother-child dyad, we found that mothers and their children worked together to reassure each other, keep each other safe, and make plans to leave their abuser. Conclusions: Safety planning for the mother-child dyad could build on children's existing coping strategies and recognize and support children's desire to protect their mother and themselves effectively and safely according to their developmental stage. [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]

In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women (n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is a risk factor for loneliness and is linked to breast cancer. Parental bonding experienced during one's childhood also plays a significant role in increasing or decreasing the risk of loneliness later in life. Previous research has highlighted the significance of ambivalence over emotional expression (AEE) and self-discrepancy in the psychological adaptation of breast cancer patients, particularly concerning the impact of parental care and control experienced by patients in their relationship with their parents during childhood. Nevertheless, previous studies have not examined the mediating effects of AEE and self-discrepancy on parental care and control, as well as loneliness, in breast cancer patients. This study aimed to investigate whether AEE and self-discrepancy mediate the association of childhood parental care and control with loneliness in breast cancer patients with a history of childhood maltreatment. One hundred and thirty-three breast cancer patients who were receiving chemotherapy within the first 3 months post-diagnosis were recruited from one private and three public hospitals in Tabriz, Iran, to complete questionnaires. Parental bonding, loneliness, AEE, and self-discrepancy were assessed using the Parental Bonding Instrument (PBI), University of California Los Angeles (UCLA) Loneliness Scale, Ambivalence over the Expression of Emotion Questionnaire (AEQ), and Self-Discrepancies Scale (S-DS). Mediation models were tested using structural equation modeling. Effects of parental care (β = −.17, p <.05) and control (β =.21, p <.001) on loneliness were significant. Furthermore, both AEE (β =.19, p <.05) and self-discrepancy (β =.23, p <.01) significantly predicted loneliness. The pathway between parental care and AEE was significant (β = −.21, p <.001), as was the direct effect of parental control on self-discrepancy (β =.19, p <.05). Bootstrapping results showed that AEE significantly mediated the relationship between parental care and loneliness (95% confidence interval [CI] [−0.09, −0.01]). In addition, there was a significant indirect effect from parental control to loneliness via self-discrepancy (95% CI [0.11, 0.01]). These findings suggest that AEE and self-discrepancy could potentially be utilized in preventing or addressing loneliness in breast cancer patients who have a history of childhood maltreatment. Future research could, for example, assess whether integrating psychosocial interventions focusing on these variables as part of medical care can improve the mental health status of this subgroup of breast cancer patients who have experienced childhood maltreatment. [ABSTRACT FROM AUTHOR]

Educational institutions and educators are significant in children's lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children's safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors' viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020–2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: (1) CSA survivors' retrospective perspectives of educators and the educational system's responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: (a) harmful and hurtful; (b) dismissive and ignoring; and (c) accepting and attending. (2) The second theme described the survivors' messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts. [ABSTRACT FROM AUTHOR]

Many studies focusing on childhood sexual abuse (CSA) may have neglected the consequences related to experiencing other types of childhood maltreatment, such as psychological maltreatment. Moreover, the literature has focused more on negative consequences related to CSA, hence potentially leaving out more adaptive and resilient trajectories. This qualitative study aimed to explore childhood psychological maltreatment and CSA, mindfulness, sexuality, and intimate relationships in adult survivors. The interview data from 19 individuals who experienced CSA and psychological maltreatment were analyzed using conventional content analysis. Four conceptual categories developed: (a) an unsafe family environment that hindered the development of positive experiences and relationships; (b) impaired mindfulness dispositions: the reliving of trauma, the avoidance of suffering, and feeling engulfed; (c) impaired intimacy: instability, codependence, emotional distance, and self-silencing; and (d) mindfulness dispositions and posttraumatic growth (PTG) in participants' intimate lives. These findings highlight that mindfulness, sexuality, and intimate relationships are often poor among survivors of psychological maltreatment and CSA. Yet opportunities to develop mindfulness dispositions appear to enhance PTG in survivors' intimate relationships, significantly contributing to survivors' healing processes. [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]

This article makes the case for a new phase of research on the abuse crisis and calls for a collaborative endeavor aiming at an interdisciplinary, historically contextualized account of the global history of abuse of children and vulnerable adults in the Catholic Church. This requires a redefinition of the scope of enquiry from the national to the global, and a refocusing of the analytical optic beyond a perpetrator-focused, pathologizing approach to clergy sexual abuse to situate sexual and spiritual abuse in the Catholic Church in its wider enabling ecosystem. We propose a scaled and spatial approach, focused on delineating understandings of the "domestic church" in a given context. This broader focus on interactions between the "three-legged stool" of the family-parish-school, particularly as contextualized in their ecclesial and socio-economic dynamics, extends the analysis beyond media-framed narratives and judicial approaches and allows for comparability across national settings. The article sets out the urgent need for a multi-disciplinary, mixed-method, and coordinated approach, given the many facets of the crisis (legal, political, cultural, financial, psychological, but also theological and spiritual), and the transnational dimensions of this epidemic within (and beyond) the Church that are yet to be fully discerned and historicized. [ABSTRACT FROM AUTHOR]

