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Objectives To examine the self-reported quality of life of maltreated children, shortly after submission of a report to an advice and reporting center on child abuse and neglect, and the extent to which child and maltreatment characteristics were associated with quality of life. Methods Participants were 228 maltreated children aged 5–16 years (M = 9.99; SD = 3.20) and their primary caregiver. Children completed the Pediatric Quality of Life Inventory. One-sample t-tests were used to compare the self-reported quality of life of the maltreated children with scores from normative populations. Stepwise multiple regression analyses were used to explore whether maltreated children’s age, gender and type of maltreatment were associated with their quality of life, controlling for socio-demographic characteristics. Results Significant differences were found between the study sample and three different normative populations regarding overall quality of life and the psychosocial health dimension of quality of life, indicating a poorer quality of life and psychosocial health for the maltreated children in this study. In addition, the socio-demographic characteristic of financial problems in the family as reported by the parent(s) was associated with children’s poorer self-reported quality of life. Conclusions The results of this study suggest that child maltreatment is negatively related to self-reported quality of life. Future research should further address the effects of child maltreatment on quality of life after child protection system interventions.

Exposure to childhood adverse events is associated with severe consequences for general health and structural and functional changes in the brain of its survivors. In order to unravel and in the end influence the pathway linking adversity and pathology, neuroimaging research is crucial. Up till now studies in minors are scarce and differ in type of adversity or methodology. Almost all studies report lower cortical thickness, but in a broad variety of regions. In this study we investigated cortical thickness measures and clinical data in a well circumscribed group of adolescents with PTSD related to childhood sexual abuse (CSA) (N = 21) and a healthy non-traumatised control group (N = 21). The ventromedial PFC (vmPFC), ACC, insula, and middle/superior temporal gyrus were chosen as ROI’s due to their respective roles in emotion and information processing. No significant effect of group was found for cortical thickness, surface area or volume in any of the ROIs. This is in line with the results of research in adult women with sexual abuse related PTSD, suggesting that this may be specific to this group, independent of age. Recent research points to differential biological and pathological consequences of different types of childhood adversity.

Mother–child dialogues about children’s emotional experiences are associated with children’s adaptive coping with stressful situations and mental health. Despite these findings, dialogues have not been examined yet in the context of child sexual abuse. This gap is surprising given that mother–child dialogues may particularly promote children’s recovery from traumatic events. The current exploratory study examined the quality of mother–child emotion dialogues, as well as the quality of child and maternal contributions to dialogues, among dyads with sexually abused children ( n = 30; 60% female; M age = 8.03), as compared with dyads with nonabused children ( n = 30; 60% female; M age = 8.20). Quality of dialogues was assessed using the Autobiographical Emotional Events Dialogue. Mothers reported on their own childhood maltreatment history and psychopathological symptoms. Results showed that dyads with abused children were more likely to engage in overwhelming/excessive dialogues and dialogues lacking content, as compared with dyads with nonabused children. After controlling for differences in background characteristics, mothers of abused children showed lower sensitive guidance. Although mothers of abused children had more experiences of childhood maltreatment and higher levels of psychopathology, they did not add to explain group differences in maternal sensitive guidance. Our findings suggest that the ability to discuss emotional experiences may be impaired among mother–child dyads with sexually abused children. This may be an important target in the treatment of sexually abused children and their families.

The study aimed to describe the psychometric properties of the Dutch version of the Trauma Symptom Checklist for Young Children (TSCYC) in normative and clinical populations in the Netherlands. Caregivers’ ratings on the TSCYC were obtained for 1,802 children from the normal population, and for 515 children from a clinical population of traumatized children. In the clinical sample, additional measures were taken. The internal consistency and test-retest reliability of TSCYC scales were adequate. Confirmatory factor analysis showed acceptable fit on the putative scale structure. Regarding criterion validity, the clinical sample scored significantly higher on all clinical scales when compared to the normal population sample. Within the clinical sample, significant associations were found between TSCYC scales and convergent scales of other instruments. The Posttraumatic Stress-Total subscale demonstrated excellent discriminative ability between traumatized children and children from the normal popula...

