Child Abuse & Neglect最新文献

Background: Youths who engage in harmful sexual behaviours (HSBs) have often experienced childhood adversity and psychosocial health problems. Greater understanding of how developmental risks cluster together and/or differ within this heterogeneous population is needed.

Objective: This research aimed to further knowledge of the aetiology and treatment needs of youths with HSBs by identifying typological differences based on co-occurrence of developmental risk factors, including adverse childhood experiences (ACEs).

Participants and setting: Data was derived from clinician case files of 386 Australian male youths receiving specialised treatment following adjudication for sexual offences.

Methods: Latent class analysis was used to determined risk-factor based typologies. Differences in offence characteristics across classes were examined using Chi-square tests and ANOVA.

Results: Four distinct profiles of young males with HSBs were identified: Limited Risk, Socially Excluded, Antisocial, and High Adversity. Characteristics of sexual harm, including offence setting, and victim age and sex, differed across these classes.

Conclusions: Findings suggest differential pathways to youth HSB, and have relevance for informing intervention efforts, to ensure responses meet the varying needs of young people.

Background: Non-attendance at follow-up psychological evaluations is a major barrier to care for adolescents at risk of suicide. Identifying the factors associated with non-attendance is essential to improving engagement with mental health services.

Objective: This study examines reasons for non-attendance among adolescents identified as at-risk for suicide.

Participants and setting: The sample consisted of 189 adolescents (72% female; mean age = 14.11, SD = 1.44) from the EPISAM-SCHOOL project who did not attend scheduled psychological evaluations.

Methods: A quantitative approach utilizing both structured psychometric data and NLP-assisted content analysis of unstructured text data was employed to classify reasons for non-attendance. Machine learning algorithms and inferential statistics were used to identify patterns and associations. Statistical analyses assessed the association between non-attendance and psychological, familial, and behavioral factors, including experiences of abuse.

Results: A Naive Bayes classifier achieved 93% accuracy in predicting non-attendance categories, which included parental refusal (most common), no response, lack of contact information, and adolescent refusal. Statistical analyses revealed significant differences in physical abuse (p = .03) and child-to-parent violence towards fathers (p = .044) among non-attendance categories.

Conclusions: Family dynamics, particularly instances of intrafamilial violence and abuse, played a crucial role in non-attendance. Stigma and adolescents' reluctance to engage with mental health services were identified as key barriers to accessing care. Findings underscore the need for multifaceted intervention strategies, including parental engagement and addressing family violence. This research contributes to the development of targeted approaches to improve engagement in mental health services for at-risk adolescents, potentially reducing suicide risk in this vulnerable population.

Background: Childhood maltreatment can have severe, long-lasting mental health consequences for survivors themselves and these effects can also be transmitted to the next generation: children of childhood maltreatment survivors are at a higher risk for various behavioural problems. However, the impact of maternal childhood maltreatment on developmental trajectories of child behaviour problems is not yet clear.

Objective: This longitudinal observational study examined associations between maternal childhood maltreatment and children's externalizing and internalizing behaviour trajectories and whether these associations were moderated by maternal early caregiving quality.

Participants and setting: A total of 164 Dutch mothers and their children (44.5% girls).

Methods: Mothers reported on their maltreatment experiences and their children's externalizing and internalizing behaviours at 6, 7, 10, and 12.5 years of age.

Results: Externalizing behaviour decreased significantly across development and there was some evidence that this decrease was stronger in more severely maltreatment-exposed mothers. Internalizing behaviour increased significantly across development, but maternal childhood maltreatment was not associated with internalizing behaviour trajectories. No moderating effects of caregiving quality emerged, but some evidence for direct associations between caregiving quality and externalizing behaviour (trajectories) was found.

Conclusions: Future research should replicate these findings in more diverse, high-risk samples and further explore protective moderators of the intergenerational effects of childhood maltreatment.

Background: Exposure to parent-perpetrated child abuse is a risk factor for adulthood major depressive disorder (MDD). Coping strategies may be a plausible mechanism underlying this relationship. The current study examined whether positive reinterpretation (PR), focus on and venting of emotion (FVE), and behavioral disengagement (BD) mediated the relationship between maternal or paternal abuse and adulthood MDD symptoms.

Method: Data from 3294 community-dwelling adults were collected across three waves, with each interval nine years apart. Structural equation mediation modeling examined whether each unique coping strategy at Wave 2 mediated the relationship between maternal or paternal abuse at Wave 1 and MDD symptoms at Wave 3, controlling for baseline MDD symptoms. Both Wave 1 maternal and paternal abuse were entered simultaneously into each of the three mediation models.

