Child Abuse & Neglect最新文献

Background: Children exposed to childhood household dysfunction (CHD) are at high risk for anxiety and depression. However, few tools are available for early identification. This study developed two risk assessment models for anxiety and depression in children with CHD to enable early detection and intervention.

Methods: A cross-sectional study recruited 1276 children with CHD from Changsha, Hunan, who were randomly divided into training and validation sets (7:3). Bidirectional stepwise multivariate logistic regressions were used to develop models based on socio-demographic, individual, family, and societal levels. Model performance was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, specificity, and accuracy (ACC).

Results: Among the participants, 736 (57.8 %) had depression risk, and 892 (70.0 %) had anxiety risk. The Anxiety Risk Model included seven variables: gender, grade, rumination, adolescent life events, number of childhood trauma experiences, positive coping style, and sleep quality. It demonstrated strong performance with an AUC of 0.875 (95 % CI: 0.852-0.897) in the training set and 0.864 (95 % CI: 0.826-0.902) in the validation set, with a sensitivity of 74.3 %, specificity of 79.6 %, and an accuracy of 75.1 %. The Depression Risk Model included five variables: grade, rumination, adolescent life events, positive coping style, and sleep quality, with an AUC of 0.895 (95 % CI: 0.874-0.916) in the training set and 0.869 (95 % CI: 0.829-0.908) in the validation set, with sensitivity of 75.1 %, specificity of 80.9 %, and accuracy of 76.8 %.

Conclusion: The two risk assessment models offer valuable insights into the early identification of children at risk of depression and anxiety within similar urban adolescent populations. These findings necessitate further validation using longitudinal designs within larger and more diverse populations to confirm the models' generalizability and robustness before recommendations for wider clinical application can be made.

Background: Sexual violence during youth has serious consequences for short- and long-term health and wellbeing. It is not well understood how risk of sexual violence varies across intersecting social identities.

Objective: This study aims to investigate disparities in sexual violence experienced amongst adolescents, at the intersections of sex, race and ethnicity, and sexual orientation.

Participants and setting: Data were extracted from the 2023 National Youth Risk Behavior Survey, a biennial school-based cross-sectional study conducted across the United States.

Methods: A multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was carried out, defining 40 intersectional strata by sex, race and ethnicity, and sexual orientation. Three outcomes were evaluated: (i) ever having forced sexual intercourse, (ii) any sexual violence in the past year, (iii) dating sexual violence in the past year.

Results: There was substantial between-stratum heterogeneity in predicted probabilities of forced intercourse and sexual violence. The highest risk strata overwhelmingly comprised non-heterosexual individuals and females, whilst the lowest risk strata comprised heterosexual individuals and males. Fixed effects of sex, race and ethnicity, and sexual orientation explained 82.4 % to 86.8 % of the between-stratum variance, but residual variance remained. The median odds ratio (MOR) indicated that risk of ever having had forced intercourse could double depending on intersectional identity (MOR: 2.04; 95 % CI: 1.73 to 2.54).

Conclusions: Findings support the hypothesis that risk is concentrated in multiply marginalized groups. Intersectional multilevel modelling revealed stark inequalities in adolescent sexual violence risk that are not fully explained by additive effects.

Background: Worldwide many children experience violent discipline by teachers in schools. To prevent it effectively, key determinants need to be examined systematically.

Objective: This study investigates structural (meetings and activities), interpersonal (norms on violent discipline, quality of relationships among teachers) and individual factors (attitudes towards violent discipline, perceived stress) and their relation to teacher violent discipline.

Participants: In a multi-informant approach, 117 head teachers, 1490 teachers, and 3495 students from 72 school clusters in Ghana, Tanzania and Uganda were included.

Methods: Using multilevel analysis, we examined the relations between structural, interpersonal and individual factors and violent discipline (reported by teachers and students) on both individual and school level. Fixed effects with random intercepts were examined.

Results: On the teacher level, favorable attitudes (f² = 0.11), norms (f² = 0.07) supporting violent discipline, and higher work-related stress (f² = 0.04), were positively associated with teacher violent discipline. At the school level, favorable school norms (f² = 0.84), lower quality of teacher relationships (f² = 0.12), and higher stress levels (f² = 0.07) were linked to more teacher violent discipline. In the student-reported data, head teachers' favorable attitudes towards violent discipline were related with more teacher violent discipline. Better quality of teacher relationships and school-wide activities were associated with less violent discipline.

Conclusions: In the school context, both individual- (attitudes, perceived norms and stress) and school-level factors (school norms) contribute to children's risk of violent discipline. Preventative interventions should address both individual and contextual determinants of violent discipline within the immediate social environment of children.