Search Results (199)

We aimed to review and synthesize the literature on risk and resilience factors for research-induced distress (RID) among qualitative child abuse researchers, with the review guided by the Lippencott-Joanna Briggs Institute methodology for qualitative reviews. We searched Scopus, PsychINFO, MEDLINE, and ProQuest, with two researchers independently reviewing title/abstracts and full-text articles for inclusion, and with additional articles found using citation searches of identified articles and through a perusal of articles in key child abuse and qualitative research journals. We synthesized 30 unique studies, with this synthesis revealing that risk and salutary factors for RID outcomes emanate from all levels of the research ecology and, consequently, that optimal strategies for the primary and secondary prevention of RID could profitably adopt a multi-systemic perspective. Findings from this review provide child abuse researchers and members of academia with a detailed and systematic overview of potential threats and salutary influences for RID that could be used to (1) inform the development of comprehensive pre-research (and ongoing) training programmes for researchers, and (2) guide the development of secondary prevention programmes designed to mitigate RID outcomes. With respect to future research, this review suggests that the focus of research could usefully be extended in order to: (1) provide a more comprehensive perspective on the experiences of researchers living in low- to middle-income countries, and (2) ensure children’s rights to be heard, and to participate in research on matters that affect them, are more comprehensively addressed. Full article

Intergenerational trauma, violence, and maltreatment, in which symptoms or experiences of an ancestor’s trauma repeat or otherwise manifest in subsequent generations, presents a weighty societal challenge to which a multiplicity of therapeutic intervention strategies have been applied. Theoretical perspectives are antecedent to clinical and social intervention, informing decisions in both policy and practice. However, these frequently remain subliminal or imperceptible in the discourse, resulting in interventions that remain somewhat dislocated from their theoretical foundations. This narrative review seeks to summarize and discuss each of these theories as they apply to intergenerational trauma, violence, and maltreatment, and to reveal their potential association with specific intervention models or approaches. It positions flexibility between theories and the integration of theories as opportunities to reach new and enhanced understandings and to engender distinctive therapeutic interventions. An enriched understanding of the theories explaining intergenerational trauma, violence, and maltreatment, a deeper appreciation for the pertinence of theory for practice, and an incitement to blend theoretical perspectives in unique ways is, herewith, reached. Full article

The Adverse Childhood Experiences (ACEs) and Adverse Family Experiences (AFEs) frameworks have been employed extensively in research. However, to date, no such studies have considered both frameworks concurrently, nor have they explored the similarities and differences in resilience between siblings with ACE- and AFE-exposed parent(s). Doing so could, perhaps, establish the ways in which adversity is transmitted through generations and subsequently identify what trajectories to address in potential interventions. Thus, the objectives of this study were to examine the experiences of families with intergenerational ACE and AFE trauma, and to ascertain what influences similarities and differences in sibling resilience. The thematic analysis of two family case studies (n = 6) proposed a narrative encompassing fear, relationships and challenging trauma. Findings demonstrated the influence of neighbourhood violence which appeared to initiate this narrative. The fear associated with neighbourhood violence and maltreatment in early childhood appeared to influence both the parent–child bond and intimate relationships. Finally, participants demonstrated the protective properties of dissociation and sibling parentification, exhibiting their relationship with resilience. Investigators suggested neighbourhood violence be considered in the ACE questionnaire to inform current and future policies, and to safeguard the needs of families affected by intergenerational trauma. Full article

Background/Objectives: Medical procedures can be a traumatic event for both children and their parents. Children who have experienced maltreatment or early traumatic experiences are at a higher risk for various emotional, behavioral, and health issues, including declining mental health. This may include experiencing heightened distress following medical procedures. The goal of this paper is to investigate the risk of distress symptoms following medical procedures for children with a history of child maltreatment vs. controls. Methods: A prospective study of 219 parents and children hospitalized in a pediatric surgical ward was conducted, with participants divided into study and control groups based on their reports of early traumatic experiences. Questionnaires measuring psychological distress were administered before the medical procedure and 3–5 months after discharge. Results: Children from the study group displayed significantly more distress symptoms before and after the procedure, with a substantial post-procedure increase. Parents of children who endured prior trauma and child maltreatment also exhibited elevated pre-procedure distress. Prior trauma and child maltreatment independently contributed to heightened medical distress. Post-procedure child distress was influenced by the early traumatic events and also by family support, socioeconomic status, and parental procedure-related post-traumatic stress symptoms. Conclusions: Children with a history of child maltreatment and trauma show an increased chance of psychological distress following medical procedures. Medical teams should be aware of this heightened risk and provide appropriate support. Full article

