Child Maltreatment最新文献

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.

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.

Children and youth with intellectual and developmental disabilities (IDD) face a high risk of victimization (including child abuse, neglect, bullying), yet prevention strategies for this population remain underrepresented and under-evaluated. This scoping review analyzes ten community-based victimization prevention programs for youth with IDD (ages 10-25) across North America, the Middle East, Europe, and Australia. Programs varied in structure, content, and teaching strategies, with all delivered over multiple sessions and most including evaluations of learning outcomes or implementation quality. However, none were adapted on a broad scale across multiple settings, populations, or geographic regions or addressed multiple forms of victimization. Given the effectiveness of prevention education in related fields, rigorous evaluation and tailored, evidence-based approaches are needed to enhance their impact. This review highlights existing programs, their methodologies, and the available evidence on their effectiveness, identifying key areas for future research and development in victimization prevention for children and youth with IDD.

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.

It is critical that researchers gather evidence of factors that identify infants at risk of out-of-home placement based on types of substance exposures and demographic characteristics. This study applied a validated medical record data extraction tool on data derived from a multi-site (N = 30) pediatric clinical trials network (ISPCTN) study of Neonatal Opioid Withdrawal (ACT NOW study). Participants included 1808 birthing parent-infant dyads with documented NOWS scoring or prenatal opioid exposure. Non-Hispanic White pregnant persons comprised the largest proportion of the sample (69.8%), followed by Non-Hispanic Black (11.6%), Non-Hispanic Multiracial and Other race (8.5%), and Hispanic (6.2%). Most notably, infant prenatal substance exposure across alcohol, cocaine, meth/amphetamine, and opioids, had the lowest possibility of discharging to parent(s). Additionally, latent class analysis identified distinct classes of substance use during pregnancy that were associated with different probabilities of discharging to parent(s). Specifically, less than half of infants (47%-49%) in the Poly-use and Meth/amphetamine classes were discharged to their parent(s). Severity of infant withdrawal symptoms influenced placement decisions within the Poly-use and Prescription Opioid classes. Findings can inform standard practices for increasing support for pregnant persons and substance-exposed infants including identification, subsequent referrals, communication with Child Protective Services, and plans of safe care.

This study aimed to investigate the connection between childhood abuse history and cardiovascular health indicators among a nationally representative sample of young adults aged 24-32. Using data from waves three and four of the National Longitudinal Study of Adolescent to Adult Health (n = 4, 164) multivariate logistic regression was employed to investigate childhood trauma (i.e., childhood physical abuse, sexual abuse, and neglect) as predictors for cardiovascular disease, hypertension, high cholesterol, diabetes, and obesity. Results showed that adults who reported history of sexual abuse were 4.3 times more likely to report diagnosis of cardiovascular disease and those who reported childhood physical abuse at wave three had 1.4 times the odds of reporting high cholesterol diagnosis. Although trauma history is often calculated as a composite, some forms of childhood abuse may have greater impacts on cardiovascular risk than others.