Child Maltreatment最新文献

Indigenous children in settler-colonial societies have historically been exposed to frequent family separation; yet contemporary family separation through out-of-home-care (OOHC) remains understudied. We analyzed annual OOHC rates among indigenous and non-indigenous children (2010-2023) in four countries: Australia, United States, Denmark, and Kalaallit Nunaat (Greenland). Data sources included national child welfare databases and population registers. We computed observed annual rates and generated age-standardized rates using parametric bootstrap approaches with Generalized Additive Models. We found that indigenous children experienced substantially higher OOHC rates across all countries. Annual rates ranged from around 1.5% (US) to around 6% (Australia, Greenland) among indigenous children, versus 0.6-0.9% among non-indigenous children. Risk ratios were highest in Australia (10.1-11.4) and lowest in the US (1.5-1.9). Our findings demonstrate that indigenous children remain disproportionately exposed to OOHC, with substantial cross-national variation in magnitude and age patterns that likely reflects different policy environments and child welfare practices.

Interventions for children at risk for fatal injury have been limited by the lack of systematic methods to detect and classify the circumstances surrounding deaths recorded in unstructured text narratives. To address this gap, we analyzed N = 453 child fatality reports from the Pennsylvania Department of Human Services (2016-2023). Each report was merged with the 2016-2021 American Community Survey (ACS) five-year estimates by county of death, incorporating county-level indicators of poverty and racial composition to provide sociodemographic context, as well as with report-level metadata on year and county of death. We then applied Natural Language Processing and Structured Topic Modeling, a machine learning algorithm that incorporated both ACS data and report metadata, to identify common themes in the narratives. The model revealed 11 distinct categories that included Severe Traumatic Injury (12%); Homicide due to Parental Neglect (10%); Medical History or Illness (11%); Institutional Negligence (5.3%); Sleep-Related Deaths (12%); Aggravated Assault (11%); Substance Misuse (13.4%); Failure to Supervise (6%); Supervisory Neglect (6%); Drowning (8%); and Firearm-Related Injury (6%). Analysis of temporal and sociodemographic covariates showed that some themes (e.g., Homicide due to Parental Neglect) declined over time, while others (e.g., Substance Misuse) became more prevalent. Counties with higher poverty levels and larger non-White populations showed a greater prevalence of Firearm-Related Injury and Severe Traumatic Injury, while counties with larger non-White populations had lower rates of Drowning and a marginal association with fewer Sleep-Related Deaths. Integrating ACS data and report-level metadata with computational text analysis and machine learning models can generate actionable insights into the circumstances of child deaths, strengthen fatality surveillance, and inform targeted prevention strategies.

In response to the COVID-19 pandemic, Illinois funded the rapid scale-up of a whole-school trauma approach, Resilience Education to Advance Community Healing (REACH). Schools that took part in REACH formed a team, participated in training, completed the Trauma Responsive Schools Implementation Assessment (TRS-IA) and then developed an action plan based on the results of that assessment. The independent, quasi-experimental outcome evaluation of REACH capitalized on natural contrasts between the 950 schools that enrolled in REACH and the 3,035 schools that did not, and REACH schools that attained more versus fewer implementation milestones. Analyses showed that 132 REACH schools with pre/post data significantly improved their scores on all eight dimensions of the TRS-IA. Controlling for school characteristics and baseline levels of outcome variables, we saw that REACH schools were more likely to retain their teachers than were schools that had not enrolled in REACH. REACH schools that were "engaged" had fewer students who were chronically absent than REACH schools that were not engaged. REACH schools that were "very engaged" had fewer out-of- school suspensions than schools that were not engaged. There was no relationship between REACH and school climate. Overall, REACH is a promising whole-school trauma-responsive intervention.

Theories of change in trauma-informed care emphasize the need go beyond individual transformation and act upon the organization-level. The National Child Traumatic Stress Network's Trauma-Informed Organizational Assessment (TIOA), implemented within an implementation framework, is intended to assist with organization-level change. This paper explores properties of the measure, which evaluates 87 practices across nine domains. The TIOA uniquely incorporates the assessment of practices related to race and culture as well as partnerships with youth and families. In a sample of 23 child-serving organizations (N = 1,224), the TIOA demonstrated excellent internal consistency (Cronbach's alpha >0.93) and good or moderate test-retest reliability. The TIOA was usable by staff in a range of settings and few differences were seen in characteristics such as role in the organization or race. The TIOA provides actionable, organization-level recommendations to help identify strengths and areas for improvement, ultimately supporting environments where staff, children, and families thrive.