Child maltreatment is a worldwide issue with serious consequences throughout life. Maltreated children tend to be at greater risk of developing aggressive and antisocial behaviours (e.g., violent behaviour in adulthood). The present study aims to analyse how temperament mediates the relationship between childhood trauma and sexual violence perpetration in adolescence. The present cross-sectional study was conducted with 252 Portuguese adolescent students between ages 11 and 20 years (n = 126 boys), of whom 126 self-identified as perpetrators of sexual violence. Overall, the results show that temperament mediated the relationship between emotional abuse and the perpetration of sexual violence. Limitations and implications for future studies were discussed. This study will be crucial for the development of intervention programs on violence and will help to explore these practices in intimate relationships. A better understanding of violence through the identification of variables of interest will allow a better understanding of this phenomenon, deepening the relational dynamics between the different genders. Full article

Neighborhood contexts, such as structures and social processes, have been explored to understand the etiology of child maltreatment, through the application of an ecological framework in child maltreatment research. While two comprehensive reviews on the relationship between neighborhood structural characteristics and child maltreatment were conducted in the 2000s, no prior study has synthesized the impacts of neighborhood social processes on child maltreatment. This study critically reviews extant literature on the role of neighborhood social processes in child maltreatment by employing the scoping review method, in accordance with the PRISMA-ScR reporting guidelines. The final review included 41 studies between the 1970s and 2022. Findings from the 41 studies were mixed by types of social processes measures, analytic approaches, and types of maltreatment. Future research directions are discussed based on the summary of the key findings. Full article

The COVID-19 pandemic had a global impact on mental health. Identification of individuals at higher or lower risk of mental health problems may assist with targeting prevention, support and treatment efforts during future pandemics. Using a Canadian national mental health survey that collected data during the pandemic period (March 2022–December 2022), this study examined the vulnerability of participants reporting abuse during their childhood by examining the annual prevalence of mood, anxiety and substance use disorders. Psychiatric disorders were identified using a version of the Composite International Diagnostic Interview (CIDI). Because childhood adversities are well-known risk factors for mental disorders, the analysis focused on interactions between childhood adversities and pandemic-related stressors by estimating the relative excess risk due to interaction (RERI). RERIs provide evidence of synergy based on the occurrence of greater than additive interactions. Physical and sexual abuse interacted synergistically with pandemic-related stressors in predicting mood and anxiety disorders. No synergies were found for substance use disorders. Childhood adversities increase vulnerability to later stressors and may be useful for the identification of individuals more likely to have mental health needs during this type of public health emergency. Full article

Infantile occult exposure to cocaine in domestic environments represents a complex clinical and medico-legal problem, which can be associated with abuse and neglect and with potential short- and long-term health risks for children. The authors present a retrospective study on 764 children under 14 years old who accessed the Emergency Department of IRCCS Meyer from 2016 to 2023 and were included in the GAIA (Child and Adolescent Abuse Group) protocol for suspected maltreatment and abuse, and for which a urine toxicology analysis was performed. The aim is to discuss the medico-legal implications and highlight the need for a thorough evaluation and management of such situations. Urine screening tests for substances of abuse (e.g., cocaine, opiates, etc.) were performed with an EMIT^® Siemens VIVA-E drug testing system (Siemens, Newark DE) in 124 cases for which the child’s clinical condition raised suspicion of intoxication, or the family context indicated distress or substance abuse dependency. The screening results revealed the presence of cocaine and its main metabolite, benzoylecgonine, in the urine of 11 children. In one case, a single girl was brought to the Emergency Department by staff from the facility where she and her mother were staying. In most of the cases, children were brought to the Emergency Department by their parents who accessed the Emergency Department due to various clinical manifestations (drowsiness, agitation, seizures, hypotonia, diarrhea, vomiting, etc.), except for one case of eye trauma suspected to be caused by abuse or neglect by one of the parents. Three of the children did not have signs or symptoms attributable to substance exposure, whilst eight of the cases presented some of the symptoms associated with occult infant exposure to cocaine, such as neurological manifestations, seizures, gastrointestinal symptoms, and respiratory depression. The probable mode of intake was mostly through breastfeeding and continuous environmental exposure due to domestic contamination or inhalation of “crack”. In the case of a 12-hour-old infant, there was probable prenatal in utero exposure. All the children were hospitalized, some for medical reasons and others solely as a precautionary measure for proper care. In all cases, a report was made to the Prosecutors as required by the Italian Penal Code, as well as to the Court of Minor. The study highlighted the importance of a multidisciplinary approach involving pediatricians, social workers, and forensics, as well as close collaboration with the relevant authorities, as the Gaia service at IRCCS Meyer offers. The occasional detection of cocaine in cases that showed no suspicion of intoxication led to a modification of the procedure and the development of a standardized protocol at IRCCS Meyer both in terms of prevention and in the detection and interception of hidden cases, in order to intervene early and initiate the necessary care pathways (secondary prevention). This protocol includes routine toxicological urine testing in all suspected or confirmed cases of child abuse, not just in those where symptoms might suggest a suspicion of intoxication. Full article