Results: PR did not mediate the relationship between recalled parent-perpetrated child abuse and MDD severity (standardized β = 0.001 to 0.002). BD and FVE mediated the relationship between maternal abuse and MDD severity (β = 0.006 to 0.020) but not paternal abuse (both βs = -0.003). Maternal abuse was associated with higher BD and FVE (β = 0.175 to 0.628), which were both associated with increased MDD severity (β = 0.086 to 0.112).

Discussion: BD and FVE are possible mechanisms linking childhood experiences to adulthood MDD severity. Identifying maladaptive coping as mediators highlights its role in shaping long-term mental health. Targeting these coping patterns may help reduce the enduring impact of child abuse on adult mental health, reinforcing the importance of early prevention.

Background: Prediction models for child maltreatment risk are increasingly used to support decisions in child protection, yet concerns remain about methodological quality, transparency, calibration, and equity, particularly when tools are derived from administrative data.

Objective: To systematically review prediction models for child maltreatment risk and evaluate adherence to TRIPOD, risk of bias and applicability using PROBAST, and the extent of evidence on calibration, external validation, and fairness.

Methods: We included quantitative studies that developed or validated multivariable prediction models for maltreatment-related outcomes in child protection or public health contexts. Electronic databases and registers (2010-2025) were searched for studies reporting model performance. Two reviewers independently screened records, extracted data, and appraised reporting using TRIPOD and risk of bias/applicability using PROBAST. Owing to heterogeneity in outcomes, model types, and data sources, findings were synthesized narratively.

Results: Fourteen studies met inclusion criteria. Most used administrative or clinical datasets and logistic regression or machine learning models, achieving moderate to high discrimination. Five themes emerged: partial TRIPOD adherence; frequent analysis-domain bias; limited calibration and decision-analytic evaluation; sparse external validation and model updating; and uneven fairness auditing.

Conclusions: Current maltreatment prediction models show promising discrimination but are constrained by incomplete reporting, methodological weaknesses, and limited evidence on calibration, transportability, and equity. Future work should align with TRIPOD and PROBAST, embed validation and calibration, and incorporate fairness auditing.

Background: Children in contact with children's social care (CSC) services have high levels of hospital utilisation, but patterns before and after referral remain insufficiently understood.

Objective: To evaluate healthcare utilisation two years before and after CSC referral.

Participants and setting: Retrospective cohort using ECHILD linked health and social care data, including children with a first CSC referral between 2009 and 2018 in England.

Methods: We compared monthly planned and unplanned hospital contact rates for Children in Need, Children under Protection Plans, and Children Looked After with age-sex-matched cohorts. We used interrupted time series analysis to examine how healthcare utilisation changed following referral. We also explored reasons for hospital contacts.

Results: We analysed >12 million hospital contacts for 1,014,330 Children in Need, 204,240 Children under Protection Plan and 177,640 Children Looked After. Children Looked After had the highest average number of total contacts (11.8 per child over a 4 year period), followed by Children in Need (8.8) and Children under Protection Plans (8.4). All CSC groups had about twice the contacts of matched peers. Healthcare utilisation increased sharply prior to referral, with a peak around referral. After referral, planned care increased and unplanned care decreased, with pre referral upward trends slowing or reversing. The most common reason for healthcare utilisation was mental health-related.

Conclusions: At a population level, CSC referral marks a pivotal point in healthcare utilisation, with a shift from unplanned to planned care. This may reflect more structured engagement with health services and coordinated support for children and families.

Background: Child maltreatment is highly prevalent in rural areas, yet evidence-based parenting programs remain largely inaccessible because of caregivers' inflexible work schedules and the shortage of trained facilitators. To enhance its scalability and cost-effectiveness, we adapted the Chinese version of Parenting for Lifelong Health for Young Children (PLH-YC) program into a self-directed online format with two group discussions and evaluated its impact in rural China.

Methods: Twelve classes (191 caregivers) in one rural kindergarten were cluster-randomized 1:1 to either a self-directed online PLH-YC program (100 caregivers) or a book-reading control (91 caregivers). Assessments were conducted at baseline, two weeks post-intervention, and three-month follow-up. Analyses adhered to the intention-to-treat principle, using zero-inflated negative binomial regression for count outcomes (e.g., child maltreatment) and linear mixed-effects regression for continuous outcomes (e.g., positive parenting practices).