The present study examined couples' childhood maltreatment (CM) profiles and their associations with both partners' sexual health over one year. Participants were 885 couples (M_{age =} 31.22) who completed measures of CM (baseline) and sexual satisfaction, distress and function (baseline, 6- and 12-months). Dyadic latent profile analyses yielded five profiles: Partner 1 Neglected, Low CM, Partner 2 Physically Abused, Partner 2 Sexually Abused, and Partner 1 Sexually Abused. Initial levels of sexual satisfaction, distress and function showed the greatest sexual health in Low CM and the worst in Partner 1 Neglected. Decreases in sexual satisfaction were steeper in Partner 1 Sexually Abused than Low CM; sexual distress decreased for Low CM and increased for Partner 1 Neglected and Partner 2 Sexually Abused; decreases in sexual function were steeper in Partner 1 Neglected and Partner 2 Sexually Abused than Low CM. Profiles involving greater CM are associated with worse sexual health.

Identifying proximal and multigenerational distal risk mechanisms through which adversity exposure may shape neuroendocrine dysregulation among children is critical to advancing effective preventive interventions for adversity-exposed individuals. Utilizing longitudinal data (N = 247), the current study examined maternal and offspring history of childhood maltreatment (CM) as predictors of offspring cortisol/DHEA ratios, and, in exploratory analyses, extended this longitudinally to offspring depressive symptoms in young adulthood. Youth (ages 8-13 years) initially attended a research camp, then were followed up approximately eight years later (ages 18-22 years). Maternal history of CM significantly predicted their offspring's childhood cortisol/DHEA ratio over and above the effects of the offspring's history of CM. Offspring CM was not a significant predictor of the ratio. The cortisol/DHEA ratio did not mediate the relationship between maternal history of CM and offspring emerging adulthood depression. Results highlight an intergenerational cascade of CM and negative outcomes and support inclusion of maternal experiences in screening for at-risk youth.

We conducted a nation-wide online survey of school nurses in the United States to estimate the prevalence of suspected medical child abuse (MCA) among seriously ill or disabled students attending elementary or pre-school. Prior to being informed of our interest in MCA, the nurses identified a single seriously ill or disabled student to report on and provided information about themselves, the selected student, and the student's caregiver. They were then told the true purpose of the study and asked to rate their suspicions that the student they had selected was a victim of MCA, and at the very end of the survey we asked all the nurses if they worked with a student who they suspected was experiencing MCA. Prevalence of suspected MCA among the blindly selected seriously ill or disabled students, was 23127 per 1000. Half the nurses completing the survey reported they currently cared for a suspected MCA victim, suggesting a minimum prevalence of 22/1000 among seriously ill or disabled students in their care. The results suggest the setting of school nursing holds potential as both a venue for research on MCA and an important setting for finding and helping victims of MCA.

Previous studies have reported mixed findings regarding the relationship between childhood maltreatment and midlife mortality. To fill gaps in the literature, we examine the impact of childhood maltreatment on midlife mortality and test potential explanations for the relationship. Using a prospective cohort design, individuals with documented histories of childhood maltreatment (ages 0-11 years) during 1967-1971 and a demographically matched control group were followed into midlife. The National Death Index and Social Security Death Index were searched for all individuals (N = 1575) to determine date and cause of death. Individuals who survived were interviewed in 1989-1995 (M age = 29). By 2023, 18% (N = 283) had died. Contrary to expectations, there were no significant differences in midlife mortality between maltreated and control groups overall. Incidence rates for maltreated females were higher than for control females. Physically abused males were at decreased risk of midlife mortality. Among individuals interviewed in young adulthood, being female reduced risk, whereas lower SES and suicide attempt increased risk for midlife mortality. Childhood maltreatment, alcohol, drugs, anxiety, depression, smoking, and violent arrests did not. SES and problematic behaviors appear to play an important role in understanding midlife mortality and suggest targets for intervention.

Biological embedding of stress is a process commonly observed among individuals with histories of early life adversity. Adverse experiences can get "under the skin" and influence the neural and biological characteristics of an individual, impacting a range of health domains including inflammation. This study aimed to identify characteristics that protect individuals against immune health challenges following childhood abuse (e.g., physical, emotional, sexual). Childhood self-regulation and peer likeability were tested as moderators in the effects of abuse on emerging adulthood inflammation. Participants (N = 421) were drawn from a follow-up study of emerging adults with and without maltreatment histories who participated in a research camp program as children. Maltreatment was determined based on CPS record data, self-regulation was informed by camp counselor report, peer likeability was indicated through camp participants' ratings, and adulthood inflammation was identified via salivary C-reactive protein (CRP). Results indicated that childhood abuse did not have a significant main effect on emerging adulthood inflammation. However, among youth who were more behaviorally disinhibited, the experience of abuse was predictive of lower inflammation. Peer likeability did not significantly moderate the association between abuse and inflammation. Results underscore how multifinality in health outcomes following abuse, including resilience, may be shaped by individual characteristics.