Background: The Child Sexual Behavior Inventory (CSBI) is one of the few instruments available to assess sexual behavior in children. Because of cross-cultural differences in the definition of normal and atypical sexual behaviors, the CSBI is not generalizable to other countries. Objective: The current study examined psychometric properties of the Dutch version of the CSBI. Participants and setting: The study represents 3206 children from a normative sample, and 932 children from clinical samples. Methods: Parents ratings on the CSBI, and questionnaires for psychosocial problems were obtained to assess psychometric properties. Results: Results showed that Dutch parents interpret more CSBI items as developmentally appropriate than USA parents. Reliability coefficients indicated internal consistency (α = .39–.82), test-retest (r = .86, p < .000) and interrater reliability (Cohen's d =0.47, p >.05). Positive correlations between the CSBI total scale and the subscales demonstrated content validity (r = .32–.96, p < .01). Differences between normative and clinical samples on the CSBI total (ηp2 = .01–.65, p < .000), DRSB (ηp2 = .00–.03, p = .00–.38) and SASI scales (ηp2 =.00–.18, p < .01) indicated construct validity. Within the clinical samples, highest associations were found between the CSBI score and convergent measures (r = .64, p < .000). Lowest associations were found between the CSBI scores and divergent measures r = .14–.54, p = n.s.−

Nonoffending mothers of sexually abused children often exhibit high levels of posttraumatic stress (PTS) symptoms. Emerging evidence suggests that trait-like individual differences in sensitivity to disgust play a role in the development of PTS symptoms. One such individual difference, disgust sensitivity, has not been examined as far as we are aware among victims of secondary traumatic stress. The current study examined associations between disgust sensitivity and PTS symptoms among mothers of sexually abused children (N = 72). Mothers completed the Impact of Event Scale-Revised and the Three Domain Disgust Scale (Tybur, Lieberman, & Griskevicius, 2009). More than one third of mothers scored above a suggested cutoff (mean score = 1.5) for high levels of PTS symptoms. Hierarchical linear regression analysis results indicated that sexual disgust sensitivity (β = .39, p = .002) was associated with PTS symptoms (R(2) = .18). An interaction analysis showed that sexual disgust sensitivity was associated with maternal PTS symptoms only when the perpetrator was not biologically related to the child (β = -.32, p = .047; R(2) = .28). Our findings suggested that sexual disgust sensitivity may be a risk factor for developing PTS symptoms among mothers of sexually abused children.

This study examined the association between interparental violence (IPV), child abuse and neglect, other traumatic experiences, and children’s post-traumatic stress (PTS) symptoms and explored the moderating role of family functioning in the aftermath of IPV. One hundred and twenty IPV-exposed children (53.3 % male, M age = 9.85) and parents who were referred to community mental health centers participated in the study. Combined, IPV, child abuse and neglect, and other traumatic experiences were associated with PTS symptoms. For family functioning, higher levels of parenting stress were associated with higher levels of PTS symptoms. No moderating effects were found. To understand the variability in PTS symptoms among children exposed to IPV, other traumatic and stressful experiences need to be taken into account.

Although child sexual abuse (CSA) is associated with psychopathology, limited research examined mechanisms through which CSA leads to psychopathology in children. It is generally assumed that CSA is associated with secrecy among children, to our knowledge this assumption has not yet been empirically tested. This gap in our understanding of the aftermath of CSA is surprising in light of abundant evidence linking secrecy to psychopathology among children. The current study examined whether, as compared to children who have not experienced CSA, CSA victims have a greater tendency for secrecy as reported by mothers and children, and whether psychopathology in CSA victims may be explained by their tendency to keep secrets. Sixty-three non-offending mothers and their sexually abused children (68.3% female; M age. = 10.89) and 48 mothers and their non-abused children (62.5% female; M age = 11.17) completed questionnaires on secrecy and psychopathology (i.e., internalizing and externalizing behavior problems). Mothers of abused children perceived higher levels of secrecy and psychopathology in their children as compared to mothers of non-abused children. There were no differences in child-reported secrecy between abused and non-abused children. Mediation analyses revealed that mother-reported secrecy mediated the association between CSA and psychopathology. These findings suggest that secrecy is a potential mechanism underlying psychopathology associated with CSA, which has important implications for treatment of abused children.

