Search Results (40)

The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs—more specifically, child abuse and child neglect—and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience. Full article

Background and Objectives: This study aimed to determine the initial clinical characteristics of children diagnosed with intentional head trauma (IHT) to obtain information about the long-term developmental, psychological, and psychosocial status of these children, to detect delayed sequelae, and to find out information about their judicial processes. Materials and Methods: Fourteen children who were followed up with the diagnosis of IHT in the Ankara Child Protection Unit between 2010 and 2021 were included in the study. These cases were evaluated in terms of physical, developmental, psychological, and visual findings. A complete physical examination was performed on the patients and their anthropometric measurements were taken. Anterior and posterior segment evaluations and visual field examinations were conducted in the visual assessment. The Expanded Guide for Monitoring Child Development and Vineland Adaptive Behavior Scale Third Edition was used in the developmental assessment. A psychiatric evaluation was performed using the Ankara Developmental Screening Inventory, Crowell observation, Affective Disorders and Schizophrenia Form, and Wechsler Intelligence Scale for Children. Results: Of the patients diagnosed with IHT, 71.4% were male and the mean age was 8.39 ± 5.86 (1.27–22.30; IQR: 3.55–11.96) months. In the long-term follow-up, cerebral palsy was detected in three of the children, epilepsy in one, optic atrophy and deviation due to this in one, and deviation due to brain trauma in one. Motor delay was detected in 50.0% of the patients, language delay in 37.5%, cognitive delay in 37.5%, and attention deficit and hyperactivity disorder in 25%. It was observed that the people who caused the injuries of two patients were punished. Conclusions: Children diagnosed with IHT should be monitored with transdisciplinary methods in terms of physical and mental health throughout childhood, starting from the first intervention. Awareness of IHT diagnosis should be increased with training in social service approaches and judicial authorities providing services for child neglect and abuse. Full article

Background: This study examines child abuse in sports environments through Ecological Systems Theory, revealing the multifaceted nature of abuse and the impact of environmental factors at various levels. Methods: With a study design using the phenomenology approach, a qualitative research method, data were collected through semi-structured, in-depth interviews with 11 Turkish participants, including 5 athletes, 4 coaches, and 2 academics with coaching experience in Sports Sciences. Thematic analysis was used to evaluate the data, categorizing findings into four levels: microsystem, mesosystem, exosystem, and macrosystem. Results: Findings show that at the microsystem level, children are exposed to physical, emotional, and sexual abuse, as well as neglect, largely through interactions with coaches and teammates. Physical abuse includes non-contact forms, like dehydration and forced training, and contact abuse, such as violence from coaches and peers. Emotional abuse manifests through psychological pressures and verbal attacks, creating a toxic environment. At the mesosystem level, excessive parental trust in coaches reduces oversight, leaving children vulnerable. In the exosystem, inadequate supervision of coaches and a lack of response to abuse cases by sports clubs worsen the issue. At the macrosystem level, cultural norms and societal attitudes normalize abuse, especially affecting female athletes. Conclusions: The study highlights the need for comprehensive interventions, including family awareness, stricter coach oversight, and robust policies within sports organizations to protect children. By emphasizing the interaction of individual, familial, and societal factors, this research underscores the importance of collective efforts to ensure safer sports environments. Full article

The aim of this study is to examine the mediating role of dissociation in emotional regulation and parental child-containing function skills of mothers exposed to childhood trauma. The research was conducted with 400 mothers between the ages of 20–60 who had childhood trauma and currently have children between the ages of 0–18. The relational screening model, one of the general screening models, was used in the research. The sample of the research was selected using the convenient sampling method and the simple random method. Research data were collected with the Sociodemographic Information Form, Childhood Trauma Scale (CTS), Parental Child-Containing Function Scale (PCCFS), Emotion Regulation Difficulty Scale (ERDS), and Dissociative Experiences Scale (DES). According to the results obtained in the study, physical abuse (β = 0.197; 95% CI [0.124; 0.268]), physical neglect (β = 0.232; 95% CI [0.161; 0.306]), emotional abuse (β = 0.238; 95% CI [0.169; 0.309]), emotional neglect (β = 0.210; 95% CI [0.150; 0.275]), and sexual abuse (β = 0.139; 95% CI [0.058; 0.220]) were found to have a significant indirect effect on emotion regulation difficulties through dissociative experiences. In addition, physical abuse (β = 0.122; 95% CI [0.071; 0.181]), physical neglect (β = 0.151; 95% CI [0.084; 0.228]), emotional abuse (β = 0.158; 95% CI [0.086; 0.238]), emotional neglect (β = 0.159; 95% CI [0.093; 0.235]), and sexual abuse (β = 0.086; 95% CI [0.039; 0.150] was found to have a significant indirect effect on parental child-containing function skills through dissociative experiences. Full article

