Search Results (215)

Child maltreatment (MALT) is a devastating form of early-life adversity (ELA) and a primary risk for mental and physical illness. It is difficult to disentangle postnatal caregiving effects from heritable factors. Here we investigated the long-term effects of maternal care using a cross-fostering design to control for biological/heritable factors on immune function and inflammation during adolescence in a translational and naturalistic macaque model of MALT. We studied the impact of MALT on the immunophenotype of peripheral blood mononuclear cells (PBMCs) and assessed glucocorticoid receptor expression and function during adolescence. MALT was associated with elevated expression of NR3C1, the gene that encodes for the glucocorticoid receptor, in PBMCs. Glucocorticoid receptor function was not altered by MALT when examined for response to dexamethasone (DEX). In addition, MALT led to a reduction in the percentage of naïve CD4⁺ T cells and an increase in the percentage of central memory (Tcm) CD4⁺ T cells. These results suggest that MALT-exposed adolescents show residual effects of MALT on CD4⁺ T cells and increased expression of NR3C1 without demonstration of increased function of the glucocorticoid receptor. Taken together, these results suggest that ELA has enduring implications for cellular glucocorticoid receptor biology and CD4⁺ T cells. Full article

Background: Medical child abuse (MCA), previously known as Münchausen syndrome by proxy, involves the fabrication or induction of illness by caregivers—most commonly the mother—leading to unnecessary medical interventions and potential harm to the child. Methods: This retrospective study analyzed cases of suspected or confirmed MCA managed by the GAIA multidisciplinary team at Meyer Children’s Hospital, Florence, between 2010 and 2022. Cases were identified using Rosenberg diagnostic criteria and red flags outlined by the American Academy of Pediatrics (AAP) and the Royal College of Paediatrics and Child Health (RCPCH). Data were extracted from medical records and analyzed descriptively. Results: Among 816 cases of child maltreatment, 8 (0.99%) were identified as MCA. The median age of affected children was 5 years (range: 4–12 years), with a female predominance (6/8, 75%). All perpetrators were biological mothers (8/8, 100%). Children had a median of 23 emergency department visits (range: 4–44), with the most frequent presentations being fever (6/8, 75%), minor trauma (7/8, 87.5%), respiratory complaints (5/8, 62.5%), and gastrointestinal symptoms (4/8, 50%). According to Rosenberg criteria, 5 cases (62.5%) were classified as “possible diagnosis,” 1 (12.5%) as “definitive diagnosis,” 1 (12.5%) as “diagnosis by exclusion,” and 1 (12.5%) as “inconclusive.” Conclusions: Despite its low prevalence, MCA poses serious clinical and ethical challenges. Early detection requires thorough documentation, interdisciplinary collaboration, and improved access to shared medical records. The GAIA model offers a replicable framework for effective multidisciplinary management. Full article

We examine access to U.S. welfare programs—Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)—as primary prevention strategies against adverse childhood experiences (ACEs). Using the University of Kentucky’s National Welfare Data and National Survey of Children’s Health (2016–2022), we estimate two-way fixed effects models linking state-level access rates to child-level ACE incidence. TANF access predicts reduced parental mental illness (fully adjusted β = −5.40, 95% CI: −8.80, −2.00), and parental incarceration in the model adjusted for state-level factors (β = −4.44, 95% CI: −8.84, −0.05), though the latter attenuates with child-level covariate adjustment. Unexpectedly, SNAP access correlates with slight increases in neighborhood violence exposure (fully adjusted β = 0.95, 95% CI: 0.39, 1.51) and parental substance use (crude β = 0.48, 95% CI: 0.04, 0.93) in crude models. Robustness checks show greater TANF access is associated with fewer total ACEs (β = −0.27, 95% CI: −0.46, −0.07). Results suggest that welfare programs hinge on broader social contexts; TANF access appears protective, while SNAP findings diverge from prior research, likely reflecting measurement or contextual limitations that merit careful further investigation, rather than overinterpretations of program harm. Full article

Prior work established the presence of six crosscutting patterns of clinically significant family maltreatment (FM) and psychological health (PH) problems among active-duty service members. Here, we develop a brief screener for these patterns via Classification and Regression Trees (CART) analyses using a sample of active-duty members of the United States Air Force. CART is a predictive algorithm used in machine learning. It balances prediction accuracy and model parsimony to identify an optimal set of predictors and identifies the thresholds on those predictors in relation to a discrete condition of interest (e.g., diagnosis of pathology). A 22-item screener predicted membership in five of the six classes (sensitivities and specificities > 0.96; positive and negative predictive values > 0.90). However, for service members at extremely high risk of clinically significant externalizing behavior, sensitivity and positive predictive values were much lower. The resulting 22-item brief screener can facilitate feasible, cost-effective detection of five of the six identified FM and PH problem patterns with a small number of items. The sixth pattern can be predicted far better than chance. Researchers and policymakers can use this tool to guide prevention efforts for FM and PH problems in service members. Full article

Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. Additionally, it assessed the association between systemic factors, such as nutritional status and psychological conditions, and the severity of oro-dental lesions, with the goal of informing future preventive strategies and public health interventions. Methods: A retrospective analysis was conducted on 333 pediatric patients diagnosed with dental neglect. Clinical data were collected from two centers between 2020 and 2024. Oral health status, socio-demographic characteristics, and psychological conditions were evaluated. Statistical analyses included Fisher’s Exact Test, Mann–Whitney U Test, and Bonferroni-adjusted Z-tests, with significance set at p ≤ 0.05. Results: Among the 333 participants, 52.9% were male, with a mean age of 8.75 ± 3.29 years. Most children (81.7%) resided in rural areas, and 55.6% were first-born. Carious lesions were identified in 100% of cases, with 54.7% showing complications such as endodontic pathology. Poor oral hygiene was reported in 99.1% of children, while 58.6% presented signs of periodontal disease and 37.2% reported spontaneous gingival bleeding. Acute pain was experienced by 40.2% of participants. Nutritional issues were prevalent, with 24.3% classified as obese and 21.6% as malnourished. Significant associations were found between lesion severity and both psychological disorders (p < 0.001) and malnutrition (p < 0.001). Conclusions: This study identifies untreated carious lesions, poor oral hygiene, acute dental pain, and oro-dental trauma as key clinical indicators of pediatric dental neglect, with rural residency and limited education as significant socio-demographic risk factors. The findings highlight the urgent need for integrated, community-based strategies, including school-based screenings, parental education, and referral pathways, to improve early detection and prevention in Romania. Full article

Refugee mothers are at heightened risk of developing negative family dynamics due to traumatic experiences and unstable living conditions, often impacting their children in lasting ways. This partially mixed, explanatory mixed-methods pilot study examines the potential of Drama Therapy as a psychosocial intervention to reduce harmful parenting behaviors and strengthen parent–child relationships. The study engaged 20 refugee mothers who participated in a three-session intervention based on Emunah’s five-phase model. Data collection included pre-intervention demographic information, two standardized psychological scales—The Child–Parent Relationship Scale and the Parent Anger Scale—and post-intervention focus group discussions. The findings indicate that the Drama Therapy Intervention (DTI) helped reduce parental anger and improve emotional regulation, leading to more positive interactions with children and decreased conflict within the family. Focus group insights revealed that the mothers’ ongoing and past traumas significantly shaped their emotional responses and parenting styles. This pilot study highlights the importance of addressing maternal mental health in post-displacement contexts. Although one cannot draw causal inferences of efficacy in the absence of a control group, the findings provide preliminary evidence that Drama Therapy can be an effective tool for reducing parental maltreatment and improving family relationships among refugee populations. Full article

Background: Emotional abuse is both prevalent and underrecognized particularly in culturally complex settings like India. Adolescents, being in a critical developmental phase, are especially vulnerable to the long-lasting psychological effects of emotional abuse. This qualitative literature review aims to synthesize findings from primary studies that explore the lived experiences of emotional abuse among Indian adolescents and identify emerging patterns across sociocultural contexts. Method: Electronic databases, including DOAJ, Google Scholar, ProQuest, JSTOR, Pubmed, PsycNet, and SCOPUS, were searched for peer-reviewed articles published in English up to March 2025. Inclusion criteria comprised qualitative or mixed-methods research focusing on emotional abuse among adolescents aged 12–20 in Indian contexts. The Critical Appraisal Skills Programme (CASP) was used for quality assessment. Results: Five major thematic domains were identified across the included studies: (1) Family as a primary site of emotional abuse; (2) Gendered experiences of abuse; (3) Cultural normalization and silence; (4) Psychological and emotional consequences; and (5) Coping and resilience among adolescents. These themes reflect shared experiences of emotional abuse shaped by cultural, familial, and gender-based expectations. Conclusions: This review highlights the urgent need for increased awareness and culturally sensitive interventions addressing emotional abuse in Indian adolescents. The findings suggest that parents, educators, and policymakers must recognize emotionally harmful behaviors and implement prevention-oriented strategies, particularly through non-violent communication and adolescent mental health support frameworks. Full article