Adverse childhood experiences (ACE) substantially increase the risk of later psychiatric and somatic pathology. While neurobiological factors are likely to play a mediating role, specific insights are lacking. The scarce neuroimaging studies in traumatised pediatric populations have provided inconsistent results, potentially due to the inclusion of different types of trauma. To further improve our understanding of the neurobiology of pediatric psychotrauma, this study seeks to investigate abnormalities in grey matter volume (GMV) in a homogeneous group of adolescents with posttraumatic stress disorder (PTSD) due to childhood sexual abuse (CSA) and the relationship between GMV and symptom severity. We performed a voxel based morphometry (VBM) analysis in 21 adolescents with CSA-related PTSD and 25 matched non-traumatised, non- clinical adolescents. Hippocampus, amygdala, anterior cingulate cortex (ACC), medial PFC (mPFC) and superior temporal gyrus (STG) were chosen as regions of interest (ROIs). Trauma symptomatology was measured with the Trauma Symptom Checklist for Children (TSCC) and dissociation symptoms with the Adolescent Dissociative Experiences Scale (A-DES). The ROI analysis showed that the CSA-related PTSD group had significant smaller volumes of the dorsal ACC as compared to healthy controls. However, no correlations were found between GMV and scores on the TSCC and A-DES. The smaller ACC volume is partly in line with previous studies in traumatised youth and is a consistent finding in traumatised adults. Taken together our results suggest that the dorsal ACC is implicated in the neurobiological sequelae of CSA, potentially associated with an altered evaluative processing of emotion, but not directly with PTSD severity.

The Children's Revised Impact of Event Scale (CRIES-13) is a brief self-report measure designed to screen children for posttraumatic stress disorder (PTSD). This study investigates the psychometric properties of a Dutch version of the CRIES-13-parent version and evaluates its correlation with the child version. A sample of 59 trauma-exposed children (8 years-18 years) and their parents completed an assessment including the CRIES-13 (child/parent version) along with the Anxiety Disorders Interview Schedule for DSM-IV: Parent version. Results demonstrated good internal consistency (α = .87) with acceptable values for the 3 subscales. A strong correlation (r = .73) with another measure of PTSD and lower correlations with a behavioral measure (r = .15 to .38) were found, confirming the convergent/divergent validity. A cutoff score ≥ 31 emerged as the best balance between sensitivity and specificity, and correctly classified 83.6% of all children as having a diagnosis of PTSD. This study provides support for the reliability and validity of the CRIES-13-parent version as a screening measure for posttraumatic stress in children.

Early identification of posttraumatic stress disorder (PTSD) in children is important to offer them appropriate and timely treatment. The Children's Revised Impact of Event Scale (CRIES) is a brief self-report measure designed to screen children for PTSD. Research regarding the diagnostic validity of the CRIES is still insufficient, has been restricted to specific populations, and sample sizes have often been small. This study evaluated the reliability and validity of the 8-item (CRIES-8) and 13-item (CRIES-13) versions of the CRIES in a large clinically referred sample. The measure was completed by 395 Dutch children (7-18 years) who had experienced a wide variety of traumatic events. PTSD was assessed using the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent version. A cutoff score of 17 on the CRIES-8 and 30 on the CRIES-13 emerged as the best balance between sensitivity and specificity, and correctly classified 78%-81% of all children. The CRIES-13 outperformed the CRIES-8, in that the overall efficiency of the CRIES-13 was slightly superior (.81 and .78, respectively). The CRIES appears to be a reliable and valid measure, which gives clinicians a brief and user-friendly instrument to identify children who may have PTSD and offer them appropriate and timely treatment.