Child maltreatment is a global public health issue known to affect an average of 600,000 U.S. children of all ages (0–18 years old) annually. However, a preponderance of preventive programs target children on the younger end of the spectrum, specifically those aged 0–5. Annual reports of the prevalence of maltreatment provide opportunities to analyze trends, but in 2009, these reports stopped reporting the ages of victims for each type of maltreatment (i.e., neglect, physical abuse, emotional abuse, and sexual abuse). This omission limits the ability to match (or design) prevention programs responsive to the ages of those at greatest risk. Using data from the National Child Abuse and Neglect Data System (NCANDS) from 2011–2020, this secondary data analysis describes trends for four types of maltreatment by age from an epidemiological perspective. Implications for practice (i.e., prevention) and policy are presented. The findings of this study offer the first step in what is hoped to be a line of research that seeks to identify, match, and/or develop evidence-based programs to prevent child maltreatment among the populations at highest risk. Full article

Many studies have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate the association of 13 common types of ACEs with NSSI, suicidal ideation (SI), and suicide attempts (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 (994 male, 777 female) students aged 11–16 (12.9 ± 0.6) years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included in the analysis. ACEs, including childhood maltreatment, other common forms of ACEs, and smoking, were measured via the Chinese version of the Child Trauma Questionnaire (CTQ) and a series of valid questionnaires that were derived from previous studies. NSSI was measured using the Chinese version of the Functional Assessment of Self-mutilation. SI and SA were measured using questions derived from the Global School Based Student Health Survey. Depressive symptoms were measured via the Chinese version of the Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured via the General Anxiety Disorder-7. Of the included participants, 92.0% reported one or more category of ACEs. Smoking, parent–child separation, emotional abuse, physical abuse, and being bullied were positively associated with NSSI; smoking, parent–child separation, emotional abuse, physical abuse, emotional neglect, and being bullied were positively associated with SI; smoking, emotional abuse, and being bullied were positively associated with SA. The associations of ACEs with NSSI, SI, and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse, and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms. In conclusion, not all the types of ACEs are independently associated with NSSI, and suicidality and other associations may mediate through depressive and anxiety symptoms. Target interventions for adolescents’ NSSI and suicidality should focus on those who have a history of ACEs and depressive and anxiety symptoms. Full article

Child abuse and neglect is a common, underreported, and worldwide problem. Health care providers play an important role in detecting and reporting this problem. This study examined the knowledge on the clinical signs and mimickers of child abuse among Belgian trainees in family medicine and pediatrics. Participants filled out an anonymous online survey of 15 fictional but realistic cases with either suspicious or non-suspicious signs of abuse or neglect in the context of primary or emergency care. The overall score on all cases, the number of correct answers per case, and the median score were calculated, and the association of the participant’s demographic characteristics with their score was examined using regression analysis. A total of 70 participants completed the survey. The overall median score was 73.3% (IQR 20.0%). The suspicious cases were solved more correctly than the non-suspicious cases (median: 85.7% versus 62.5%, p < 0.001). Regression analysis could not reveal a significant association of type and level of education with the performance on the survey. Knowledge of the clinical signs of child maltreatment among pediatricians and general practitioners in training is good, but there is still room for improvement. Full article