Background/Objectives: Post-traumatic stress disorder (PTSD) is a complex condition influenced by both genetic and environmental factors. This longitudinal study aimed to explore the connection between two specific genetic polymorphisms, Val66Met and 5-HTTLPR, and the lifetime prevalence of PTSD in patients from primary care settings. We also examined the role of sociodemographic and psychosocial factors to provide a more comprehensive view of PTSD risk. Methods: We recruited a cohort of primary care patients and diagnosed PTSD using a standardized diagnostic interview. Genetic analyses focused on Val66Met and 5-HTTLPR polymorphisms. We applied logistic regression to assess the association between these genetic markers and PTSD, considering factors such as gender, family history of depression, and experiences of childhood maltreatment. Results: Our findings show that women, individuals with a family history of depression, and those exposed to childhood maltreatment have a higher risk of developing PTSD. While the Val66Met polymorphism was not significantly associated with PTSD, the 5-HTTLPR polymorphism showed a marginal relationship. No significant interaction was found between the two polymorphisms in relation to PTSD. Conclusions: This study underscores the multifactorial nature of PTSD, influenced by both genetic and environmental factors. The findings point to the importance of further research on genetic predispositions and highlight the value of early interventions for high-risk populations in primary care settings. Full article

The NYC Administration for Children’s Services and MDRC have partnered since 2021 to develop a rigorous research agenda leading to an impact evaluation of the Family Treatment and Rehabilitation (FT/R) model, a “home-grown” New York City intervention for families experiencing substance misuse and/or mental health challenges that put children at risk of maltreatment. This paper will describe the first phase of that research, which had two goals: (1) to refine a logic model that would result in a shared understanding of core components of the FT/R model, and (2) to create a plan for a subsequent implementation study that would enable MDRC and ACS to understand how 18 FT/R programs are implementing the model across New York City. The paper will describe the team’s orientation to this research, including centering equity in the work by prioritizing the inclusion of staff and family perspectives. Next steps in the research roadmap will be discussed, including convening a council of lived experience advisors, as well as implications for evidence-building for sustainability. This research has the long-term potential to support FT/R’s inclusion in the Family First Prevention Services Clearinghouse and ultimately, the leveraging of Title IV-E funds to support scaling of a locally developed, culturally responsive, and adaptable child welfare prevention model beyond New York City. Full article

This study reflects the evidence-building journey for the Colorado Kinnected kinship navigator program. Colorado Kinnected expands the scope of services, resources, and supports offered to kinship families through an innovative approach that enhances an earlier Kinship Supports Demonstration Project. The Colorado Kinnected target population includes kinship caregivers caring for children and youth of any age with an open child welfare case. The primary purpose of the program is to reduce child welfare involvement by limiting traditional foster care and congregate care use when out-of-home placements are required. A randomized controlled trial was conducted from June to November 2020 to examine the impact of the Colorado Kinnected kinship navigator program on the kinship placement outcomes of 402 children and youth with an open child welfare case in seven Colorado counties. The initial study found that children and youth placed with kinship caregivers who received Colorado Kinnected services were significantly more likely to reunify with their parents after their kinship placements ended than were children and youth who received kinship supports as usual. The sustained effects study featured additional analyses of traditional foster and congregate care entry rates within six months of kinship placement for the same sample of children and youth. Children and youth in the intervention group were significantly less likely than children and youth in the control group to enter foster care or congregate care within six months after the end of their kinship placements. Overall, both analyses indicate that the Colorado Kinnected program promotes sustained permanency among children and youth in formal kinship placements. Data equity analyses to explore the contextual sensitivity of the intervention are detailed, and implications for practice, policy, and research are discussed. Full article