Vroegtijdige signalering van posttraumatische stressstoornis PTSS) is van belang ter preventie van chronische problematiek en om kinderen tijdig en effectief te behandelen. De Children’s Revised Impact of Event Scale CRIES-13) is een korte screeningslijst om PTSS bij kinderen te signaleren. Deze studie heeft als doel de betrouwbaarheid en validiteit van de CRIES-13 te onderzoeken. De CRIES-13 is afgenomen bij 395 kinderen (7-18 jaar) die zijn blootgesteld aan een traumatiserende gebeurtenis. De Anxiety Disorders Interview Schedule for DSM-IV: Child and parent version ADIS-C/P) is gebruikt voor het vaststellen van PTSS. De interne consistentie en test-hertestbetrouwbaarheid van de CRIES-13 waren acceptabel tot goed. Een afkapwaarde van 30 of hoger bleek de beste balans te bieden tussen sensitiviteit en specificiteit, en leverde een correcte classificatie van 81% van alle kinderen op. De CRIES-13 is een betrouwbaar en valide instrument waarmee professionals posttraumatische stressklachten snel en eenvoudig kunnen herkennen en kinderen gerichter kunnen doorverwijzen voor aanvullende diagnostiek of een passende behandeling.

High family risk was tested as an impediment to recovery in children exposed to interparental violence (IPV) participating in community-based intervention. Characteristics of IPV were also explored as moderators for the effect of an IPV-focused intervention over a common factors intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6 to 12 years; 55.5% boys) were fitted in a multilevel model. Outcomes were clinical classifications of internalizing and externalizing problems, and posttraumatic stress symptoms. Tested moderators were child maltreatment, symptoms of disordered attachment, parental psychopathology, parenting stress, poverty, and IPV characteristics. Children without symptoms of disinhibited social engagement disorder, children of parents with high levels of psychopathology, and children of parents with high levels of parenting stress showed strongest recovery. Participation in an IPV-focused intervention was not more effective than in a common factors intervention, irrespective of the nature of the IPV. Based on rate of recovery, participation in community-based group interventions does not need to be contraindicated for children facing high family risk after being exposed to IPV, except for children with symptoms of disinhibited social engagement disorder. (PsycINFO Database Record (c) 2014 APA, all rights reserved). Language: en

A community-based intervention with specific factors for children and parents exposed to interparental violence (IPV) was compared with a control intervention based on non-specific factors. We hypothesized that participation in an intervention with specific factors, focused on IPV, parenting and coping, would be associated with better recovery. IPV exposed children and parents were group randomized over a specific factors- and control intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6-12 years, 55.5% boys) were fitted in a multilevel model. Outcomes were parent and teacher reported children's internalizing and externalizing problems (CBCL, TRF), child self-reported depressive symptoms (CDI) and parent and child reported children's post-traumatic stress symptoms (TSCYC, TSCC). Based on intention-to-treat and completer analyses, children in the specific factors intervention did not show better recovery than children in the control intervention. Children in both interventions decreased significantly in parent-reported children's internalizing and externalizing problems and post-traumatic stress symptoms. Children reported a decrease in their mean level of depressive and post-traumatic stress symptoms. Teachers reported a decrease in internalizing problems, but not in externalizing problems. No association between time since exposure and level and course of symptoms was found. Treatment differentiation was assessed and both programs were significantly different on hypothesized effective factors. Higher treatment adherence in both programs did not result in a larger difference in recovery. IPV exposed children improve over the course and after participating in a community-based child- and parent program, but specific factors in intervention may not carry additional benefits when implemented in community settings.

Background: In the Netherlands, suspected cases of child maltreatment can be reported to an advice and reporting center on child abuse and neglect (Advies- en Meldpunt Kindermishandeling or AMK). AMKs investigate these reports, screen for problems in the family and its surroundings and refer to child welfare. Over the last decades the focus of AMK investigations has changed from an adult-only approach to a more child-oriented approach using a Child-Interview intervention. The effects and cost-effectiveness of AMK involvement in the Netherlands have never been studied. The primary aim of this study is therefore to examine the effect of the participation of maltreated children aged 6-18 years in the Child-Interview intervention on their mental health and quality of life. As a second aim, this study will examine the balance between additional costs and effects of the Child-Interview intervention in comparison with AMK investigation without the Child-Interview intervention (adult-only intervention). Design/Methods. A quasi-experiment will be performed consisting of two post-intervention measurements of two nonequivalent groups: an intervention group, in which the Child-Interview intervention has been used during the AMK investigation, and a control group, in which the intervention has not been used (adult-only intervention). Participants from an ongoing prospective study on the mental health and quality of life of maltreated children after a report to an AMK, will be contacted to complete a questionnaire twice. Multivariate regression analyses will be used to determine effectiveness of the Child-Interview intervention. The economic evaluation will involve a cost-effectiveness analysis and a cost-utility analysis. Results/Discussion. This will be the first study to examine the effect of AMK involvement in the Netherlands. Using the Child-Interview intervention during AMK investigation may prevent or reduce negative outcomes of child maltreatment, which may result in a lower consumption of healthcare and other services. In addition, the importance of economic evaluations is increasingly recognized, and economic evaluations about child maltreatment are scarce. Limitations include the risk of potential recall bias and selection bias. Trial registration. NTR3728, funded by ZonMw, project 15700.2012. © 2013 Snoeren et al.; licensee BioMed Central Ltd.