Purpose: Human trafficking occurs when a person uses force, fraud, or coercion to obtain an act or service from another person. While trafficking is often depicted as a crime perpetrated by strangers, recent literature has found family members can also be traffickers. Only four peer reviewed studies have specifically examined familial trafficking. Method: The current study builds upon this sparse literature by reviewing medical charts of patients in a large hospital system who were identified as survivors of familial trafficking between October 2017 and September 2021. Descriptive statistics are reported for all 39 identified patients. Results: Majority of patients were female (92.3%) and under 36 years old (56.4%; M = 34.2, SD = 11.6). Despite most patients now being adults, all except one were minors at the time the trafficking began. Parents were the most common perpetrator (66.7%) followed by aunt/uncle (12.8%). Nine cases were chosen, given level of detail in patient charts, to be highlighted in a case series to further describe the experiences of these survivors. Cases examined included labor trafficking, parents as perpetrators, intersection of substance use, and males as victims. Force was the most common means of control used and often manifested as physical or sexual abuse that preceded the exploitation. Another reoccurring theme was substance use being a factor when parents were perpetrators. Conclusion: The findings from this paper can help inform screening techniques by encouraging providers to inquire about familial relationships. Findings may also be helpful for providers working with this population and future research endeavors. [ABSTRACT FROM AUTHOR]

Purpose: Child sexual abuse (CSA) has short-term and long-term effects on survivors, but distress after the abuse varies widely and not all survivors show a significant degree of distress. Factors contributing to the variations of CSA outcomes need to be further investigated. The present study examines the moderating role of childhood attachment in the relationship between the experience of CSA and adult attachment, psychological distress, and self-esteem. Methods: Seven hundred and sixty-seven adults participated in this study, of which 427 (55.67%) reported a history of CSA. Participants were recruited from various social media websites (e.g., Facebook, Craigslist, discussion board, university announcement board). To examine the moderating role of childhood attachment between the experience of CSA and adult attachment, we conducted path analysis. Results: Childhood attachment significantly predicted adult attachment, psychological distress, and self-esteem in adulthood and moderated the relation between CSA and anxious adult attachment; CSA survivors with more secure childhood attachment were less likely to develop anxious attachment in adulthood. Additionally, CSA survivors reported less secure adult attachment, more psychological distress, and lower self-esteem than did individuals without a history of CSA. Furthermore, secure childhood attachment was significantly associated with secure adult attachment, lower levels of psychological distress, and higher levels of self-esteem. Conclusions: The results suggested that secure childhood attachment at least partially protected against negative long-term effects of CSA and fostered healthier intrapersonal and interpersonal adjustment in CSA survivors. [ABSTRACT FROM AUTHOR]

Studies on child sexual abuse (CSA) have mostly focused on female survivors. However, men are not spared from this type of abuse, as one in 10 men report having experienced CSA before the age of 18. Some adult male victims of CSA, in trying to cope with their history of sexual abuse, overinvest in typically masculine behaviors, such as aggression and rule breaking, which are considered externalizing behaviors. This study aimed to (a) describe the range of externalizing behaviors in adult men who have experienced CSA and (b) explore the functions underlying these behaviors from the perspective of male survivors. Individual semistructured interviews were conducted with 26 Canadian male survivors, aged between 31 and 66, who were recruited via CSA community services. A qualitative-directed content analysis was performed, guided by Achenbach and Rescorla's taxonomy of externalizing behaviors. Three main categories of externalizing behaviors emerged from respondents' narratives: (a) aggressive behaviors to express anger and protect integrity; (b) rule-breaking behaviors to protest against an injustice; (c) alcohol and drug use to avoid suffering triggered by CSA. These findings highlight the diversity of behaviors in which male survivors report engaging in response to CSA. Even if they may express their suffering in an explosive way, it is important to support male victims appropriately while recognizing the functions underlying their externalizing behaviors. Approaches to supporting survivors' recovery should address their feelings of anger and sense of injustice, the use of avoidance-based coping mechanisms, and masculine norms. Public Significance Statement: Men who have experienced child sexual abuse may externalize their suffering through various behaviors that may be perceived as problematic, including aggressive behaviors, transgressive behaviors, and substance abuse. It is important to offer appropriate support to male survivors, even if their distress might be expressed in ways that are not typically associated with victimhood. [ABSTRACT FROM AUTHOR]

Maltreatment survivors are at a heightened risk for revictimization during adulthood. Yet, existing work has specifically focused on sexual revictimization, and it is unclear what factors increase one's risk for revictimization more broadly. Posttraumatic stress symptoms (PTSS), anger, and substance use have been identified as factors associated with sexual revictimization; the function of these variables is ambiguous in the broader revictimization framework. There is also a lack of understanding regarding the roles of the DSM-5 posttraumatic stress disorder (PTSD) symptom clusters and revictimization. This study aimed to 1) examine the links between maltreatment and revictimization and three factors (i.e., PTSS, anger, and substance use), 2) determine whether there are indirect effects between maltreatment and revictimization through each factor, and 3) investigate whether PTSD clusters have indirect effects on the relationship between maltreatment and revictimization. The sample included 350 maltreated college women (Mage = 21.96, SD = 5.31; 54.2% White) from two universities. Findings indicated that maltreatment and revictimization were linked with PTSS (B = 4.65, B = 0.03, respectively). Only maltreatment was related to anger, B = 1.70, and revictimization was tied to substance use, B = 0.08. Only PTSS had an indirect effect on the link between maltreatment and revictimization (B = 0.13). Maltreatment was related to each of the four PTSD symptom clusters, but the clusters had no indirect effects on the association between maltreatment and revictimization. These findings indicate that PTSS may be uniquely important in increasing the risk for revictimization among women. [ABSTRACT FROM AUTHOR]