Purpose: This study aimed to explore links between child maltreatment (CM) and experiences of interpersonal violence (IV) in sport among adolescent sport participants. To our knowledge, no studies have yet considered this association. This is surprising given that the literature outside of sport clearly shows that CM is related to revictimization in adolescence and adulthood. Methods: The sample consists of 983 adolescents aged 14 to 18 years old participating in an organized sport. They completed a self-report survey in class at six Canadian schools assessing CM and IV in sport. Logistic regressions were performed to examine the associations between CM and IV in sport. Results: Child physical abuse, emotional abuse, and exposure to domestic violence were significantly associated with psychological violence and neglect in sport. Exposure to domestic violence was the only form of CM significantly associated with physical violence in sport. Child sexual abuse and neglect were significantly associated with sexual violence in sport, while child emotional abuse and exposure to domestic violence were significantly associated with peer violence in sport. Physical abuse was the only form of CM significantly associated with coach violence. Child physical abuse, emotional abuse, neglect, and exposure to domestic violence were positively associated with violence from parents in sport. Conclusions: Considering the associations between CM and IV in sport, further investigations are necessary on how to prevent revictimization. It also highlights the importance of athlete-centered and trauma-informed practices in sport. Implications and Contribution: This study was the first, to our knowledge, to show the relationship between CM and the experience of IV in organized sport, as reported by 983 Canadian adolescents. Our findings reveal different associations depending on the type of IV (physical, sexual, psychological, or neglect) and the perpetrators (peers, coaches, or parents). Full article

Background: Child abuse represents an important issue in the medico-legal and social context. In the last few decades, various aspects and mechanisms have been identified in child abuse case studies; however, constant research is needed in the field. With this paper, the authors will present a case of a new entity of Abusive Head Trauma that has come to the attention of medico-legal experts. Discussion: The trauma analysis performed on the cranio-encephalic district of the baby revealed quite peculiar lesions that led the authors to exclude that the injuries had been solely caused by violent shaking of the baby’s head, as suggested by Shaken Baby Syndrome. Instead, the authors hypothesised that another lesion mechanism had been added to this one, namely latero-lateral cranial compression. The comprehensive and exhaustive analysis of the case led the authors to present a new possible entity in child abuse trauma, namely ‘Compressed Baby Head’. Conclusions: To the best of our knowledge, in the current literature, no similar clinical cases have ever been described. Thus, the case’s uniqueness deserves to be brought to the attention of experts and the entire scientific community, as well as medical personnel, paediatricians, and reanimators. These professional figures are the first individuals who may encounter complex clinical cases such as the one presented in this paper; thus, they need to know how to properly manage the case and ensure protection for the abused infants and children. Full article

Child maltreatment is considered a pressing social question, compromising the present and future mental and physical health of one in four children in Europe. While children younger than three years of age are especially vulnerable, few screening instruments are available for the detection of risk in this age group. The purpose of this research was to develop a screening tool for childcare professionals working in public and private daycare settings to support them in the early identification and referral of infants and toddlers exposed to emotional and physical abuse and neglect by primary caregivers, to be used in different settings across four European countries: Belgium, Italy, Latvia, and Hungary. Method: A stratified process was used to create the screening tool: We started by using Living lab methodology to co-create the screening tool with its final users, which was followed by testing the tool with a total of 120 childcare professionals from the four participating countries. Results: During the Living Lab phase, a screening tool with three layers was developed. The initial layer includes five “red flags” that signal particular concern and require immediate action. The second layer is a quick screener with twelve items focused on four areas: neglect of basic needs, delays in development, unusual behaviors, and interaction with caregivers. The third layer is an in-depth questionnaire that aids in formalizing a thorough observation of twenty-five items within the same four areas as the quick screener. After a one-day training session, 120 childcare professionals caring for children aged 0–3 from four countries assessed the screening tool and their overall training experience. Childcare professionals reported great satisfaction with the three-layered structure, which made the tool versatile, and agreed on its content, which was considered helpful in the daycare setting for the regular evaluation of the behavior of children and their primary caregivers, thus improving the early observation of change from the normal behavior of the infant or toddler. Conclusion: The three-layered screening tool was reported as feasible, practical, and with great content validity by childcare professionals working in four European countries. Full article

The current study applied a family systems approach to examine dyadic parental risk factors linked with mother–father co-involved physical abuse, neglect, sexual abuse, and emotional abuse. Parental substance use, mental health problems, disability and medical conditions, inadequate housing, economic insecurity, intimate partner violence, and prior maltreatment history were investigated as key risk factors at the dyadic parental level. Logistic regression analysis was conducted using national child welfare administrative data from the National Child Abuse and Neglect Data System. The results showed differential associations between risk factors and four child maltreatment types: physical abuse, neglect, emotional abuse, and sexual abuse. Intimate partner violence was associated with higher odds of mother–father co-involved neglect and emotional abuse. Parental substance use, inadequate housing, and prior maltreatment history were all associated with higher odds of mother–father co-involved neglect, but lower odds of physical abuse. Parental disability and medical conditions were associated with higher odds of mother-father co-involved sexual abuse, whereas parental substance use was associated with lower odds of sexual abuse. Implications include more nuanced ways of addressing multiple risk factors within the family to prevent future occurrences of child maltreatment involving both mothers and fathers. Full article