Nonoffending mothers of sexually abused children often exhibit high levels of posttraumatic stress (PTS) symptoms. Emerging evidence suggests that trait-like individual differences in sensitivity to disgust play a role in the development of PTS symptoms. One such individual difference, disgust sensitivity, has not been examined as far as we are aware among victims of secondary traumatic stress. The current study examined associations between disgust sensitivity and PTS symptoms among mothers of sexually abused children (N = 72). Mothers completed the Impact of Event Scale-Revised and the Three Domain Disgust Scale (Tybur, Lieberman,Griskevicius, 2009). More than one third of mothers scored above a suggested cutoff (mean score = 1.5) for high levels of PTS symptoms. Hierarchical linear regression analysis results indicated that sexual disgust sensitivity (β = .39, p = .002) was associated with PTS symptoms (R(2) = .18). An interaction analysis showed that sexual disgust sensitivity was associated with maternal PTS symptoms only when the perpetrator was not biologically related to the child (β = -.32, p = .047; R(2) = .28). Our findings suggested that sexual disgust sensitivity may be a risk factor for developing PTS symptoms among mothers of sexually abused children.

Objectives. A clear association between exposure to intimate partner violence (IPV) and children's physical health is still not well determined, because adverse effects might be explained by the confounding detrimental effects of other traumatic experiences. This study investigated whether children exposed to IPV have higher risks for physical health complaints compared to children in a general population sample. Second, health complaint differences were explored between IPV witnesses and those who in addition experienced other forms of abuse or neglect. Design. Risk estimates for 21 everyday physical health complaints were made for children exposed to IPV compared to a general population sample using odds ratios. Methods. Primary caregivers of 275 child witnesses of IPV (6-12 years of age) referred to several specialized mental health or child welfare institutes throughout the Netherlands (2004-2009) reported on children's somatic complaints using 21 items of the Child Behaviour Checklist (CBCL; Achenbach & Rescorla, 2001) reflecting sleeping, eating, pain complaints, and self-harm. Results. Compared to a population sample (n = 903), child witnesses more often experienced health complaints, in particular, more eating, sleeping, and pain problems and more self-harm. Few differences in health complaints were found between child witnesses with and without additional adverse experiences of maltreatment. Conclusions. The degree of physical health complaints in children exposed to IPV is considerable, whether or not they were also victims of other forms of abuse. Early attention to everyday health complaints in children exposed to IPV might prevent more serious health problems in adolescence and adulthood.

OBJECTIVE: This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a high risk clinical sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms. METHODS: The study population comprised 208 children (M=7.81 years, SD=2.39, range 2-12) who were referred to mental health and welfare institutions after reported Intimate Partner Violence (IPV). At intake, caregivers, children, and teachers completed questionnaires on Adverse Childhood Experiences, behavior and emotional problems, and trauma symptoms. RESULTS: The results showed that child witnesses of IPV were also exposed to other adverse experiences, such as abuse, household dysfunction and neglect. The mean number of ACEs was 5.08 (range 2-9). Twenty percent of the children in this sample experienced seven ACEs or more. The number of ACEs children were exposed to was unrelated to the level of emotional and behavioral problems, except for trauma related symptoms reported by parents. CONCLUSIONS: This study shows that children who witnessed Intimate Partner Violence were also exposed to other adverse experiences. The results of this study may imply that in this high-risk clinical sample of children exposed to IPV, additional adverse experiences have a limited relationship to psychological outcomes. PRACTICE IMPLICATIONS: A thorough assessment and inclusion of all Adverse Childhood Experiences is necessary for a comprehensive treatment program. Language: en

Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent–child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6–12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent–child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent–child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.

