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The relationship between early life stress and post-traumatic stress disorder in adults with primary chronic pain (PCP) is not fully understood. This systematic review aims to explain, analyze, and summarize information to understand how adverse childhood experiences (ACEs) or early life stress and their relationship with the development of Post Traumatic Stress Disorder (PTSD) symptoms in adulthood, could imply the later development of primary chronic pain. Of 133 eligible articles, nine that met the inclusion criteria for this study were selected. Four of the studies concluded that there is a probability of severity of somatic symptoms (such as PCP) in those who experienced ACE with a diagnostic presence of PTSD. [ABSTRACT FROM AUTHOR]

This study analyses teachers' knowledge about child maltreatment in the family and explores their professional background in dealing with this problem. 227 pre-school and primary teachers from Andalusia (Spain) participated in the study. The majority of the teachers had never reported a case of child maltreatment during their professional background. These situations were experienced by the teachers with high levels of emotional impact, and both they and their schools showed high levels of involvement in cases identified. Three teacher profiles were identified, the group of trained teachers being the most capable of identifying more complex signs of child maltreatment, followed by those with more years of seniority. The process of detection and reporting of child maltreatment in the school setting is complex, and a wide range of elements need to be analysed conjointly. [ABSTRACT FROM AUTHOR]

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INTRODUCCIÓN: El maltrato infantil (MI) es un problema de salud pública de impacto global, con manifestaciones orales y dentales que pueden ser indicativas de abuso. Por tanto, resulta fundamental sensibilizar a los profesionales de la salud para que estén alerta a cualquier signo que presente sospecha de MI. OBJETIVOS: Se propuso contribuir con la actualización de manifestaciones clínicas del MI. Además, construir una guía sobre indicadores clínicos que colaboren en el diagnóstico de abuso. MATERIAL Y MÉTODO: Se realizó un estudio documental, utilizando criterios de inclusión, exclusión y palabras claves con el fin de fundamentar de forma teórica el papel del odontopediatra en el diagnóstico de MI. Se realizó una revisión sistemática siguiendo las directrices PRISMA. Se utilizaron bases de datos Medline/PubMed con términos MeSH, cubriendo artículos publicados entre 2020 y 2023. Se aplicaron filtros de idioma (inglés y español) seleccionando artículos relevantes, eliminando duplicados o fuera del alcance del estudio. RESULTADOS: De 26 artículos incluidos, el 65,4% fueron publicados en revistas odontológicas y el 16% en pediátricas. Se determinó que ninguna lesión odontológica por abuso físico es patognomónica, aunque algunas infecciones orales (gonorrea y sífilis) son indicativas claras de abuso sexual. Se observó que lesiones y enfermedades causadas por negligencia resultaron frecuentes, pero no definitivas para diagnosticar abuso sin la presencia de otros factores de riesgo. Se destacó la implementación de espacios educativos continuos para profesionales ya que fortalecen el reconocimiento de signos de MI y evitan que el niño sea nuevamente agredido. CONCLUSIÓN: Las lesiones orales asociadas con el MI son comunes, pero no siempre concluyentes. Los pediatras y odontopediatras deben actualizar su capacitación en estos indicadores, así como en la documentación y denuncia de casos sospechosos. Una mejor formación y colaboración entre especialistas incrementa la prevención y detección del MI, y la protección de los menores vulnerables

Background: Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented.Purpose: To examine the associations between childhood maltreatment and incident arrhythmias, and whether a genetic predisposition to arrhythmias modifies these associations.Methods: This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident arrhythmias (AF, ventricular arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias.Results: During a median follow-up of 12.21 years (interquartile range, 11.49–12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3–5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09–1.37), VA (HR, 1.39; 95%CI 1.03–1.89), and BA (HR, 1.32; 95%CI 1.09–1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (Poverall

Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear.Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety.Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment.Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse – but not physical or emotional abuse – a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types.Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.

The absence of a logical formal representation of the overlapping signs of child abuse (CA) is a knowledge gap that affects identification, evaluation, and intervention processes in different fields of knowledge, especially forensic and clinical. This study aimed to analyze through a literature review to what extent the signs and symptoms of the different types of CA present co-occurrence and overlap (intersection) between them; what is exposed as an input to propose a logical formal representation. To do this, a quick literature review of the scientific production published on the co-occurrence of signs in the different modalities of child abuse is carried out. Twenty-six articles published from 2017 to October 2022 were systematized. The results show the challenges that professionals have in the evaluation processes and the establishment of the causal link, given that sharing the signs between different types of CA could generate false positives and false negatives; therefore, caution must be exercised when establishing relationships between psychological and behavioral manifestations and MI hypotheses. Finally, a logical formal representation of the superposition of signs is proposed and with it, empirical evidence to the frame of reference. [ABSTRACT FROM AUTHOR]

Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual’s life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social.A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care.Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities.In summary, this work aims to promote the training and awareness of all professionals specialized in children’s health, so that they pursue the goal of achieving their patients’ greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice. Resumen: La violencia es un problema de salud pública. Esta, cuando afecta a la infancia, puede generar enfermedad a lo largo de toda la vida del individuo. Aparte de poder producir daños en la esfera física, psíquica y social, supone una vulneración de los derechos de los niños afectados y un elevado consumo de recursos tanto económicos como sociales.Multitud de investigaciones han mejorado la atención a esta violencia. Sin embargo, estos avances no son parejos con el manejo práctico que se realiza a las víctimas tanto en la atención primaria como en la hospitalaria. Existe una significativa área de mejora para la atención pediátrica.A través de este artículo, distintos profesionales de todas las áreas sanitarias pediátricas establecidas desarrollan líneas generales de conocimiento y actuación con respecto a la violencia contra la infancia. Se hace un recorrido a través de la legislación relacionada con la infancia, las distintas tipologías de maltrato que existen, sus efectos, manejo y prevención. Concluye con un epílogo, a través del cual pretendemos mover sensibilidades.En resumen, este es un trabajo que pretende fomentar la formación y sensibilización de todos los profesionales especializados en la salud infantil, para que persigan como objetivo el que sus pacientes alcancen su mayor potencial en la vida y, de esa manera, ayudar a crear una sociedad más sana, con menos enfermedad y más justa.

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Background: Welcoming child victims of maltreatment is a care strategy that requires a physical space, a qualified team, and a reporting system as well as the adoption of a more sensitive approach by health professionals. Objective: To describe the knowledge and practice of health professionals who provide care for maltreated children focusing on patient welcoming. Methodology: This is a qualitative, descriptive, exploratory study that used individual non-directive interviews in a hospital setting for data collection. A thematic analysis was conducted on the data collected. Results: A total of 23 health professionals participated in the study. Most participants were women and 17 had no formal qualifications. The welcoming practices were identified through the analysis of the statements, behaviors, and care practices of the participants. Conclusion: Health professionals have developed their knowledge through professional practice, training, and sensitivity. Inadequate training hinders the identification of child and adolescent victims of maltreatment. Younger children are more vulnerable and may suffer from neglect. Welcoming practices must be articulated with other professional sectors using a common line of care model. [ABSTRACT FROM AUTHOR]

Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors. Design, setting, and participants: The cross-sectional study included 63 university’s college students with a mean age of 19.6 years (N = 95,833). Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable’s relative importance. Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P < .001), followed by sexual and physical abuse. For non-depressed individuals, emotional abuse in childhood was the strongest NSSI predictor (Chi-Square, 2084.171; adjusted P < .001), with sexual and verbal bullying in the past year representing the most significant proximal risks. Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults. [ABSTRACT FROM AUTHOR]

Background: Maternal experiences of childhood maltreatment (CM) constitute a risk factor for impairments in the mother–child relationship. One mechanism underlying this intergenerational transmission may be maternal hypothalamic–pituitary–adrenal axis dysregulation. Yet, few studies have examined different maltreatment subtypes, including emotional neglect, considered concurrent depressive symptoms, and used long-term integrated glucocorticoid measures. Objective: This study aimed to investigate associations between maternal CM history, postpartum glucocorticoids in hair, and mother–child bonding. In exploratory analyses, we tested whether specific subtypes of CM had differential implications for glucocorticoid secretion and bonding. Methods: During pregnancy, N = 269 mothers from the prospective cohort study DREAMHAIR provided retrospective information on CM and current information regarding psychological and hair-related variables. Hair samples were collected 8 weeks after delivery for quantification of maternal long-term hair cortisol and cortisone concentrations in 2-cm scalp-near hair samples. Mother–child bonding was measured 8 weeks and 14 months after birth using the Postpartum Bonding Questionnaire. Results: While bivariate correlations revealed significant associations of CM with bonding and hair cortisol, regression findings showed CM was associated with impaired bonding 8 weeks (overall CM trend-level; emotional neglect p = .038) and 14 months (emotional neglect trend level p = .041) after birth, however not after controlling for depressive symptoms at the time point of the outcome. In regression analyses, CM was not associated with maternal hair glucocorticoids 8 weeks postpartum. Maternal hair glucocorticoid concentrations were not related to mother–child bonding and did not mediate associations between CM and mother–child bonding. Conclusion: Data tentatively suggest that mothers with CM experiences, in particular emotional neglect, may be at risk for suboptimal bonding to their child, however current depressive symptoms seem to be more important. Our data provide no evidence for a crucial role of glucocorticoid secretion, yet aetiological processes of long-term glucocorticoid secretion and bonding are complex and more severely affected samples should be examined. [ABSTRACT FROM AUTHOR]

Background: While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe. Objective: We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics. Methods: We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (Fragebogen zu Dissoziativen Symptomen-20) in a large aggregate sample (n = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics. Results: Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout. Conclusions: The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors – cognitive overgeneralisation, rumination and social problem-solving – as mediating factors in the relationship between childhood trauma and symptoms of depression. Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling. Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies. Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problemsolving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma. [ABSTRACT FROM AUTHOR]