Traumatic experiences in childhood can lead to trauma symptoms and impaired mental health, especially when children are exposed to war and political violence. Despite significant attention to child's exposure to traumas, few instruments to detect potentially traumatic events have been validated psychometrically. Our study aimed to develop, adapt and validate a user-friendly traumatic events checklist in Palestinian children living in three areas affected by low-intensity war and ongoing political and military violence. 965 Palestinian children (494 males and 471 females) living in the Gaza Strip, West Bank and East Jerusalem were administered with a tailor-made Traumatic Events checklist, Children Impact of Events scale, and Strengths and Difficulties Scale. Exploratory and Confirmatory factor analysis was run to detect the factorial structure of the checklist. Furthermore, ANOVA was performed to identify statistically significant demographic differences among participants. A three factors structure emerged with Political violence-related traumatic experiences (PVTE), military violence against individuals (MVI), and military violence against individuals and families (MVF). Gaza children and adolescents resulted in being the most exposed to potentially traumatic events. The instrument can clearly portray potentially traumatic experiences in children exposed to violent events and adverse childhood experiences. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma has been linked to increased risk of schizophrenia and social dysfunction, and oxytocin and its receptor gene have been implicated in regulating social behavior. This study investigated the potential role of oxytocin and oxytocin receptor gene (OXTR) in mediating the effects of childhood trauma on social functioning in schizophrenia. Methods: The study consisted of 382 patients with schizophrenia and 178 healthy controls who were assessed using the Taiwanese version of the Childhood Trauma Questionnaire (CTQ-SF), the Social Functioning Scale (SFS), and plasma oxytocin levels. DNA was extracted to genotype the OXTR and ten single-nucleotide polymorphisms (SNPs; rs2254298, rs237885, rs237887, rs237899, rs53576, rs9840864, rs13316193, rs7632287, rs1042778, and rs237895) were selected. Results: Patients with schizophrenia showed higher CTQ-SF scores (t = 12.549, p < 0.001), lower SFS scores (t = −46.951, p < 0.001), and lower plasma oxytocin levels (t = −5.448, p < 0.001) compared to healthy controls. The study also found significant differences in OXTR SNPs between both groups, with risk alleles being more prevalent in patients with schizophrenia (t = 2.734, p = 0.006). Results indicated a significant moderated mediation effect, with oxytocin and the OXTR SNPs partially mediating the relationship between childhood trauma exposure and social functioning in patients with schizophrenia (index of mediation = 0.038, 95% CI [0.033–0.044]). Conclusions: The findings suggest that oxytocin and its receptor gene may be promising targets for interventions aimed at improving social functioning in patients with a history of childhood trauma and schizophrenia. However, further research is needed to fully understand these effects and the potential of oxytocin-based interventions in this population. [ABSTRACT FROM AUTHOR]

Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016–2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p <.001, 95% CI = 3.15–6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR =.69, p <.01, 95% CI =.54–.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families. [ABSTRACT FROM AUTHOR]

The study utilized a latent profile analysis to evaluate distinct combinations of men's childhood victimization experiences and their communal predictive ability for sexual aggression (SA) and intimate partner violence (IPV) perpetration. Men living in the United States (N = 399) completed assessments of emotional, physical, and sexual childhood victimization, as well as SA and IPV toward women. The results indicated that members of profiles characterized by moderate to high frequencies of childhood victimization—especially sexual victimization—were at increased risk of SA and IPV perpetration. Contrary to expectations, adult- versus peer-perpetrated victimization did not appear to substantially alter risk of perpetration. [ABSTRACT FROM AUTHOR]

There is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. 3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. The findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. The study's cross-sectional design hindered the inference of causality. The present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement. • Childhood maltreatment was positively associated with the automatic-negative reinforcement of NSSI. • Alexithymia served as a partial mediator in this relationship between childhood maltreatment and the automatic negative reinforcement of NSSI. • Help-seeking attitudes influenced the mediation effect of alexithymia in the association between childhood maltreatment and the automatic-negative reinforcement of NSSI. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) of mothers have been shown to be associated with children's mental health and behavior problems. It is important to identify effective intervention points to prevent negative consequences among children. This study aimed to investigate whether mothers' education is protective against children's depressive symptoms in families with mothers who experienced parental divorce in childhood. Data from a cross-sectional study of 5th and 8th grade children and their caregivers in a prefecture in Japan were used. Final analytic sample consisted of 9666 child-caregiver pairs. Mediation analyses using inverse odds weighting were performed where the exposure was maternal experience of parental divorce in childhood, outcome was child depressive symptoms, and potential mediators were maternal education beyond high school, maternal mental health, and household income. Maternal experience of parental divorce was associated with an elevated risk of child depressive symptoms (risk ratio: 1.22, 95 % confidence interval (CI): 1.07–1.39). Mediation analyses indicated that the combination of maternal education, maternal depression and household income mediated about half of the total effect. In the model where maternal education was the sole mediator, maternal education mediated nearly half of the total effect (risk ratio: 1.10, 95 % CI: 1.01–1.20). Results should be cautiously interpreted given observational and cross-sectional nature of the data. Maternal education beyond high school may be protective against negative mental health consequences among children due to mothers' experience of parental divorce. Further studies are needed regarding potential mechanisms and the roles of other potential mediators. • Maternal experience of parental divorce was associated with an elevated risk of their children's depressive symptoms. • Maternal education mediated the link between maternal experience of parental divorce and their children's mental health. • Maternal education may be protective against children's depressive symptoms due to mothers' experience of parental divorce. [ABSTRACT FROM AUTHOR]