Results: Two weeks post-intervention, caregivers in the self-directed group reported a 33% reduction in overall child maltreatment (IRR = 0.67, p < 0.001), a moderate increase in positive parenting (d = 0.53, p < 0.001), a small-to-moderate changes in parent-child relationship quality (d = 0.32, p < 0.001) and parenting stress (d = -0.31, p < 0.001) relative to controls. At the three-month follow-up, reductions in child behavior problems became significant (d = -0.40, p < 0.001). Parenting efficacy and parental depressive symptoms did not differ between groups at both time points.

Conclusion: The self-directed online PLH-YC program, combined with group discussions, provided an effective, low-cost, and scalable option for disadvantaged rural caregivers in China.

Background: Children and young people in contact with child protection services often experience poorer life outcomes compared to their peers. Limited research exists on the reasons behind this disparity from the perspective of those with direct lived experience.

Objective: To explore and amplify the voices of care leavers (adults formerly in care) and understand their unique experiences and perspectives on the benefits and challenges of being a child or young person in care.

Participants and setting: Seven care leavers aged 19-69 years (three Australian Aboriginal, four non-First Nations), participated in a semi-structured, open-ended interview.

Methods: Founded in exploratory and participatory methodology, interviews were examined using qualitative thematic analysis to identify patterns of meaning connected to the research question.

Findings: Six themes were identified: 1) Care can be good…but it is luck of the draw; 2) Care is conditional; 3) Don't stand up on unlevel ground; 4) OOHC is not my identity (an identity to be hidden, yet a desire to be known); 5) Not my real family or my real home (the desire to belong and be at home); and 6) Kept in the dark - seen but not heard (powerless and uninformed).

Conclusion: Care leaver's stories challenge assumed narratives about Out-Of-Home Care, highlighting how short-term, inconsistent care undermines children's need for stability, participation and meaningful relationships. Findings contribute theoretically by examining intersectionality in care contexts and practically by advocating for relational continuity as well as child-centred, participatory, culturally responsive models of care.

Background: Children and adolescents in the Middle East and North Africa (MENA) region experience high rates of psychological distress due to armed conflict and displacement, with limited access to traditional mental health care. This has led to increased interest in digital mental health interventions (DMHIs) as a potential solution.

Objective: This systematic review evaluates the effectiveness of DMHIs in reducing PTSD, anxiety, and depression symptoms, as well as improving overall wellbeing in MENA children and adolescents affected by armed conflict. It also explores barriers and facilitators to implementation in conflict-affected and displacement settings.

Participants and setting: The review included studies involving children and adolescents ages (5-18), from MENA countries affected by armed-conflict or displacement.

Methods: We conducted a systematic search of PubMed, PsycINFO, CINAHL, and gray literature using a structured Population, Intervention, Outcome (PIO) framework, along with expert consultations, following PRISMA guidelines. The quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT), and findings were synthesized narratively.

Results: Ten studies on digital games, telehealth, and online interventions showed significant reductions in PTSD, anxiety, and depression, with medium to large effect sizes. Gamified interventions in schools and healthcare settings had the highest engagement. Key barriers included infrastructure, digital illiteracy, and stigma, while facilitators were cultural adaptation and integration into existing systems.

Conclusions: DMHIs are a promising strategy for addressing mental health needs in conflict-affected children and adolescents. Future efforts should prioritize cost-effective, offline compatible models and greater integration into education and healthcare systems for sustainability.

Introduction: It is challenging for children and adolescents to report and seek help for child welfare endangerment. Online chat-based counseling services have emerged as viable, low-threshold options, enabling at-risk individuals to seek help digitally. Krisenchat is a confidential, 24/7 chat service designed to assist young people in acute crises.

Objective: This study aimed to characterize users of krisenchat who were flagged by counselors as potentially cases of child welfare endangerment, and to differentiate them from other users of the service.

Participants and setting: Anonymized data were obtained from the n = 29,387 krisenchat users between January and December 2023.

Methods: Demographic information, utilization behavior, suicidality, and use of professional help services were documented by counselors, while user satisfaction, recommendation rates, and emotional distress were assessed through voluntary surveys following consultation.

Results: Overall, 10.7% of users were flagged by counselors as suspected cases of child welfare endangerment. These users were more likely to be younger (M = 14 vs. M = 17), female (84.3% vs. 76.7%), and to report sexual violence (15.6% vs. 5.5%) and suicidal behavior (10.9% vs. 4.2%) compared to those not flagged. They also reported higher emotional distress (M = 6.80 pre vs. M = 4.65 post, p < .001) than other users (M = 4.65 pre vs. M = 4.57 post, p = .550) prior to the chat.

Conclusions: The findings highlight the potential of messenger-based platforms as tools for early detection and intervention, while underscoring the importance of trust-building to facilitate full disclosure.