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For new fathers, parenting stress is a risk factor for impaired early parenting and child maltreatment perpetration. Predictors of parenting stress, including fathers' own experiences of trauma, could be useful intervention targets to support new fathers. We aim to examine associations between new fathers' own histories of child maltreatment, and their perinatal mental health, relationships, and parenting stress. We recruited 298 first‐time fathers for a survey that measured child maltreatment history, trauma sequelae including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), interpersonal reactivity, substance use, anger expression, coparenting quality, and parenting stress. On the Parenting Stress Index (PSI) (from 36 to 180), bivariate analysis demonstrated that new fathers who experienced child maltreatment (n = 94) had significantly higher parenting stress (x̅ = 85.3, σ = 18.7) than those who did not (n = 204; x̅ = 76.0, σ = 16.6; P <.000). Hierarchical linear regression modeling indicated that a child maltreatment history, PTSD, and MDD were significantly associated with parenting stress. The strongest predictors of parenting stress were coparenting quality and complex trauma sequelae—interpersonal reactivity and anger expression. Interventions to reduce fathers' parenting stress by targeting known mental health and relationship sequelae of maltreatment are promising avenues to breaking intergenerational transmission of child maltreatment and psychiatric vulnerability. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM). Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income. Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form. Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries. Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity. Across the four countries (Canada, Cameroon, Germany, Japan), more experiences of physical abuse and emotional maltreatment were associated with lower resilience; more experiences of emotional maltreatment were associated with greater post-traumatic growth. Higher levels of post-traumatic growth and resilience were found in Cameroon as compared to other countries. Positive changes following child maltreatment vary across cultures and experiences of specific child maltreatment subtypes, but the perceived acceptability of child maltreatment did not exert an influence on salutogenic post-traumatic outcomes. [ABSTRACT FROM AUTHOR]

Background: Individuals with child maltreatment (CM) experiences show alterations in emotion recognition (ER). However, previous research has mainly focused on populations with specific mental disorders, which makes it unclear whether alterations in the recognition of facial expressions are related to CM, to the presence of mental disorders or to the combination of CM and mental disorders, and on ER of emotional, rather than neutral facial expressions. Moreover, commonly, recognition of static stimulus material was researched. Objective: We assessed recognition of dynamic (closer to real life) negative, positive and neutral facial expressions in individuals characterised by CM, rather than a specific mental disorder. Moreover, we assessed whether they show a negativity bias for neutral facial expressions and whether the presence of one or more mental disorders affects recognition. Methods: Ninety-eight adults with CM experiences (CM+) and 60 non-maltreated (CM−) adult controls watched 200 non-manipulated coloured video sequences, showing 20 neutral and 180 emotional facial expressions, and indicated whether they interpreted each expression as neutral or as one of eight emotions. Results: The CM+ showed significantly lower scores in the recognition of positive, negative and neutral facial expressions than the CM− group (p <.050). Furthermore, the CM+ group showed a negativity bias for neutral facial expressions (p <.001). When accounting for mental disorders, significant effects stayed consistent, except for the recognition of positive facial expressions: individuals from the CM+ group with but not without mental disorder scored lower than controls without mental disorder. Conclusions: CM might have long-lasting influences on the ER abilities of those affected. Future research should explore possible effects of ER alterations on everyday life, including implications of the negativity bias for neutral facial expressions on emotional wellbeing and relationship satisfaction, providing a basis for interventions that improve social functioning. Child maltreatment (CM) in adults is linked to emotion recognition alterations if no current mental disorders are present. Interpretation of positive, negative and neutral facial expressions is impaired. Adults with a history of CM tend to interpret neutral expressions as negative. [ABSTRACT FROM AUTHOR]

Background: Early trauma predicts poor psychological and physical health. Glutamatergic synaptic processes offer one avenue for understanding this relationship, given glutamate's abundance and involvement in reward and stress sensitivity, emotion, and learning. Trauma-induced glutamatergic excitotoxicity may alter neuroplasticity and approach/avoidance tendencies, increasing risk for psychiatric disorders. Studies examine upstream or downstream effects instead of glutamatergic synaptic processes in vivo, limiting understanding of how trauma affects the brain. Objective: In a pilot study using a previously published data set, we examine associations between early trauma and a proposed measure of synaptic strength in vivo in one of the largest human samples to undergo Carbon-13 (13C MRS) magnetic resonance spectroscopy. Participants were 18 healthy controls and 16 patients with PTSD (male and female). Method: Energy per cycle (EPC), which represents the ratio of neuronal oxidative energy production to glutamate neurotransmitter cycling, was generated as a putative measure of glutamatergic synaptic strength. Results: Results revealed that early trauma was positively correlated with EPC in individuals with PTSD, but not in healthy controls. Increased synaptic strength was associated with reduced behavioural inhibition, and EPC showed stronger associations between reward responsivity and early trauma for those with higher EPC. Conclusion: In the largest known human sample to undergo 13C MRS, we show that early trauma is positively correlated with EPC, a direct measure of synaptic strength. Our study findings have implications for pharmacological treatments thought to impact synaptic plasticity, such as ketamine and psilocybin. Abnormalities in the strength of synaptic connections have been implicated in trauma and trauma-related disorders but not directly examined. We used magnetic resonance spectroscopy to investigate the association between early trauma and an in vivo measure of synaptic strength. For people with posttraumatic stress disorder, as early trauma severity increased, synaptic strength increased, highlighting the potential for treatments thought to change synaptic connections in trauma-related disorders. [ABSTRACT FROM AUTHOR]