Although adverse childhood experiences (ACEs) are associated with lifelong health harms, current surveillance data on exposures to childhood adversity among adults are either unavailable or incomplete for many states. In this study, recent data from a nationally representative survey were used to obtain the current and complete estimates of ACEs at the national and state levels. Current, complete, by-state estimates of adverse childhood experiences were obtained by applying small area estimation technique to individual-level data on adults aged ≥18 years from 2019–2020 Behavioral Risk Factor Surveillance System survey. The standardized questions about childhood adversity included in the 2019–2020 survey allowed for obtaining estimates of ACE consistent across states. All missing responses to childhood adversity questions (states did not offer such questions or offered them to only some respondents; respondents skipped questions) were predicted through multilevel mixed-effects logistic small area estimation regressions. The analyses were conducted between October 2022 and May 2023. An estimated 62.8% of U.S. adults had past exposure to ACEs (range: 54.9% in Connecticut; 72.5% in Maine). Emotional abuse (34.5%) was the most common; household member incarceration (10.6%) was the least common. Sexual abuse varied markedly between females (22.2%) and males (5.4%). Exposure to most types of adverse childhood experiences was lowest for adults who were non-Hispanic White, had the highest level of education (college degree) or income (annual income ≥$50,000), or had access to a personal healthcare provider. Current complete estimates of ACEs demonstrate high countrywide exposures and stark sociodemographic inequalities in the burden, highlighting opportunities to prevent adverse childhood experiences by focusing social, educational, medical, and public health interventions on populations disproportionately impacted. [ABSTRACT FROM AUTHOR]

Although different studies have found that exposure to intimate partner violence (IPV) in childhood is linked to IPV perpetration in adulthood, others have revealed null effects. Previous research has also found that some factors might mediate the relationship between exposure to IPV in childhood and later IPV perpetration. As far as we know, no studies examined the role of aggression in this relationship. This study aimed to analyze the link between exposure to IPV in childhood and IPV perpetration in adulthood and verify whether this relationship was mediated by aggression and its components (verbal and physical aggression, anger, and hostility). Two hundred and forty five men convicted of domestic violence, from prison and community, were recruited. Correlation analysis revealed a positive link between exposure to IPV in childhood, aggression traits, and specifically physical aggression, and IPV frequency in adulthood. Overall aggression traits and physical aggression traits were statistically significant mediator variables explaining almost 15% of the overall effect of exposure to IPV in childhood on overall IPV frequency in adulthood. These findings unravel the role of aggression in the perpetration of physical and total IPV, claiming our attention to the need to include strategies to increase emotion regulation and problem-solving strategies in intervention programs. [ABSTRACT FROM AUTHOR]

Extensive research has been conducted on the link between trauma, child maltreatment (CM), and chronic pain. Although the risk of suffering from chronic pain among CM survivors has been established, much less is known about the experience of pain during CM incidents or whether such peritraumatic pain sensations are associated with later chronic pain. This scoping review was conducted to synthesize the existing literature on pain during and a short time following CM (i.e., peritraumatic pain). Utilizing the preferred reporting items for systematic reviews and meta-analyses guidelines, the current review included 11 manuscripts, which met the following criteria: (a) refer to physical pain experienced during or a short time after CM, (b) were published in peer-reviewed journals, and (c) were written in English. The review demonstrated that most of the included studies were not intentionally focused on peritraumatic pain, the majority used qualitative research methods, and all were cross-sectional. Furthermore, although validated questionnaires are available, most of the studies did not utilize such measures. Those that intentionally reported pain demonstrated its high intensity and prevalence in CM incidents, indicating that pain is inherently embedded in the experience of maltreatment. The findings spotlight an underdeveloped research realm on a phenomenon that may hold significant empirical, clinical, and legal implications. Research endeavors should initiate interdisciplinary bodies of knowledge to establish well-validated research methodologies that properly quantify peritraumatic pain in trauma and CM. [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]

In contrast to adults, there is considerably less research on childhood or adolescent exposure to sexual harassment (CAESH), its lasting psychological correlates, and whether such experiences should be included in definitions of childhood sexual abuse. The current study examined the prevalence and symptomatic sequels of unwanted flirting, being "checked out" sexually, unwanted sexual attention, sexual comments, propositions, and related noncontact behaviors that occurred before age 18, as well as the multivariate relationship between CAESH and contact child sexual abuse (C-CSA) in a diverse online sample of 528 individuals. CAESH was very common, with over 95% of women and 64% of men reporting at least one experience of noncontact sexual harassment before age 18. When childhood sexual abuse was operationalized as the presence of either C-CSA or a total CAESH score of 18 or higher (corresponding to an average score of "3–5 times" prior to age 18), the prevalence was 67% for women and 26% for men, more than three times higher than C-CSA alone. This expanded definition was associated with significantly more anxiety, depression, and posttraumatic stress relative to C-CSA alone. These results suggest that CAESH is a significant source of symptoms in adults and support the emerging perspective that childhood sexual abuse may be best understood as including both contact and noncontact events. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Adverse childhood experiences (ACEs) are traumatic experiences that occur prior to age 18 years and can have a long-term impact on adult physical and mental health. Knowledge of ACEs, including the link between ACEs and health, and trauma-informed care (TIC), is essential for medical professionals to ensure respectful and compassionate care for those with a history of childhood adversity. This study examined medical students' knowledge, attitudes toward, and identification of ACEs and TIC to inform curricular efforts. METHODS: Using a cross-sectional design, students were recruited from 2 medical schools, one allopathic (medical degree) and one osteopathic (doctor of osteopathic medicine degree) to complete an electronic needs assessment survey. The survey included a patient vignette to assess students' ability to identify ACEs as contributing factors to patient health. The students were blind to the full purpose of the study to obtain an objective measurement of their ability to identify ACEs as contributors to patient health. Additional questions targeting knowledge and attitudes of ACEs and TIC were devised from previously published surveys with supplemental study-designed questions. RESULTS: Two hundred forty students completed the survey. Results demonstrated variable ability to identify ACEs; strong general knowledge of ACEs, with less developed practical knowledge; and overall positive attitudes toward ACEs and TIC. No differences were found between the medical degree and doctor of osteopathic medicine degree, or year in program. CONCLUSIONS: Medical students would benefit from curricular efforts that help to increase knowledge of the link between ACEs and health, increase practical application of ACEs and TIC, and improve their ability to identify ACEs in clinical scenarios. [ABSTRACT FROM AUTHOR]

