Search

Background and aimsChildren's initial reports often play a key role in the identification of maltreatment, and a sizeable amount of scientific research has examined how children disclose sexual and physical abuse. Although neglect constitutes a large proportion of maltreatment experiences, relatively little attention has been directed toward understanding whether and how children disclose neglect. The overarching aim of the present study was to document this process by comparing disclosure patterns in cases of neglect to those in cases of sexual abuse.MethodRedacted jurisdiction reports (N = 136) of substantiated dependency cases of neglect (n = 71) and sexual abuse (n = 65) in 4- to 17-year-olds were coded for why maltreatment was suspected, and for children's perceived awareness and disclosure of the maltreatment.ResultsNeglect was most often initially suspected via contact with emergency services (e.g., police, emergency medical services), whereas sexual abuse was most often initially suspected as a result of children's statements. Children evidenced greater perceived awareness of sexual abuse than neglect and were more likely to disclose the former in their first investigative interview. Perceived awareness was further associated with a higher likelihood of children's statements initiating discovery of maltreatment and disclosing in the first investigative interview.ConclusionsChildren may benefit from greater knowledge about their needs for safety, supervision, and provision in the home, which could increase the likelihood they would disclose neglect. Such, in turn, could lead to earlier interventions for children and families.

BackgroundChronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has difficulty responding. Some primary care practices are providing integrated behavioral health care (IBH), where primary care and behavioral health providers work together, in one location, using a team-based approach. Research suggests there may be an association between IBH and improved patient outcomes. However, it is often difficult for practices to achieve high levels of integration. The Integrating Behavioral Health and Primary Care study responds to this need by testing the effectiveness of a comprehensive practice-level intervention designed to improve outcomes in patients with multiple chronic medical and behavioral health conditions by increasing the practice's degree of behavioral health integration.MethodsForty-five primary care practices, with existing onsite behavioral health care, will be recruited for this study. Forty-three practices will be randomized to the intervention or usual care arm, while 2 practices will be considered "Vanguard" (pilot) practices for developing the intervention. The intervention is a 24-month supported practice change process including an online curriculum, a practice redesign and implementation workbook, remote quality improvement coaching services, and an online learning community. Each practice's degree of behavioral health integration will be measured using the Practice Integration Profile. Approximately 75 patients with both chronic medical and behavioral health conditions from each practice will be asked to complete a series of surveys to measure patient-centered outcomes. Change in practice degree of behavioral health integration and patient-centered outcomes will be compared between the two groups. Practice-level case studies will be conducted to better understand the contextual factors influencing integration.DiscussionAs primary care practices are encouraged to provide IBH services, evidence-based interventions to increase practice integration will be needed. This study will demonstrate the effectiveness of one such intervention in a pragmatic, real-world setting.Trial registrationClinicalTrials.gov NCT02868983 . Registered on August 16, 2016.

This study focused on the development of the Socialization of Lying scale for which exploratory factor analysis demonstrated four empirically interpretable subscales: Parents' Values and Direct Socialization about Honesty, Encouragement and Modeling of Lying, Consequences for Lying, and The Child's Problematic Lying. These emergent factors suggest that parents teach and give messages about honesty in explicit and implicit ways that may map onto the different domains in which they socialize the behavior. Future research should focus on further validation and revision of items. This measure can serve as tool for researchers to examine the influence of parent values and socialization practices on children's truth and lie-telling behavior.