El maltrato infantil es considerado una problemática social que afecta al desarrollo integral de niños, niñas y adolescentes, ante la cual se establecen normativas que regulen y garanticen sus derechos. La presente ponencia tiene como objetivo, identificar las situaciones que amenazan o vulneran los derechos del niño en Guayaquil. Metodológicamente se desarrolló una investigación con enfoque mixto y el tipo de investigación que se utilizó fue la exploratoria analítica. La población de la presente investigación abarca los 170 expedientes de casos que fueron presentados en la Junta de Protección de Derechos durante el año 2020, seleccionados como muestra 119 de estos. Se utiliza la entrevista como instrumento para la recolección de datos, develando que, en relación con los tipos de vulneración de derechos, la integridad personal resulta el más vulnerado, generado como una reacción de los comportamientos en los que se desenvuelven los agresores de los niños y niñas.

BACKGROUND: Drug poisoning in Pediatric Emergency Services is a rare event, especially in children under 3 years. Cocaine intoxication in childhood can occur passively or by intentionally. CLINICAL CASE: A 4-month-old infant presented with right eyelid edema, skin lesions, excessive sleepiness, and food refusal. The patient's general condition was fair, he complained, had pale skin and several ecchymoses and small hematomas were observed in different evolutionary stages, in addition to lesions compatible with scratches on the face, micropetechiae on the dorsum of the penis and anal fissures. Laboratory studies reported disorder in liver function/disorder of liver function. The urine toxicological examination tested positive for cocaine. He received intravenous fluid therapy in the first 12 hours of admission, with a negative response for cocaine in urine in the first 24 hours. Clinical evolution was favorable and transaminase, creatine phosphokinase and troponin values normalized 12 days after admission. A progressive decrease in hematomas was also observed. The diagnosis of hypertransaminasemia secondary to cocaine intoxication and suspicion of physical abuse where established. CONCLUSIONS: Patients with physical abuse (child abuse) have a higher risk of exposure to drugs, so this study supports the recommendation to to carry out drug screening in these cases. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Munchausen by proxy constitutes a form of child abuse in which the people in charge of caring for a child or adolescent (Children or Adolescents), usually the mother, exaggerate the symptoms of an existing illness, invent stories, falsify symptoms or alter studies. It is usually difficult to detect, patients are subjected to a series of unnecessary and potentially harmful studies, procedures and treatments. OBJECTIVE: Identify the characteristics of patients with Munchausen by proxy, the most frequent symptoms and pathologies and the characteristics of the main caregiver. MATERIALS AND METHODS: An observational, retrospective, cross-sectional, descriptive study was carried out on the cases treated over a period of 6 years at the Clinic for Comprehensive Care of Abused Children (CAINM) of the National Institute of Pediatrics. RESULTS: Of the cases studied, there were no differences in terms of gender, the usual presentation was with an average of 5 years, in relation to the clinical characteristics, mixed symptoms predominated, characterized by respiratory, gastrointestinal and hematological conditions. In relation to family characteristics, the mother was the main caregiver. CONCLUSION: This is an entity that is difficult to detect, due to the variability of the clinical picture, it occurs in the medical field, which leads the doctor to perpetuate the cycle and possible damage. Being familiar with this condition helps to suspect and channel cases in a timely manner. [ABSTRACT FROM AUTHOR]