Emotional abuse up to age 18 is associated with depressive symptoms in adulthood, yet few studies have examined these links in Black females. Despite research documenting the moderating role of sleep duration on early adversity and mental health, no studies have examined whether sleep duration during adolescence moderates the relations between emotional abuse up to age 18 and depressive symptoms in adulthood. We examined these relations in 690 Black females from the National Longitudinal Study of Adolescent Health (Add Health)—Public Use. Individuals reported the frequency of emotional abuse up to age 18, hours of sleep during adolescence, and depressive symptoms using the 10-item version of the Center for Epidemiological Studies Depression Scale. Only 55% of adolescents reported sleeping the recommended 8–10 hr per night. Frequent emotional abuse before age 18 years was associated with more adult depressive symptoms for those with shorter, but not longer, sleep duration. Greater attention should be placed on facilitating and promoting sleep health for Black females. Public Policy Relevance Statement: Sleep health is a social justice issue. Sufficient sleep is essential for health and well-being, yet few adolescents, particularly Black youth, get the recommended 8–10 hr of sleep at night. Our findings demonstrating the beneficial role of sleep among Black females underscore the need for culturally informed programs and policies to promote sleep, particularly for those who have experienced emotional abuse. Promising ways to enhance sleep may be via messaging at youth programs and settings where community members can share information about the benefits of sleep and ways to promote sleep health and social justice. [ABSTRACT FROM AUTHOR]

The rate of incarceration in the United States has increased at an alarming rate in the past 30 years and thus so has the number of children having a household member incarcerated (referred to as household incarceration). Associations between experiencing household incarceration in childhood and later negative health and developmental outcomes are well-documented; however, the underlying mechanisms linking this childhood stressor and adult outcomes have been less well studied. Using state Behavioral Risk Factor Surveillance System survey data (N = 145,102), this study examines how experiencing household incarceration during childhood is associated with mental and physical health in adulthood and mediational pathways through suboptimal sleep (short or long sleep). Results indicate there were significant indirect effects of household incarceration to physical and mental distress through short sleep (≤6 hr per 24 hr) and long sleep (≥10 hr per 24 hr), and a significant indirect effect of household incarceration to body mass index through short sleep. Findings from the present study highlight indirect pathways through which household incarceration in childhood is linked with sleep health in adulthood and, in turn, to negative mental and physical health. Public Policy Relevance Statement: Mass incarceration in the United States has far-reaching health implications, including for the family and household members of those who are incarcerated. Healthy sleep functioning is known to buffer the effects of stress on health. Findings from the present study highlight that suboptimal sleep is one explanatory pathway linking household incarceration in childhood and diminished health in adulthood. Those who have experienced household incarceration in childhood should be targeted for preventive and interventive measures that optimize sleep duration, thus promoting overall mental and physical health. [ABSTRACT FROM AUTHOR]

Time attitudes indicate how individuals feel about the past, present, and future. A growing body of research has demonstrated that scores on the Adolescent and Adult Time Inventory-Time Attitudes Scale relate meaningfully to a variety of measures of well-being and psychiatric symptomatology. To date, no study has examined how (if at all) Time Attitudes scores relate to psychiatric disorder. The present study used an existing clinical cohort (N = 68) and assessed the associations among time attitudes, lifetime disorder, and a retrospective measure of childhood trauma. Preliminary analyses revealed that mean scores of the six time attitudes in the present study did not differ substantially from scores reported in a recent meta-analysis. Correlations between time attitude scores and retrospective trauma scores were particularly large for past negative and past positive. Individuals with no past or current disorder reported substantially higher positive attitudes and substantially lower negative attitudes than those without a disorder across all three time periods with interpretable effect sizes. Finally, past negative time attitudes scores were significantly associated with lifetime mood or anxiety disorder, prior to adjustment for scores on self-reported childhood trauma. These results suggest that time attitudes could be a variable of consequence beyond feelings of general well-being and beyond psychiatric symptoms. More studies with larger sample sizes are required in order to examine the relationship between time attitudes and psychiatric disorder. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) devastatingly impacts an individual's behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, "nobody believed me", "cannot live like others", lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors. [ABSTRACT FROM AUTHOR]