Background : Posttraumatic stress disorder (PTSD) can be a debilitating disorder and often co-occurs with other psychiatric disorders, such as mood, behavioral, and anxiety disorders. Early identification of PTSD and psychiatric comorbidity is highly relevant in order to offer children appropriate and timely treatment. The Children’s Revised Impact of Event Scale (CRIES-13) is a reliable and valid self-report measure designed to screen children for PTSD. However, this measure is not useful as a screen for psychiatric comorbidity in children with probable PTSD. Objective : This study evaluated the screening accuracy of the CRIES-Plus, that is, the CRIES-13 combined with 12 additional items to detect psychiatric comorbidity. Method : The CRIES-Plus was completed by 398 Dutch children (7–18 years) exposed to various traumatic events. Psychiatric diagnoses were assessed using the Anxiety Disorders Interview Schedule for DSM-IV: Child version. Results : Six additional items were significantly associated with mood disorders, three items were associated with behavioral disorders, and five items with anxiety disorders. Additional items associated with mood and anxiety disorders demonstrated good discriminatory ability, with cut-off scores of ≥14 and ≥10, respectively. Items associated with behavioral disorders had poor to fair discriminatory ability, with no clear cut-off point. Conclusions : Our findings support the use of the CRIES-Plus to screen for PTSD and comorbid disorders which may help clinicians in assigning appropriate follow-up diagnostic and clinical care. Keywords: PTSD; trauma; diagnosis; screening; assessment; children; adolescents; CRIES (Published: 28 August 2015) Responsible Editor: Rita Rosner, KU Eichstaett-Ingolstadt, Germany. For the abstract or full text in other languages, please see Supplementary files in the column to the right (under ‘Article Tools’) Citation: European Journal of Psychotraumatology 2015, 6 : 26661 - http://dx.doi.org/10.3402/ejpt.v6.26661

Interparental violence is both common and harmful and impacts children’s lives directly and indirectly. Direct effects refer to affective, behavioral, and cognitive responses to interparental violence and psychosocial adjustment. Indirect effects refer to deteriorated parental availability and parent-child interaction. Standard Trauma Focused Cognitive Behavioral Therapy may be insufficient for children traumatized by exposure to interparental violence, given the pervasive impact of interparental violence on the family system. HORIZON is a trauma focused cognitive behavioral therapy based group program with the added component of a preparatory parenting program aimed at improving parental availability; and the added component of parent-child sessions to improve parent-child interaction. This is a multicenter, multi-informant and multi-method randomized clinical trial study with a 2 by 2 factorial experimental design. Participants (N = 100) are children (4–12 years), and their parents, who have been exposed to interparental violence. The main aim of the study is to test the effects of two parental components as an addition to a trauma focused cognitive behavioral based group therapy for reducing children’s symptoms. Primary outcome measures are posttraumatic stress symptoms, and internalizing and externalizing problems in children. The secondary aim of the study is to test the effect of the two added components on adjustment problems in children and to test whether enhanced effects can be explained by changes in children’s responses towards experienced violence, in parental availability, and in quality of parent-child interaction. To address this secondary aim, the main parameters are observational and questionnaire measures of parental availability, parent-child relationship variables, children’s adjustment problems and children’s responses to interparental violence. Data are collected three times: before and after the program and six months later. Both intention-to-treat and completer analyses will be done. The current study will enhance our understanding of the efficacy interparental violence-related parental components added to trauma focused cognitive behavioral group program for children who have been exposed to IPV. It will illuminate mechanisms underlying change by considering multiple dimensions of child responses, parenting variables and identify selection criteria for participation in treatment. Netherlands Trial Register NTR4015 . Registered 4th of June, 2013.

(2002). Child (Sexual) Abuse: A Universal Problem, and Sri Lanka Is No Exception. Journal of Child Sexual Abuse: Vol. 11, No. 2, pp. 115-124.