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Introducción. El maltrato a la infancia y la adolescencia es un problema a nivel mundial que tiene graves consecuencias que pueden durar toda la vida. La detección y evaluación eficaz del maltrato infantil se considera esencial para facilitar el proceso de toma de decisiones profesional. No obstante, en la actualidad, la descentralización de la atención, la falta de rigurosidad científica y objetiva en los diagnósticos y las evaluaciones parciales y fragmentadas pueden dificultar la adopción de medidas de protección efectivas. Objetivo. El objetivo de este estudio es presentar el proceso de diseño de la herramienta DAP 360º, creada para colaborar en el juicio profesional para la evaluación y declaración de riesgo y/o desprotección en la infancia y adolescencia. Metodología. El diseño empleado corresponde al desarrollo de escalas e incluye tres pasos fundamentales: construcción de ítems, análisis teórico y evaluación psicométrica. Para ello, se han combinado técnicas cualitativas y cuantitativas en la que han participado más de 300 profesionales y personas expertas que trabajan en servicios de atención a niños, niñas y adolescentes (NNA) de diferentes ámbitos de intervención en la Comunidad Valenciana (España). Resultados. DAP 360º se ha diseñado en formato rúbrica y estructurado en torno a dos secciones principales, 15 dimensiones y 97 indicadores de riesgo y protección. El desarrollo de esta herramienta permite establecer un diagnóstico completo de todas las áreas tanto de riesgo como también de protección de niños, niñas y adolescentes. Es un instrumento riguroso, consistente y fiable respecto a las situaciones de riesgo en la infancia y la adolescencia, identificando rangos de gravedad de la situación por la que atraviesa el NNA y unificando las diferentes áreas que evolucionan desde el riesgo a la desprotección del NNA, añadiendo, además, factores protectores para equilibrar las circunstancias de riesgo. DAP 360º articula, mediante una herramienta de software, la evaluación del riesgo y/o desprotección de la infancia y la adolescencia, la coordinación en tiempo real de profesionales e instituciones, el establecimiento de rangos de gravedad y la ponderación de factores protectores y de riesgo sobre el diagnóstico, y enlaza objetivos de intervención con áreas y servicios responsables de la misma. Conclusiones. La creación de instrumentos de evaluación válidos y fiables permite agilizar los procesos diagnósticos, invierte en la prevención, y garantiza la toma de decisiones respaldada en evidencias objetivas y coordinada entre diferentes profesionales, servicios y niveles de intervención. Asimismo, la detección y evaluación eficaz del riesgo y la desprotección en la infancia y la adolescencia permite sistematizar intervenciones, reevaluar casos y desarrollar actuaciones de éxito ajustadas a las necesidades del momento. La evaluación por diferentes profesionales en tiempo real es un factor determinante, ya que permite diseñar intervenciones de acuerdo con las potencialidades y déficits que se manifiestan. Esto tendrá implicaciones significativas para la calidad de vida y el bienestar de niños, niñas y adolescentes y sus familias.

Los factores de riesgo y protección pueden ser utilizados para evaluar, prevenir e intervenir en el maltrato infantil. El objetivo de este estudio es analizar longitudinalmente el riesgo en la infancia y la adolescencia, para determinar qué factores pueden ser empleados como indicadores de evolución. Se empleó una muestra de 102 niños, niñas y adolescentes que participaban en el sistema de bienestar infantil español, en tres momentos temporales. Los resultados indicaron que existe una evolución del riesgo, con una tendencia general de disminución de riesgos e incremento de elementos protectores. Nuestros hallazgos identificaron la existencia de factores dinámicos y estáticos. Este estudio pone de manifiesto la relevancia de la atención e intervención continuada y a largo plazo para fortalecer los factores de protección y disminuir los de riesgo en niños, niñas y adolescentes.

Background/Aim: Young people in care may show significant mental health difficulties because of previous adverse experiences, such as maltreatment or violence. However, no meta-analyses have been conducted on this topic. We aim to identify the role of previous maltreatment in current symptoms of children and adolescents in out-of-home care. Method: A search in Academic Search Complete, PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, Medline, Web of Science and Scopus databases was conducted. Studies were included if they were empirical and quantitative, involved school-aged children and adolescents, assessed maltreatment before placement in care and current internalizing and externalizing symptoms. Multiple effect sizes were extracted from each primary study, and a three-level meta-analysis for each type of maltreatment associated with internalizing and externalizing symptoms was conducted. Results: The search yielded 122 effects sizes from 28 studies. Results indicated significant overall effects of general maltreatment (r = .260), abuse (emotional/physical) (r = .135) and sexual abuse (r = .247) on internalizing symptoms. In relation to externalizing symptoms, overall effects of abuse (emotional/physical) (r = .097) and sexual abuse (r = .187) were identified. The overall effect sizes of neglect were neither significant for internalizing or externalizing symptoms. A set of moderators was tested, and significant effects were found for the type of maltreatment measure on internalizing symptoms and for gender on externalizing symptoms. Conclusions: This study provides new insights beyond previous systematic reviews, as we were able to disentangle the associations between maltreatment and internalizing and externalizing symptoms in out-of-home care. [ABSTRACT FROM AUTHOR]