(1) Background: Childhood obesity and dental caries are common chronic conditions with multiple contributing factors, linked to negative health consequences and significant expenses in healthcare. The aim of this study was to assess the correlation between obesity and dental caries in school-aged children; (2) Methods: Data from 3323 6–12-year-old children from the National Health and Nutrition Examination Survey (NHANES) 2011–2016 were analyzed. The NHANES was conducted at the Centers for Disease Control and Prevention (CDC) in the United States. The CDC standard was used to define obesity. Dental caries was measured during clinical examinations and summarized using DMFT scores for caries experience and prevalence (dt > 0) for untreated caries. The study examined the correlation between obesity and dental caries using regression models that considered demographic variables, family socioeconomic status, and the child's intake of added sugars as controlling factors; (3) Results: The association between obesity and dental caries was not significant in either unadjusted or adjusted models; and (4) Conclusion: The data indicate that untreated caries and caries experiences are not directly correlated with childhood obesity. There are, however, common causes of poor dental health and childhood obesity: culture, poverty level, lifestyle, and family traditions and habits. Dentists must be aware of factors influencing the development of childhood caries so that they can intervene as early as possible. [ABSTRACT FROM AUTHOR]

Given the alarming increase in incidences of child sexual abuse (CSA), the present study was conceived to conduct a feasibility trial for a brief CSA-focused cognitive-behavioral intervention for children. A quasi-experimental single-group pre-post design with convenient sampling was adopted. The intervention module was administered to 20 children aged 7–13 years (M = 10.4, SD = 1.3) with a CSA history. The intervention was spread across a minimum of six required sessions and a maximum of 12 sessions held weekly for approximately 90 to 120 minutes' duration to restore the child's functioning and to assist the child in processing and managing trauma effectively along with initiating the process of growth. Child PTSD Symptom Scale (CPSS), Children's Impact of Events Scale−13 (CRIES-13), Developmental Psychopathology Checklist (DPCL), Multidimensional Scale for Child Sexual Abuse (MSCSA) and Children's Global Assessment Scale (CGAS) were used to measure the impact of the intervention on the children. Estimation of improvement was done using Wilcoxon signed rank test, effect size and subjective feedback from children. Feasibility assessment was done across five parameters: recruitment, data collection, attrition, adherence and improvement. We found that the intervention led to significant improvement in scores of all scales with a large effect size of.50 for MSCSA and CRIES-13 and medium effect size for CGAS, CRIES-13 (Intrusion & Avoidance), CPSS, and DPCL. Feasibility was estimated to be high across all five parameters of the assessment. Thus, the newly developed intervention was found to be helpful in restoring the child's functioning, and assisting the child in processing, and managing trauma effectively. [ABSTRACT FROM AUTHOR]

Purpose: Early experiences of childhood maltreatment have been linked to intimate partner violence (IPV) later in adulthood. Few studies, however, have examined the prospective relationship between child maltreatment and IPV perpetration in the context of proximal and distal risk factors for violence, such as depression and alcohol misuse. Method: Data from 370 adult respondents are from the Lehigh Longitudinal Study. Child maltreatment was measured prospectively at preschool ages and school-ages. Proximal and distal risk factors for adult IPV perpetration were measured in adolescence and at two time points in adulthood (age 36 and 46 years of age, on average). Hierarchical regression models were used to examine the prediction of IPV perpetration from earlier time points. Results: Results indicate that exposure to child maltreatment, frequent alcohol use in adolescence, adolescent depression, frequent alcohol use at age 36, and adult depression at age 36 are predictive of IPV perpetration at age 36. Adolescent aggression and frequent alcohol use at age 46 were significantly predictive of IPV perpetration at age 46. Conclusions: Findings identify multiple points across the life course for intervention. Interventions targeting adolescent and adult mental health and alcohol use may lessen the risk for adult IPV perpetration. [ABSTRACT FROM AUTHOR]

This was a record-linkage analysis of a birth cohort to examine the association between self-reported self-harm in adulthood and childhood maltreatment (CM) as prospectively notified to authorities and self-reported on the Child Trauma Questionnaire. There were 2507 participants at 30-year follow-up with data on both CM and self-reported self-harm including an intent to die. Of the participants, 304 (12.1%) had self-harmed at some time in their lives while 150 (4.2%) had wanted to die. The prevalence of self- and agency-reported maltreatment was 513 (20.5%) and 143 (5.7%) respectively. On adjusted analyses, CM irrespective of reporting source showed significant associations with both suicidal outcomes. Physical and emotional abuse showed the strongest associations while findings for neglect were mixed. The only association for sexual abuse was for self-reported maltreatment and intent to die but numbers may have been under-powered. [ABSTRACT FROM AUTHOR]

Past research has emphasized the impact of prior trauma on adult depression and anxiety rates. However, few studies have examined the simultaneous connection between various trauma characteristics (e.g., type, variety, repetition, timing) and symptoms of depression and anxiety in adults. Understanding how these different trauma characteristics relate to mental health issues can offer valuable insight into predicting the onset of such problems. We conducted a cross-sectional analysis with 356 adult participants to explore the associations between lifetime trauma history and depression/anxiety scores. Participants retrospectively reported on five different traumatic experiences from birth to the present, including childhood physical abuse, witnessing parental violence, lifetime experiences of rape, witnessing trauma to loved ones, and the unexpected death of loved ones. For each trauma type, participants indicated the timing of their first exposure and the frequency of subsequent occurrences. Depression and anxiety symptoms in the past 2 weeks were also self-reported. Multiple regression analyses with covariates were employed. On average, participants experienced two out of the five trauma types. Regardless of the type, having at least one traumatic experience was linked to higher depression and anxiety scores. Those who experienced all five trauma types reported the highest levels of depression and anxiety. Repeated instances of rape, witnessing trauma to loved ones, and the death of loved ones were significantly associated with elevated depression and anxiety scores. The timing of exposure to the unexpected death of loved ones predicted higher depression scores in childhood compared to adulthood, while no relationship between timing and anxiety scores was observed. Other trauma types did not show significant associations. Our study enhances knowledge of the link between trauma and depression/anxiety by elucidating how various trauma characteristics, such as type, variety, repetition, and timing of trauma, have differential influences on depression and anxiety scores. [ABSTRACT FROM AUTHOR]