ObjectiveChild neglect is often initially identified via adults who come into contact with children and report their suspicions to the authorities. Little is known about what behaviors laypersons view as constituting neglect and hence worth reporting. We examined laypersons' perceptions of neglect and poverty, particularly how these factors independently and jointly shaped laypersons' decisions about what warrants official reporting of neglect, and how laypersons' socioeconomic background related to their decisions.HypothesesWe anticipated that neglect would be correctly perceived as such, but that extreme poverty would also be perceived as neglect, with these latter perceptions being most pronounced among laypersons of higher socioeconomic background.MethodIn 2 studies, adults read vignettes about a mother's care of her daughter and rendered decisions about whether the mother's behavior met the legal standard of neglect and should be reported. In Study 1 (N = 365, 55% female, mean age = 37.12 years), indicators of poverty and neglect were manipulated. In Study 2 (N = 474, 53% female, mean age = 38.25 years), only poverty (housing instability: homelessness vs. not) was manipulated.ResultsLaypersons often conflated poverty and neglect, especially in circumstances of homelessness. Laypersons of lower socioeconomic background were less likely to perceive neglect in general and to report an obligation to make a referral (R2s ranged from 17-26%, odds ratios ranged from 2.24-3.08).ConclusionsLaypersons may overreport neglect in circumstances of poverty. Increasing public awareness of how to recognize and separate neglect from poverty may enhance identification of vulnerable children and families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An alarming number of youth worldwide are victims of commercial sexual exploitation, particularly sex trafficking. Normative developmental processes and motivations across the adolescent period-the age when youth are at greatest risk for trafficking-combined with their history, make them highly likely to be reluctant to disclose their exploitation to police, who often encounter victims because they are suspected of delinquency and crime and who interrogate the victims as suspects. Little scientific and policy attention has been devoted to understanding how to question these victims in a way that reduces their disclosure reluctance and increases their provision of legally relevant information. In the current review, we describe research concerning trafficking victims' histories and exploitative experiences, juvenile suspects' and victims' encounters with the legal system, and best-practice forensic interviewing approaches to elicit disclosures from child victims. We highlight the implications of these areas for understanding the dynamics between how police encounter and interact with adolescent trafficking victims and whether and how the victims disclose trafficking details during these interactions. We close with an agenda for research to test interviewing methods for suspected victims of sex trafficking and with policy and practice recommendations for interviewers.

The current study examined whether age and parental reports of children's problematic lying, behavioural inhibition system (BIS) activity, and reward responsiveness predicted children's antisocial lie‐telling. Children from mostly middle and upper‐class Canadian families (ages 3–12, M = 6.23, SD = 2.52) participated in a modified Temptation Resistance Paradigm (TRP), where they were given opportunities to tell a self‐protective lie (to conceal a transgression) and an instrumental lie (to obtain a reward). Parents completed measures of their children's problematic lying tendencies, BIS activity, and reward responsiveness. Age and parent‐reported problematic lying and BIS activity were significant predictors of lie‐telling behaviour in the TRP. Instrumental liars were younger than dual liars (those who told both types of lies) and truth‐tellers. Truth‐tellers had lower parent‐reported problematic lying than instrumental and dual liars but not self‐protective liars. Dual liars had lower parent‐reported BIS activity than truth‐tellers; there were no differences among truth‐tellers, self‐protective liars, and instrumental liars. This study contributes to our understanding of the role of temperamental factors in children's lie‐telling propensity and the predictive utility of parent‐reported predictors for children's antisocial lie‐telling propensity. Our findings indicate that parents can identify and potentially address their children's problematic lying using their knowledge about their children's temperamental traits. [ABSTRACT FROM AUTHOR]

Globally, children with intellectual disabilities are at an increased risk of being victims of maltreatment compared to those without disabilities. Among the children who do disclose the abuse, limitations with communication and working memory can result in their allegation being perceived as not credible. There are several evidence-based interviewing methods available to interviewers for improving the accuracy and amount of detail in children's testimonies, such as free-recall and cognitive load questioning. In general, these interviewing methods have been developed and tested with typically developing populations, and do not take into consideration the needs of children with intellectual disabilities. Further, there is very little empirical work to guide forensic interviews with intellectually disabled populations, despite there being a great need for such strategies. To address this notable gap in the literature, the current article reviews the contemporary literature on forensic interviewing to identify the best methods for questioning children with intellectual disabilities in maltreatment cases. Adaptations to the commonly used forensic interviewing techniques, including verbal, nonverbal, and repeated questioning strategies, are proposed that address the unique developmental, social, and emotional needs of this population. Furthermore, a series of recommendations are provided to enhance the limited forensic interviewing research with this population.