The phenomenon of child abuse/maltreatment is underestimated and often represents a difficult challenge for healthcare professionals and forensic pathologists who must proceed with the differential diagnosis with accidental or self-induced events, or with lesions due to pathologies that overlap with that of mistreatment, defined as “Mimics”. This study presents a case series with the aim of discussing lesions that may mimic signs of physical abuse in children but are due to a different etiology to raise awareness and train healthcare professionals and forensic pathologists on possible confounding factors in order to avoid diagnostic errors. Six cases of “Mimics” out of 418 cases of suspected mistreatment (1.43% of cases) were identified, presenting skin lesions initially classified as injuries of abuse due to their location and type and, in particular, sexual abuse for three cases. Then, the lesions and the subjects, in particular the anamnestic history, were examined by a multidisciplinary team and the diagnosis of genital lichen sclerosus et atrophicus in three cases, and the results of popular healing techniques (i.e., “cupping”) in the other three cases were ascertained. These situations require specific skills and a forensic background from healthcare professionals to conduct a correct differential diagnosis and the intervention of a multidisciplinary team to investigate every possible pathology or alternative therapeutic practice that could simulate child abuse. In particular, when “mimics” are due to alternative medicine, it should not strictly be considered child abuse, but professionals must be aware of the hypothesis of mistreatment in case of non-medical indication or potential personal injuries from other crimes, such as illegal practice of the medicine. This awareness is also crucial to direct the child toward appropriate medical care, and it is essential to recognize that these conditions can coexist within the same clinical presentation. Full article

The association between poverty and maltreatment is well established, and numerous studies show the detrimental effects of economic and material hardship on maltreatment, child welfare involvement, and family well-being. In turn, an increasing body of literature suggests the value of programs and services that provide economic and concrete support in stabilizing and supporting families and, ultimately, reducing occurrences of maltreatment. In this article, we examine the effectiveness of economic and concrete support in reducing primary outcomes of child maltreatment and child welfare involvement and in improving secondary outcomes of child and adult well-being through a systematic review of the literature. We review studies published between 1990 and 2023 through searches of scholarly databases, child welfare websites, and evidence-based clearinghouses. We used a two-stage review process to identify a final sample of articles for data extraction. Twenty-four studies with low risk of bias were included in the synthesis. Regardless of delivery mechanism, we found consistent, favorable evidence of the impact of economic and concrete support as a prevention strategy to reduce child maltreatment and child welfare entry and to a lesser extent, improvements in child and adult well-being across these studies. Implications for policy, practice, and racial equity are discussed. Full article

Background: The manifestation of complex trauma results from exposure to severe and repetitive stressors occurring within the caregiver system. Frequently associated with child maltreatment, complex trauma can lead to impairments in multiple domains, including attachment, affect and behavioural regulation, and cognition. Treatments, including Trauma-Focused Cognitive Behavioural Therapy, have been shown to be efficacious, but high attrition rates point to the need for complementary methods that boost client retention and treatment efficacy. This systematic review examines whether dog-assisted therapy has beneficial impacts on the treatment of complex trauma and whether it can decrease treatment attrition among children presenting with complex trauma exposure. Methods: We followed PRISMA guidelines to locate relevant research reports. Seven published research reports matched the inclusion criteria. Results: Dog-assisted therapy may increase the efficacy of standard interventions for complex trauma, although only one study formally assessed treatment retention. Across most studies, there is an overall lack of detailed information on the nature of therapeutic activities involving the dog and how these activities may complement or enhance therapy as usual. Studies were of varying methodological quality, impacting the reliability of findings. Conclusions: Future studies should aim to better describe and justify dog-assisted therapy techniques and evaluate these in comparison with standard evidence-based approaches to the treatment of childhood complex trauma. Full article

Background/objectives: This study examined the association between maternal anger, children’s externalizing symptoms, and the moderating impact of maternal adverse childhood experiences (ACEs) in the context of intimate partner violence (IPV). The primary objective was to investigate whether maternal ACEs alter the link between maternal anger and children’s externalizing symptoms, guided by theoretical frameworks such as the stress sensitization and stress steeling models. Methods: A sample of 159 Portuguese mothers exposed to IPV participated in the study, completing a protocol of self-report measures. Measured variables included maternal anger, ACEs, children’s externalizing symptoms, and IPV. Results: Results indicate a significant moderation effect of ACEs on the association between maternal anger and externalizing symptoms at low levels of ACEs. Conversely, at moderate and high ACEs levels, no statistically significant association exists between maternal anger and children’s externalizing symptoms. Conclusions: Clinical implications emphasize the importance of tailored parenting interventions to prevent externalizing symptoms in children, integrating diverse emotion regulation strategies while considering the impact of maternal ACEs. Full article