Copyright of Roca: Revista Científico-Educacional de la Provincia de Granma is the property of Universidad de Granma, Departamento Editorial and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Novedades en Población is the property of Universidad de La Habana, Centro de Estudios Demograficos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Self-injurious behavior is considered a serious public health problem; however there are little statistics and empirical research in Argentina. In this work, we sought to know personal and contextual aspects of adolescents with self-injurious behavior from a clinical sample made up of subjects admitted to a mental health program in a municipality in the province of Buenos Aires. Discovery: ages lower than expected (13.3% between 6 and 11 years); predominance of the female sex (79.44%); high prevalence of adverse events such as child and adolescent abuse (86%); family problems (90%) and socio-economic vulnerability (55%); cuts as the predominant type of self-injurious behavior; limited therapeutic adherence; and self-injurious behavior sustained mainly by negative intrapersonal reinforcement (consistent with the explanatory model of emotional regulation). The findings are analyzed from a critical epidemiology perspective. The production of information regarding this problem is relevant insofar as it allows generating a diagnosis after which to produce appropriate public health responses. The lack of information contributes to the support of beliefs that naturalize the appearance of self-injurious behavior in adolescents, particularly in women, and generates prejudices regarding the motivations behind self-injurious actions. [ABSTRACT FROM AUTHOR]

Copyright of Panamerican Journal of Neuropsychology / Cuadernos de Neuropsicología is the property of Cuadernos de Neuropsicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El maltrato infantil es toda acción que atenta contra los derechos más básicos de niñas, niños y adolescentes los cuales afectan su desarrollo físico y mental (OMS, 2020). La población infantil del sector rural es vulnerable y coexiste con problemáticas biopsicosociales, el estudio exploratorio inicial permite abordar esta temática a nivel psicológico para evaluar el impacto negativo de exposición a la violencia en los contextos casa, escuela, colegio y televisión. Participaron 36 niños, niñas y adolescentes de la parroquia Atahualpa, 18 hombres y 18 mujeres de 6 a 15 años (M=10,92; DT=2,36). Se aplicó el cuestionario exposición a la violencia CEV y al mismo tiempo se realizaron entrevistas para confirmar la información obtenida. Entre los diversos resultados se destaca que no se hallaron diferencias estadísticamente significativas en los diversos contextos de violencia evaluados, se evidenció que las mujeres presentan un rango mayor en exposición a la violencia en casa en comparación a los hombres, en este mismo contexto se obtuvo el valor más elevado con un 75%, seguido de calle con 72% indicando la necesidad de realizar un estudio más amplio que permita focalizar los posibles factores de riesgo en los niños y adolescentes.

La literatura científica recoge un amplio número de investigaciones que destacan el impacto del maltrato infantil, incluyendo el abuso sexual infantil (ASI), sobre la salud mental. Sin embargo, los estudios que exploran y relacionan estas variables en muestras de adolescentes en medidas judiciales todavía son escasos. Por ello, el objetivo principal de esta investigación fue analizar la prevalencia del maltrato infantil en la historia de vida de estos adolescentes, las diferencias de género en diferentes tipos de maltrato y la posible relación entre el maltrato infantil, la regulación emocional y la autoestima. Se administró la adaptación de la Child Abuse and Trauma scale (CAT), la subescala de abuso sexual del Juvenile Victimization Questionnaire (JVQ), la Escala de Dificultades en la Regulación Emocional (DERS) y la escala de Autoestima de Rosenberg (RSE) a 30 adolescentes (22 hombres y 8 mujeres) de entre 15 y 17 años (M=16,33; DT=0,76) de una residencia socioeducativa de Castellón (España). En el caso del CAT, solo se encontraron diferencias de género estadísticamente significativas en el ítem de experiencias sexuales traumáticas pasadas (U=49; p=.009). Las mujeres informaron de más experiencias de este tipo. Sin embargo, en el JVQ no se encontraron diferencias en este sentido. Un 20% de adolescentes informó haber sido víctima de ASI, el 13,6% de los hombres y el 37,5% de las mujeres. Por lo que respecta a la relación entre las variables, se encontró una asociación estadísticamente significativa con signo negativo entre la regulación emocional y la autoestima (r=-.599; p=.009). Conocer en profundidad la relación entre las experiencias de maltrato en la infancia y el desarrollo de problemas de salud mental en adolescentes que han cometido un delito podría ser útil para desarrollar estrategias dirigidas no solo a la reducción de la reincidencia, sino a la mejora de la salud mental de este colectivo.

Es un estudio descriptivo, cualitativo, dirigido a una muestra a conveniencia de las autoras, se invitó a participar a más de 100 profesionales de la salud, luego de explicar de qué se trataba el estudio etnográfico para entender si existía o no violencia intrafamiliar en las mujeres profesionales de la salud, 50 aceptaron participar en la entrevista, Se desarrolló una entrevista personalizada en un ambiente controlado, se utilizaron 12 preguntas generadoras para guiar la entrevista, se grabaron los datos y luego se analizaron los datos transcritos, realizando un análisis del discurso de los resultados tabulados. El estudio realizado nos permite entender que ni la superación profesional o económica, ni el conocimiento sobre los factores que perpetúan la violencia doméstica, garantizan a las mujeres inmunidad sobre esta. Existen factores sociales, culturales y psicológicos que no están suficiente entendidos y enfrentados para detener este fenómeno multifactorial.