Context: Despite a growing commitment to integrating behavioral health (IBH) in primary care (PC), high levels of integration that improve care and outcomes are elusive. As previously reported to NAPCRG (2021), 'IBH-PC' studied the effectiveness of an intervention to support BH integration in a randomized controlled trial (RCT). A small improvement in BH integration was detected; there was no observed effect on patient outcomes. Objective: Secondary analysis to understand relationships among intervention completion, timing of study measures relative to COVID-19, level of BH integration, and patient reported outcomes. Study Design: Post-hoc analysis of pragmatic RCT. Setting: 42 primary care clinics with on-site BH services, in 13 states, Sep 2017-Dec 2020. Population: 2,426 adults with multiple chronic behavioral and medical conditions. Intervention: Clinic-level support to implement IBH using online curricula, workbooks, remote coaching, and online learning community. Outcomes and Predictors: Change in mean Patient-Reported Outcomes Measurement Information System scores (PROMIS) and median Practice Integration Profile (PIP); timing relative to COVID-19; and completion of the implementation stage of the intervention. Results: Higher PIP scores were associated with better patient outcomes in all 8 PROMIS domains at baseline and follow-up. This association was significant for Anxiety (CI -0.12, 0.00, P=0.05 and CI -0.09, -0.01, P=0.01, respectively), Social Participation (CI +0.01, +0.09, P=0.02 and CI +0.02, +0.10, P=0.01), and Mental Health Summary (CI 0.00, +0.09, P=0.05 and CI 0.00, +0.09, P=0.04). Additional analysis found that a longer lapse between the start of COVID-19 and collection of final outcomes was associated with smaller improvement in PIP (P=0.04). Among clinics in the intervention arm (n=20), those that completed implementation (n=13) had significantly larger improvement in PIP scores (P=0.013) than those that did not; their patients also reported more improvement in PROMIS scores for Mental Health Summary (P=0.02), Social Participation (P=0.01), and Fatigue (P=0.04). Conclusions: Post-hoc analyses identified associations among level of integration, improved patient reported health outcomes, and intervention completion. COVID-19 may have affected intervention completion. To help the field advance, future study must identify necessary conditions for successful implementation of IBH and the relationship between integration and health., Presenters Constance van Eeghen, DrPH, MHSA, Rodger Kessler, PhD, ABPP, Levi Bonnell, MPH, PhD Candidate, Jennifer O'Rourke-Lavoie, BS, Juvena Hitt, MPH, Gail Rose, PhD, Benjamin Littenberg, MD, Jessica Clifton, [...]

In recent years, Virtual Reality (VR) has emerged as a promising tool for enhancing training responses in high-stress professions, notably among police officers. This study investigates the psychophysiological responses and subjective user experience of active police officers undergoing Mental Health Crisis Response (MHCR) training using an immersive full-body VR system. A total of 10 active police officers with Special Weapons and Tactics (SWAT) training participated in our controlled study. Officers independently took part in one VR training session lasting 7-12 min involving an avatar in crisis portrayed by an actor. Officers wore integrated cardiovascular and electrodermal activity measurement devices for physiological monitoring. VR user experience aspects such as induced symptoms or game mechanics were investigated upon completing the training, aiming to evaluate the officer's perceptions of the technology. We used the DePICT™ scale to evaluate the de-escalation skills of officers, coded by a research professional. Our findings revealed significant differences in heart rate and heart rate variability responses between baseline and VR scenario immersion, suggesting heightened stress regulation during the MHCR simulation using fullbody VR. Arousal measurements also revealed measurable responses during the training in VR. Additionally, the user experience assessment indicated a positive reception to the VR training, with minimal VR-induced symptoms. A "Defensive-Dynamics-Dichotomy" was revealed highlighting dominant autonomic responses linked to defensive actions (e.g., officers who drew a weapon; those who kept their weapons holstered) and their respective implications for stress management and cognitive function. A unique constellation of de-escalation skills was revealed among officers who relied on weapons relative to those who did not, to resolve the scenario. The study highlighted the perceived utility of physiological monitoring technologies in enhancing police training outcomes. In conclusion, our research underscores the potential of VR as an effective tool for de-escalation training following MHCR simulated scenarios among active police officers, offering insights into its psychophysiological impact and user experience. The findings contribute to improving our understanding of the physiology associated with decision-making in police officers to draw a weapon, emphasizing the role of advanced simulation and physiological monitoring technology in developing evidence-based training programs for public safety. [ABSTRACT FROM AUTHOR]