The Children's Revised Impact of Event Scale (CRIES-13) is a brief self-report measure designed to screen children for posttraumatic stress disorder (PTSD). This study investigates the psychometric properties of a Dutch version of the CRIES-13-parent version and evaluates its correlation with the child version. A sample of 59 trauma-exposed children (8 years-18 years) and their parents completed an assessment including the CRIES-13 (child/parent version) along with the Anxiety Disorders Interview Schedule for DSM-IV: Parent version. Results demonstrated good internal consistency (α = .87) with acceptable values for the 3 subscales. A strong correlation (r = .73) with another measure of PTSD and lower correlations with a behavioral measure (r = .15 to .38) were found, confirming the convergent/divergent validity. A cutoff score ≥ 31 emerged as the best balance between sensitivity and specificity, and correctly classified 83.6% of all children as having a diagnosis of PTSD. This study provides support for the reliability and validity of the CRIES-13-parent version as a screening measure for posttraumatic stress in children.

Summary All information regarding 103 Dutch sexual abuse cases was analyzed using the Validity Checklist, the second part of the Statement Validity Analysis procedure. The fulfillment of the VC items was compared for four different age groups. Only two VC items differed significantly between the age groups. The systematic summarization of content analysis and validity checks revealed only a weak relationship between the fulfillment of the CBCA criteria and the VC items together and the outcome of the cases. The results suggest that SVA cannot yet be used as a scientifically validated instrument for judging the truthfulness of allegations of child sexual abuse.

Kinderen die ruzies en geweld tussen hun ouders meemaken, lopen een verhoogd risico op problemen. Cursussen kunnen deze problemen verminderen. Onduidelijk was hoe deze cursussen er het beste kunnen uitzien. De resultaten van het hier beschreven onderzoek laten zien dat vooral algemene cursuselementen belangrijk lijken om probleemgedrag te verminderen. Effecten van hulp worden via ouders doorgegeven: meer positieve aandacht voor ouders hangt samen met beter psychisch functioneren van ouders en kinderen.

Childhood psychological trauma is a strong predictor of psychopathology. Preclinical research points to the influence of this type of trauma on brain development. However, the effects of psychological trauma on the developing human brain are less known and a challenging question is whether the effects can be reversed or even prevented. The aim of this review is to give an overview of neuroimaging studies in traumatized juveniles and young adults up till 2012. Neuroimaging studies in children and adolescents with traumatic experiences were found to be scarce. Most studies were performed by a small number of research groups in the United States and examined structural abnormalities. The reduction in hippocampal volume reported in adults with PTSD could not be confirmed in juveniles. The most consistent finding in children and adolescents, who experienced psychological trauma are structural abnormalities of the corpus callosum. We could not identify any studies investigating treatment effects. Neuroimaging studies in traumatized children and adolescents clearly lag behind studies in traumatized adults as well as studies on ADHD and autism. © 2013 Springer-Verlag Berlin Heidelberg.

The authors first provide a brief overview of Dutch agencies that deal with child abuse and neglect, the approach to child abuse, and the position of children as witnesses in the Netherlands. Next, they present Dutch data on child abuse and neglect and child sexual abuse. They then go on to review studies on statement validity analysis. Finally, they report the results of a study in which they compared the presence of content criteria in the statements of alleged sexual abuse victims in four age groups. The comparison was made using criteria-based content analysis, one of the components of the statement validity analysis procedure.

Dit artikel beschrijft een onderzoek naar de prevalentie en incidentie van kindermishandeling, uitgevoerd in het landbouwdistrict Nickerie, Suriname. De data gelden alleen voor het genoemde district, gezien de sterke verschillen in de bevolkingssamenstelling en de sociale structuur van de diverse districten. Door 345 middelbare scholieren van twaalf tot achttien jaar werd een vragenlijst over meegemaakte onaangename gebeurtenissen ingevuld. Hieruit bleek dat 61,2% van de jongeren ooit is mishandeld, en 37,4% werd mishandeld in het jaar voorafgaand aan het onderzoek. Er zijn verschillen per sekse en bevolkingsgroep gevonden. Er is een onderlinge samenhang gevonden tussen de vijf verschillende vormen van kindermishandeling. Ook is er een relatie met biografische en sociaaldemografische variabelen gevonden bij blootstelling aan kindermishandeling. Het onderzoek vraagt om meer aandacht voor behandeling en preventie. In de toekomst zal uitgebreider onderzoek gedaan worden naar kindermishandeling in Suriname.