Background: Childhood neglect is a pervasive yet often overlooked form of maltreatment that exerts profound and lasting effects on neurodevelopment. Unlike other types of abuse, neglect is characterized by the absence of essential stimuli and caregiving, which are critical for normal brain maturation, particularly in regions involved in executive function. Objective: This narrative review aims to critically explore the neurobiological mechanisms through which early-life neglect impairs the development of executive functions. Special emphasis is placed on alterations in brain structure and function, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and emerging epigenetic evidence. Methods: A comprehensive literature search (170 articles) was conducted across PubMed, Scopus, Web of Science, and PsycINFO, including studies published between 1 January 2000 to 31 March 2025. Relevant empirical and review articles were selected based on methodological rigor, relevance to executive functioning, and focus on child neglect. Results: Evidence reveals that neglect disrupts key neural circuits, particularly those involving the prefrontal cortex and amygdala, leading to deficits in attention, working memory, impulse control, and cognitive flexibility. Chronic stress associated with neglect also induces HPA axis dysregulation and elevated cortisol levels, which further compromise neural plasticity. Additionally, epigenetic modifications appear to mediate long-term cognitive and emotional consequences. Conclusions: Childhood neglect represents a distinct and critical risk factor for executive dysfunction. Understanding the neurodevelopmental consequences of neglect is essential for developing targeted prevention strategies and therapeutic interventions aimed at supporting cognitive resilience in affected populations. Full article

Background: Peer bullying is a global problem affecting youth around the world that can impact youth development including school engagement. The relationship between child maltreatment and school bullying victimization and perpetration is well known. However, few studies have explored the extent of bullying among vulnerable groups of adolescents. Youth in orphanage care may be at higher risk of both maltreatment and bullying because of the circumstances and stigma that brought them into care. This study aimed to examine peer bullying victimization among adolescents residing in orphanage care compared to a national sample of adolescents in South Korea, and to investigate the mediating effect of bullying victimization on the relationship between child maltreatment and school engagement. This comparison allowed for an examination of how caregiving contexts may differentially influence the impact of maltreatment and bullying on school engagement. Methods: Data from the national Korean Welfare Panel Study (KoWePS) 7th wave (n = 521) and a study of 153 South Korean adolescents in orphanage care were merged into one dataset (n = 675). Analysis included descriptive and bivariate statistics, two simple mediation analyses, and multiple regression analysis to verify mediation effects using PROCESS Macro. Results: Adolescents in orphanage care reported significantly higher bullying victimization and lower school engagement than the national sample. Negative correlations were identified between child maltreatment, bullying victimization, and school engagement among adolescents in orphanage care. Importantly, bullying victimization significantly mediated the relationship between child maltreatment and school engagement within this group. Conclusions: These findings highlight the complex relationship between maltreatment and bullying victimization, emphasizing the need for comprehensive interventions addressing both maltreatment and peer bullying to enhance school engagement among vulnerable youth. Full article

Background/Objectives: Child abuse is a pervasive global issue with significant implications for the physical, emotional, and psychological well-being of victims. This review highlights the clinical, molecular, and therapeutic dimensions of child abuse, emphasizing its long-term impact and the need for interdisciplinary approaches. Early exposure to abuse activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to chronic cortisol release and subsequent neuroplastic changes in brain regions such as the hippocampus, amygdala, and prefrontal cortex. These molecular alterations, including epigenetic modifications and inflammatory responses, contribute to the heightened risk of psychiatric disorders and chronic illnesses in survivors. Clinically, child abuse presents with diverse manifestations ranging from physical injuries to psychological and developmental disorders, making timely diagnosis challenging. Methods: A multidisciplinary approach involving thorough clinical evaluation, detailed histories, and collaboration with child protection services is essential for accurate diagnosis and effective intervention. Results: Recent advances in molecular biology have identified biomarkers, such as stress-related hormones and epigenetic changes, which provide novel insights into the physiological impact of abuse and potential targets for therapeutic intervention. Current treatment strategies prioritize the child’s safety, psychological well-being, and prevention of further abuse. Trauma-focused cognitive behavioral therapy and family-centered interventions are pivotal in promoting recovery and resilience. Conclusions: Emerging research focuses on integrating molecular findings with clinical practice, utilizing digital health tools, and leveraging big data to develop predictive models and personalized treatments. Interdisciplinary collaboration remains crucial to translating research into policy and practice, ultimately aiming to mitigate the impact of child abuse and improve outcomes for survivors. Full article