Despite the fact that lie-telling is a common concern among parents, clinicians, and professionals, there has been little systematic investigation of the lies that children tell in relation to their problematic behaviors, nor of other social factors that may influence this relation. This study explored the relation between children's problem behaviors and their lie-telling in two studies. The first examined whether children would tell an antisocial lie to an unfamiliar adult to conceal cheating behavior. The second analyzed the relation between children's problem behaviors, parenting styles, and the frequency of lies reported by parents over two weeks at home. Results suggest that children with higher levels of behavior problems are more likely to tell an antisocial lie to an unfamiliar adult and have a higher frequency of parent-reported lies. Results also indicate that parenting approaches moderate the relation between behavior problems and the frequency of lies that parents report.

Students with emotional and behavioural difficulties (EBD) are more likely to struggle than their peers, which can lead to disengagement and early dropout. Although there are alternate programmes for these students, they are rarely consulted about their struggles, or about their perceived needs. The purpose of this study was to explore the lived experiences of students with EBD from their entry in mainstream classrooms to their placement in an alternate programme. During a semi-structured interview and visual mapping activity, six participants described their schooling experiences and their depictions were analysed using an interpretative phenomenological analysis. Participants described the social process of school and emphasised the importance of relationships with peers and teachers, and the challenges they experienced in these relationships, which included relational, psychological, and physical aggression. Findings highlight the need to consider the reciprocal nature of bullying for students with EBD, and its influence on their schooling.

Lying is an interpersonal exercise that requires the intentional creation of a false belief in another's mind. As such, children's development of lie-telling is related to their increasing understanding of others and may reflect the acquisition of basic social skills. Although certain types of lies may support social relationships, other types of lies are considered antisocial in nature. The goal of this study was to compare several possible correlates, such as cognitive ability and children's behavior patterns, that may be associated with children's (N = 133) use of lies in socially acceptable versus socially unacceptable ways. Children engaged in two lie-telling paradigms: one to measure socially accepted (polite) lies and one to measure socially unaccepted (instrumental) lies. Results indicate that instrumental liars were young with low theory of mind (ToM) scores and had high social skills. Polite liars were the oldest, had high ToM, and had similar levels of social skills as instrumental liars. Truth-tellers and dual liars had lower social skills and moderate ToM in comparison to the instrumental and polite liars. These findings suggest that children use lies selectively to achieve their social goals, and also suggest that children's lying behavior may change from being self-motivated to being other-motivated as they age, which may reflect socialization toward socially accepted behavior.

Virtual reality is an emerging frontier that offers immersive simulations with the capacity to revolutionize police training. This study evaluated a scenario-based training approach by comparing the delivery of simulations in Virtual Reality (VR) and Live Action (LA). Participation in this mental health crisis response training program in either format led to a significantly greater acquisition of de-escalation competencies compared to a control group. VR format showed comparable effectiveness to the LA format in bringing about improved de-escalation skills through scenario-based training. The training was equally effective across all officer experience levels. The VR group showed a greater reduction in bias towards mental illness compared to the control group. Further, the VR format was found to be no more cognitively demanding than live action. The article discusses the centrality of de-escalation skills in police practice and considers the larger implications of de-escalation training delivered through virtual reality applications for increased consistency, cost-efficiencies, and professionalization. [ABSTRACT FROM AUTHOR]