Child maltreatment is generally referred to under the global categories of physical, sexual, emotional/psychological abuse and neglect. The Concerted Action on the Prevention of Child Abuse in Europe (CAPCAE) reports on the specific forms of harm and injury, actions and persons believed responsible in eight European countries. The most common actions across all participating countries responsible for harm were those of violent parenting or absent parenting. A review of prevention strategies found that few programmes focused on specific behaviours or included measures to indicate whether their actions were successful in preventing further harm to children. It is recommended that fathers need to be targeted in prevention as well as mothers and that specific data collection of actual harms, actions, persons responsible and outcomes needs to be implemented as a priority in all European countries. Such specificity avoids a focus on risk which is unacceptable in some countries, over inclusive of parents and resource intensive

This study seeks to determine whether white matter integrity in the brain differs between adolescents with post-traumatic stress disorder (PTSD) due to child- hood sexual abuse (CSA) and matched healthy adolescents and whether there is a relationship between white matter integrity and symptom severity in the patient group. Using 3T diffusion tensor imaging, we examined fractional ani- sotropy (FA) in a group of adolescents with CSA-related PTSD (n = 20) and matched healthy controls (n = 20), in a region of interest consisting of the bilateral uncinate fas- ciculus (UF), the genu, splenium and body of the corpus callosum (CC), and the bilateral cingulum. In addition, we performed an exploratory whole brain analysis. Trauma symptomatology was measured with the Trauma Symp- tom Checklist for Children (TSCC) to enable correlational analyses between FA differences and trauma symptomatol- ogy. The PTSD group had significantly lower FA values in the genu, midbody and splenium of the CC in comparison with controls (p < 0.05, tfce corrected). Post hoc analyses of the eigenvalues of the DTI scan showed increased radial and mean diffusivity in the patient group. In addition, we found a significant negative correlation between scores on the anger subscale of the TSCC and FA values in the left body of the CC in patients (p < 0.05). Adolescents with CSA-related PTSD show decreased FA in the CC, with abnormalities in the integrity of the left body of the CC being related to anger symptoms. These findings suggest that early trauma exposure affects the development of the CC, which may play a role in the pathophysiology of PTSD in adolescents.

Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done. Discussion Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence. Trial registration Netherlands Trial Register (NTR): NTR3064

Background: Child maltreatment is recognized as a widespread problem with huge implications for mental health and quality of life. Studies have repeatedly shown that victims of child maltreatment report significantly more adverse life outcomes than non-victims. The main objective of the study is (1) to examine the mental health and quality of life of maltreated children over a 1.5 year period beginning shortly after a report has been filed with an Advies- en Meldpunt Kindermishandeling (AMK) (advice and reporting center on child abuse and neglect). Secondary objectives are: (2) to examine how relevant determinants influence the mental health and quality of life of maltreated children, and (3) to examine differences in mental health and quality of life outcomes when comparing families of Dutch origin with families originating from Morocco and Suriname. Methods/Design. A prospective study will be performed, in which parent-child dyads will be followed over a 1.5 year period. Participants will be recruited shortly after the report to the AMK and they will be asked to complete a questionnaire four times, at baseline and every six months thereafter. Data will be analyzed using a longitudinal multi-level analysis. Discussion. The study is expected to yield evidence about the mental health and quality of life of maltreated children and about determinants that influence their mental health and quality of life outcomes. Strengths of this study are (1) the design which makes it possible to start examining outcomes shortly after or even during the actual maltreatment and to follow parent-child dyads for 1.5 years, and (2) asking children as informants about their own situation by making use of self-report questionnaires as much as possible. Limitations include the risks of selection bias and loss to follow-up during 1.5 years of data collection. Trial registration. NTR3674, funded by ZonMw, project 15700.2012. © 2013 Snoeren et al.; licensee BioMed Central Ltd.