A robust body of research examines the association between socioeconomic status (SES), particularly its economic dimension, income poverty, and child maltreatment rates. However, several key questions regarding this relationship remain underexplored. Utilizing a critical literature review, this article finds that some forms of child maltreatment (i.e., sexual abuse) do not correlate with income poverty. Moreover, evidence about the effects of other dimensions of SES, including employment and education is not monolithic. The complexity of this relationship is further influenced by the data source and unit of analysis. Studies using administrative data and analyzing SES at the family or household level frequently report a strong correlation between SES and child maltreatment. However, this relationship weakens (or in some cases disappears) when examined at the neighborhood or regional level using self-report data. Our findings also suggest that the overrepresentation of minority groups in child maltreatment statistics can be, at least in part, attributed to economic disadvantages. Furthermore, social cohesion appears to buffer the effects of income poverty and material hardship, highlighting the role of inequality in weakening social networks and exacerbating socioeconomic stressors. A developing body of literature demonstrates the link between income inequality and child maltreatment rates and indicates that policies aimed at addressing the impact of SES on child maltreatment should not only focus on alleviating poverty-related factors, such as material hardship, unemployment, and housing instability, but also target broader class disparities as the common root of many social problems. Full article

Munchausen Syndrome by Proxy (MSBP) is recognized as a form of child abuse in which a caregiver induces or fabricates illnesses in their child to gain medical and social attention. MSBP represents one of the most complex and insidious forms of child abuse, characterized by an ambiguous clinical presentation that poses significant challenges for physicians, psychiatrists, and social workers. However, this condition raises critical questions regarding its diagnosis, management, and forensic implications. Traditionally, MSBP has been framed as an individual pathological manifestation of the mother, overlooking the role of the healthcare and legal systems in its identification and management. In this article, we propose a critical reflection on MSBP, emphasizing how the issue is not merely a “parental failure” but rather a systemic failure of healthcare, social, and judicial institutions in recognizing, preventing, and effectively managing such cases. Full article

Background/objectives: Adolescent dating violence (ADV) is a serious public health concern affecting youth worldwide. Potential risk factors of ADV include child maltreatment (CM) and intimate partner violence exposure (eIPV), though existing research on ADV perpetration specifically is inconsistent. There is limited research on co-occurring eIPV and CM, despite co-occurrence in 30–60% of homes where there is one. This study aims to address these gaps by testing the impact of childhood violence exposure on ADV perpetration and assessing two potential, theory-informed mitigating factors—mental health and parent–youth relationship. Methods: This study utilizes moderated-mediation structural equation modeling with longitudinal data from a sample of 2354 U.S. adolescents (10–18) and one of their caregivers. Three models were tested: (1) childhood violence exposure (eIPV only, CM only, or co-occurring CM & EIPV) and ADV perpetration; (2) mediation by mental health quality on model 1; and (3) overall moderation by parent–youth relationship quality on model 2. Results: The final sample consisted of 961 youth with a history of dating. A significant direct effect between eIPV and ADV perpetration was found. There was a significant direct effect between co-occurrence (eIPV & CM) and ADV perpetration, which was mediated by mental health quality. Conclusions: This study further emphasizes the relation between eIPV and ADV and provides novel evidence of the impact co-occurrence has on ADV. Evidence of a trauma-informed mitigating factor, mental health quality, offers a potential point of intervention to be considered by mental health providers and ADV prevention/intervention programs. Full article

Introduction: The aim of this study is to explore variables relating to teacher–student relationships, and their association with the detection of child maltreatment in secondary schools (12–18 age range), given that child and adolescent abuse is under revealed and underreported, and teachers play an important role in identifying and detecting it. Method: 662 teachers from secondary schools from different autonomous communities in Spain answered a self-administrated questionnaire. Results: This study revealed that while theoretical knowledge of the issue goes hand-in-hand with a higher self-reported ability to recognize cases among students, the same does not hold true of the teachers’ real detection capacity. Nonetheless, a relationship of trust with students and addressing child maltreatment in the classroom contributes to a better real detection capacity by teachers, relating this information to the possible existence of a teacher–student alliance. Discussion: We propose a trust-constructed relationship between both agents, named the teacher–student alliance. Prospective: These results point to the need for further research into the association and characteristics of teacher–student alliances on the identification in schools of cases of child maltreatment. Full article