Injuries constitute a large share of childhood morbidity and mortality. This study examines whether adolescents with self-reported experiences of different types of child maltreatment more frequently reported unintentional injury events requiring health- or dental care during the last year and/or hospitalization at any time during childhood. Cross-sectional data from a Swedish national representative school survey (2016) including 4741 adolescents were used (78.5% response rate). Data were analyzed with univariate tests and multiple logistic regression. Statistically significant associations between reported experiences of physical, psychological and sexual abuse, neglect, and witnessing partner violence during childhood and reported unintentional injuries requiring health- or dental care during the last year were found (aOR:s between 1.39–1.77). The corresponding association for poly-victimization was aOR 1.91 (95% CI 1.39–2.62). Furthermore, a linear-by-linear association was seen for degree of victimization and number of episodes of unintentional injuries that required care in the last year (p = 0.000), as well as lifetime hospitalizations (p = 0.000). This study shows significant associations between child maltreatment and unintentional injuries requiring health- and/or dental care and hospitalization. To improve both injury and child maltreatment prevention, healthcare professionals need to pay particular attention to children and adolescents who repeatedly seek healthcare services due to injurious events. Full article

Child maltreatment is a phenomenon of great importance due to the significant socio-health implications related to it. Purpose of the study is assessing compliance child abuse clinical management with guidelines and suggest corrective actions to avoid false negative or false positive judgments. The data come from 34 medical records of child victims of suspected abuse hospitalized in a pediatric clinic. We examined diagnostic and medico-legal management through the analysis of pediatric, dermatological, ophthalmological (including fundus examination), and gynecological (only in some cases) consultations, brain and skeletal imaging, laboratory tests (with reference to the study of hemostasis), and medico-legal advice. Of 34 patients, the average age was 23 months, ranging from 1 month to 8 years. The judgment was positive for abuse for 20 patients and negative for 12 patients; in two cases it was not possible to express a conclusive judgment. Two children died because of the injuries sustained. We underline the need of clinical-diagnostic standardized protocols, coroner in emergency settings, short-distance follow-up, social worker support. We also suggest objectifying in a descriptive way (using a common and repeatable language) and with photographic documentation the results of all the investigations carried out, to evaluate signs of physical maltreatment and neglect. Full article

Borderline personality disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study, we applied for the first time a combination of an unsupervised machine learning approach known as multimodal canonical correlation analysis plus joint independent component analysis (mCCA+jICA), in combination with a supervised machine learning approach known as random forest, to possibly find covarying gray matter and white matter (GM-WM) circuits that separate BPD from controls and that are also predictive of this diagnosis. The first analysis was used to decompose the brain into independent circuits of covarying grey and white matter concentrations. The second method was used to develop a predictive model able to correctly classify new unobserved BPD cases based on one or more circuits derived from the first analysis. To this aim, we analyzed the structural images of patients with BPD and matched healthy controls (HCs). The results showed that two GM-WM covarying circuits, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC. Notably, these circuits are affected by specific child traumatic experiences (emotional and physical neglect, and physical abuse) and predict symptoms severity in the interpersonal and impulsivity domains. These results support that BPD is characterized by anomalies in both GM and WM circuits related to early traumatic experiences and specific symptoms. Full article

Intimate partner violence (IPV) and child maltreatment (physical, emotional, sexual abuse, neglect, and children’s exposure to IPV) are two of the most common types of family violence; they are associated with a broad range of health consequences. We summarize evidence addressing the need for safe and culturally-informed clinical responses to child maltreatment and IPV, focusing on mental health settings. This considers clinical features of child maltreatment and IPV; applications of rights-based and trauma- and violence-informed care; how to ask about potential experiences of violence; safe responses to disclosures; assessment and interventions that include referral networks and resources developed in partnership with multidisciplinary and community actors; and the need for policy and practice frameworks, appropriate training and continuing professional development provisions and resources for mental health providers. Principles for a common approach to recognizing and safely responding to child maltreatment and IPV are discussed, recognizing the needs in well-resourced and scarce resource settings, and for marginalized groups in any setting. Full article