To date, the majority of research examining the effect of childhood abuse on relational aspects in adulthood is almost exclusively based on intraindividual data. The current study explores a moderating-mediating model from a dyadic perspective, examining the mediating effect that perceived intimacy has on the associations between concern couple caregiving and relationship satisfaction. It further investigates whether these mediation paths are moderated by a history of childhood abuse (physical/emotional/sexual). A total of 143 nonclinical couples (n = 286) in enduring relationships were recruited. A moderated mediation actor–partner interdependence model (moderated mediation actor-partner interdependence model (APIM)) comprised of three segments, was conducted. Results indicated that intimacy mediated the link between concern caregiving and relationship satisfaction on the actor's level, with effects applying equally to both husbands and wives. A higher level of intimacy among husbands and wives alike is linked, in turn, with higher relationship satisfaction. The path between actors' concern caregiving and their level of intimacy was moderated by the actors' childhood emotional and physical abuse; specifically, concern caregiving exerts greater effect on intimacy among participants who experienced high levels of emotional abuse, or low levels of physical abuse. Our findings highlight how different types of childhood abuse affect adult romantic relationships differently. [ABSTRACT FROM AUTHOR]

The negative effect of adverse childhood experiences (ACEs) on children's mental health is widely explored. However, the mediating and moderating mechanisms underlying this relationship among children in mainland China are rarely investigated. This study examines the indirect link from ACEs to children's depressive symptoms and self-esteem through peer victimization and positive identity. Gender differences in the pathways are also discussed. A total of 775 primary and middle school students (mean age = 12.43, 9–16 years old, 46.3% males) in Dali city of Yunnan province voluntarily participated in a questionnaire survey. The ACEs, depressive symptoms, self-esteem, peer victimization, and positive identity were assessed via questionnaire survey using validated measurement tools. Structural equation model with Amos 24.0 was used to test the hypothesized theoretical model. The results showed that ACEs had a direct effect on children's depressive symptoms and self-esteem. Meanwhile, peer victimization and positive identity partially mediated the main effect. Moreover, four paths in the model showed significant gender differences, namely, from ACEs to depressive symptoms, from ACEs to peer victimization, from positive identity to depressive symptoms, and from positive identity to self-esteem. All of these paths showed that the moderating effect was stronger for males than for females. This study contributes to the current understanding of the mechanisms of ACEs on children's depressive symptoms and self-esteem. Findings also highlight that future intervention programs and social services for enhancing children's mental health must be more targeted to male victims of ACEs. [ABSTRACT FROM AUTHOR]

Childhood epilepsy has been linked to poor academic performance, but large-scale studies are lacking. In this nation-wide study of school-aged children, we examined the association between childhood epilepsy and school performance in standardized tests according to phenotypic and treatment-related characteristics. We performed a matched register-based cohort study of children born in Denmark (1997–2009) who participated in the Danish National School Test Programme between 2010 and 2019. We used population and health registers to identify children with epilepsy and a randomly sampled sex- and age-matched reference cohort without epilepsy (ratio 1:10). Norm-based test scores from language and mathematics reflecting performance as a percentile of the nation-wide distribution of scores (scale 1–100) were used to assess academic performance. Adjusted differences in mean standardized scores between children with and without epilepsy were estimated using linear regression models. Among 582 840 children participating in the School Test Programme, we identified 4659 (0.8%) children with epilepsy (52.8% males) and 46 590 matched reference children. Median age at epilepsy onset was 7.5 years (interquartile range: 4.0–10.6). Childhood epilepsy was associated with poorer school performance overall (mean score = 48.2 versus references = 56.7; adjusted difference = −6.7, 95% CI: −7.4 to −6.0), and worse performance was found in all epilepsy subgroups, including in 3534 children with uncomplicated epilepsy (i.e. no other pre-existing neurologic or intellectual disabilities and no identified possible cause for epilepsy; adjusted difference = −6.0, 95% CI: −6.8 to −5.2). No major variation by sex, age or subject was observed, but larger score differences were seen in children using antiseizure medication at time of testing (e.g. valproate monotherapy, adjusted difference = −9.3, 95% CI: −11.5 to −7.0 and lamotrigine monotherapy, adjusted difference = −13.1, 95% CI: −15.0 to −11.3) and in children with psychiatric comorbidity, especially epilepsy with comorbid intellectual disability (adjusted difference = −27.0, 95% CI: −30.0 to −23.9) and epilepsy with comorbid attention deficit/hyperactivity disorder (adjusted difference = −15.7, 95% CI: −19.0 to −12.4). Children with epilepsy scored significantly lower than their unaffected siblings (adjusted difference = −6.2, 95% CI: −7.1 to −5.4). In conclusion, childhood epilepsy was associated with impaired academic performance throughout schooling, which suggest that there is a widespread need for educational support of children with epilepsy, even when the child has no other comorbidities and when the epilepsy appears well-managed. [ABSTRACT FROM AUTHOR]