Ante la necesidad de la preparación a las familias, deri - vado por la pandemia de la COVID 19, este trabajo tiene como objetivo, elaborar acciones de orientación a las fa - milias para la prevención del maltrato infantil en niños de la primera infancia. La implementación de algunas de las tareas fue llevada a cabo por las estudiantes del curso por encuentro de la Carrera de Educación Preescolar. Se partió del diagnóstico que ya tenían las estudiantes acerca de las familias de sus niños, referidas al acceso a Internet y otras vías para la comunicación y el estado de la preparación que poseen las familias para prevenir el maltrato infantil y por tanto sus potencialidades y necesidades de prepara - ción, las que permitieron la elaboración de las acciones. La metodología utilizada fue estrictamente bibliográfica, lo cual permitió elaboración de las acciones a realizar por las estudiantes. Se logra hasta la actualidad algunos re - sultados según las opiniones de los familiares y la positiva adaptación de los niños al regresar a las instituciones in - fantiles, pero se continúa implementando estas acciones y otras en dependencia de la situación epidemiológica y las necesidades de las familias, por lo que, en posteriores investigaciones se evidenciará los resultados alcanzados

Este estudio conceptualiza la victimización de niños/as y adolescentes (VdNyAs) de forma comprehensiva, incluyendo crimen convencional, maltrato infantil, victimización de pares y hermanos/as, atestiguar victimización y victimización indirecta, violencia en la escuela y amenazas, cyber-violencia y victimización. Centrándose en México se evalúa si las encuestas probabilísticas recientes permiten la medición comprehensiva de victimización y se examina la magnitud del fenómeno entre jóvenes. Existe una brecha entre las definiciones conceptuales e instrumentales de violencia y victimización. El conocimiento actual enfatiza el maltrato parental y el abuso. La victimización de menores de 12 años no tiende a estar incluida en las encuestas. Las fuentes de datos existentes no permiten establecer la verdadera magnitud de la VdNyAs mexicanos. Se discuten los hallazgos y las implicaciones de políticas públicas.

Child abuse is a global problem that affects children's development and can have consequences throughout their lives. Despite the need to research to eradicate this phenomenon, there has not been a bibliometric approach to its recent advances. Method: This study examined 16,708 articles on child abuse indexed in the Web of Science between 1991 and 2020 to establish research trends. Results: Child maltreatment is an active field, mainly influenced by the USA, Canada and the UK, and journals in the family studies category, especially Child Abuse & Neglect. The most relevant articles address the topic as part of Adverse Childhood Experiences or focus on its assessment. Considering the most relevant articles, the most studied topics (subjects, research, maltreatment and types of maltreatment, family and parenting, and disorders) and the main foci (maltreatment, research, sex, reporting, and sexual abuse), it is possible that the area is being restructured under the ecobiodevelopmental perspective, with emphasis on treatment and prevention. Its theoretical and practical implications are discussed. Conclusions: This study updates research trends in the field of child maltreatment, providing a comprehensive overview that suggests an evolution toward the integration of multiple disciplines and approaches. The results highlight the importance of further research on this global problem, as well as the need to evaluate existing interventions to reduce its impact on children's development. [ABSTRACT FROM AUTHOR]

Child abuse (cA) is currently considered a public health problem, which magnitude and consequences aggravate the circle of collective misery in latin America. It is a medical-socio-legal problem that begins with ignorance of its characteristics, causes and consequences, and also of the supporting legal framework. The objective of the present study is to describe the characteristics of maternal knowledge in regard to cA. Methods. An observational, cross-sectional, survey-type study was applied to mothers of pediatric patients attending the outpatient clinic at the hospital universitario de los Andes in Mérida, venezuela, from January to november 2021. Results. The population universe consisted of 10% of patients who come monthly to this health center; 150 mothers participated, mostly between 20 and 34 years of age, with a high educational level, belonging to biparental families and with outside home jobs. The survey established that information dissemination means about cA were the audiovisual media. Knowledge is adequate, with high average scores, in indicators such as recognition of cA situations, behaviors to follow and social consequences. It is also adequate, although with low average scores, when identifying the profile of the abused child and its causes. The total scores result in poor and inadequate identification of global indicators. Mothers with university studies and outside home jobs are the most susceptible to educational intervention. Conclusion: the psychosocial deterioration associated with the lack of knowledge of child mistreatment requires the implementation of medical, psychological, educational and legal interventions in order to promote individual and social responsibility towards this phenomenon. [ABSTRACT FROM AUTHOR]