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]

Whether within or outside of the psychoanalytic consulting room, when individuals or professional groups can recognize their limitations in addressing familiar challenges and have the opportunity to find partners to explore and understand the underlying sources of their distress, opportunities for new adaptive solutions emerge as well. Shared concerns about the challenges of violence exposure and childhood trauma formed the basis of what at first seemed an unlikely collaboration between psychoanalysts and other clinicians at the Yale Child Study Center and members of the New Haven Police Department. This paper will describe the development of the Child Development-Community Policing partnership and later, our engagement with policymakers. The story of how these collaborations emerged illustrates ways in which the application of the most basic psychoanalytic principles of listening, close observation, and collaborative learning led to the development of early intervention and clinical treatment that have helped to advance the field of childhood trauma. Mobilizing these collaborative efforts outside of the consultation room has, most importantly, led to a far greater number of traumatized children who no longer need to remain alone in the immediate aftermath of the traumatic realization of their worst nightmares. [ABSTRACT FROM AUTHOR]

This study aimed to assess the prevalence of adverse childhood experiences and their relationship with self-esteem among secondary school students in Jordan. A cross-sectional, retrospective design was utilized using a convenience sample of 559 secondary school children (grades 7–11). Results showed that among the participating students, emotional abuse was the most commonly reported type of abuse (59.6%), followed by household violence (52.2%), bullying (44.7%), physical abuse (31.7%), emotional neglect (26.3), physical neglect (12.7%), and parents' separation (5.2%). Male students reported significantly more physical abuse than female students (37.5% vs 26.2%, p < 0.001), and significantly more physical neglect than female students (18.2% vs 7.6%, p < 0.001). However, female students reported significantly more household violence than male student (60.0% vs 43.9%, p < 0.001). Self-esteem scores were lower for students who reported physical abuse (d = 0.38, p < 0.001), household violence (d = 0.25, p < 0.003), emotional neglect (d = 0.45, p < 0.001), physical neglect (d = 0.58, p < 0.001), and bullying (d = 0.29, p = 0.001). Self-esteem was best predicted by physical abuse (β = − 0.114, p = 0.009), emotional neglect (β = − 0.169, p < 0.001), and physical neglect (β = − 0.148, p < 0.001). Efforts should be exerted to prevent violence against children. National programs and community awareness campaigns should focus on the violence's detrimental effects on children. [ABSTRACT FROM AUTHOR]

Data on the long-term and comprehensive cost of violence are essential for informed decision making regarding the future benefits of resources directed toward violence prevention. This review aimed to summarize original per-person estimates of the attributable cost of interpersonal violence to support public health economic research and decision making. In 2023, English-language peer-reviewed journal articles published in 2000–2022 with a focus on high-income countries reporting original per-person average cost of violence estimates were identified using index terms in multiple databases. Study contents, including violence type (e.g., adverse childhood experiences), timeline and payer cost perspective (e.g., hospitalization event-only healthcare payer cost), and associated per-person cost estimates, were summarized. Costs were in 2022 U.S. dollars. Per-person cost estimates related to adverse childhood experiences, community violence, sexual violence, intimate partner violence, homicide, firearm violence, youth violence, workplace violence, and bullying from 73 studies (majority focusing on the U.S.) were summarized. For example, among 23 studies with a focus on adverse childhood experiences, monetary estimates ranged from $390 for adverse childhood experience–related annual healthcare out-of-pocket costs per U.S. adult with ≥3 adverse childhood experiences to $20.2 million for the lifetime societal economic burden of a U.S. child maltreatment fatality. This review provides a descriptive summary of available per-person cost of violence estimates. Results can help public health professionals to describe the economic burden of violence, identify the best available estimate for a particular public health question, and address data gaps. Ultimately, understanding the long-term and comprehensive cost of violence is necessary to anticipate the economic benefits of prevention. [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]

Background: Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019–21. Methods: We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention. Results: The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence. Conclusions: Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS +. Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions. [ABSTRACT FROM AUTHOR]

Research has demonstrated the predictive effect of maternal childhood maltreatment on adolescent internalizing problems. However, few studies have explored the mediating mechanisms of how mothers' experiences of childhood maltreatment are transmitted to their offspring's internalizing problems over time. The present multi-informant study investigated the potential mediating effects of maternal depressive symptoms and offspring's childhood maltreatment experiences on the relation between maternal childhood maltreatment and adolescent internalizing problems. A total of 823 Chinese youth (43.4% girls; Mage = 10.26 years, SD = 0.94) and their mothers participated in a two-wave longitudinal study with one-year intervals. Mothers reported their experiences of childhood maltreatment and depressive symptoms, while youth reported their childhood maltreatment experiences and internalizing problems. Findings of path analysis indicated that maternal emotional abuse at T1 could significantly predict adolescent internalizing problems at T2, after controlling for a baseline of adolescent internalizing problems. Maternal emotional abuse, emotional neglect, and physical neglect at T1 can influence adolescent internalizing problems at T2 through maternal depressive symptoms at T1 to adolescent internalizing problems at T1. Maternal emotional abuse at T1 displayed statistically significant indirect effects on adolescent internalizing problems at T2 successively through the pathway from adolescent emotional abuse at T1 to adolescent internalizing problems at T1. The findings supported the cycle of maltreatment hypothesis. The present study highlights the intergenerational link between maternal childhood maltreatment and adolescent internalizing problems, as well as reveals the mediating mechanisms in this relation. [ABSTRACT FROM AUTHOR]