Introduction: Dental negligence occurs when the oral health problems of children are neglected and not promptly addressed by their caregivers. Objectives: To identify the perspective of dentists, teachers in public and community health areas of dentistry faculties from two Colombian universities, regarding dental negligence affecting early childhood. Methodology: Phenomenological-descriptive qualitative study. Two online focus groups were conducted with 11 dentists, teachers in public and community health areas, with experience in early childhood. Thematic analysis was performed with the support of Atlas ti 22 software. Results: Participants agree that dental negligence affects the oral health and physical and emotional development of children. It involves cavities, pain, infections, and tooth loss. It is often unintentional, making it difficult to identify; it may result from educational shortcomings in parents; it extends beyond family responsibility, including the state and health and education institutions. It is common in contexts of social inequality and vulnerable families where parental care responsibility is delegated. Lack of awareness of the importance of deciduous dentition and cultural barriers impact this phenomenon. Conclusions: According to the participants' perspective, dental negligence in early childhood constitutes a complex issue that requires improving the capacity of family and institutional caregivers to understand the what, how, and why of temporary dentition care. Dentists need to be trained to recognize, prevent, and act promptly. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment (CM) is a common psychological stressor associated with multiple mental disorders. While CM is associated with vulnerability to depression and anxiety, little is known about the specific mechanism underlying this relationship. Objective: This study aimed to investigate the white matter (WM) of healthy adults with CM and their relationships with depression and anxiety to provide biological evidence for the development of mental disorders in subjects with childhood trauma. Methods: The CM group included 40 healthy adults with CM. The non-CM group included 40 healthy adults without CM. Diffusion tensor imaging (DTI) data were collected, and tract-based spatial statistics (TBSS) were applied to the whole brain to assess WM differences between the two groups; post-hoc fibre tractography was used to characterise the developmental differences; and mediation analysis was used to assess the relationships among the Child Trauma Questionnaire (CTQ) results, DTI indices, and depression and anxiety scores. Results: Relative to the non-CM group, the CM group revealed significantly lower fractional anisotropy (FA) in the right posterior corona radiata (PCR-R), right anterior corona radiata (ACR-R), left super corona radiata (SCR-L), anterior thalamic radiation (ATR), and right posterior limb of the internal capsule (PLIC-R). Additionally, shorter fibre bundles passed through the PCR-R, ACR-R, and ATR in the CM group compared with the non-CM group. Besides, the length of the ACR-R mediated the relationship between CM and trait anxiety. Conclusions: The alteration of white matter microstructure associated with childhood trauma in healthy adults may reflect biomarkers of childhood trauma. Besides, an alteration of WM microstructure in healthy adults with CM mediates the association between CM and trait anxiety, which may represent the vulnerability to developing mental disorders after childhood trauma experiences. In this paper, we found specific alterations associated with CM in healthy adults, which may mediate the relationship between childhood trauma and trait anxiety in later life. [ABSTRACT FROM AUTHOR]

Background: Suicide among adolescents is a huge public health concern around the world. Although childhood abuse has been established as a substantial risk factor for suicide behaviours, potential mediators in this relationship remain unclear. Objective: This study aimed to examine the mediating roles of school connectedness and psychological resilience in the association between childhood abuse and suicidal ideation among Chinese high school students. Methods: The sample involved 1607 adolescents from four high schools in Central China. Structural equation modelling (SEM) was conducted to investigate the mediation effects of school connectedness and psychological resilience on the relationship between childhood abuse and suicidal ideation. Results: The prevalence of suicidal ideation during the past week was 21.9%. Childhood abuse was positively related to the development of suicidal ideation directly and indirectly through school connectedness and psychological resilience. School connectedness and psychological resilience were also partial mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately. Conclusions: Suicidal ideation was widespread among Chinese high school students. Psychological resilience and school connectedness could attenuate the detrimental impact of childhood abuse on suicidal ideation. Findings underscore the improvement of psychological resilience and the connection to the school would be beneficial to suicide prevention among Chinese adolescents with childhood abuse. Adolescent suicide is a major public health concern worldwide. Childhood abuse exerts a negative effect on suicide behaviours. School connectedness and psychological resilience mediated the relationship between childhood abuse and suicidal ideation. [ABSTRACT FROM AUTHOR]

Child abuse in its various forms is currently a serious phenomenon that has been affecting our region throughout Latin America. Various studies suggest the serious psychological, social and public health consequences of child abuse in our society. Objective: This systematic review seeks to know the scientific literature regarding the effectiveness of the use of psychotherapy for the treatment of child abuse in any of its forms, focused on the Latin American experience. Method: Publications were selected from January 1, 2017 to October 2022, in Spanish and Portuguese. The databases used for this study were Scopus, Science direct and Scielo. Using the criteria and the Prisma method (Preferred Reporting Items For Systematic and Meta Analyses). Results: Three studies on the efficacy of psychotherapy in the treatment of child abuse were selected, the same ones that met the criteria established for this study. Conclusions: It is found that the various studies managed to reduce the related clinical symptoms, showing that they are effective in the treatment of child abuse. [ABSTRACT FROM AUTHOR]

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Copyright of Limite is the property of Universidad de Tarapaca, Departamento de Filosofia y Psicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Sociologia is the property of Universidad Nacional de Colombia, Facultad de Ciencias Humanas, Departamento de Sociologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Alternativas: Cuadernos de Trabajo Social is the property of Alternativas: Cuadernos de Trabajo Social and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)