Child Abuse & Neglect最新文献

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.

Background and aim: Adverse Childhood Experiences (ACEs) significantly raise the risk of non-suicidal self-injurious (NSSI) in adolescents with mental illnesses. However, the mechanism through which ACEs affect NSSI remains unclear. This study aims to clarify the mechanisms that influence the relationship between types of ACEs, violence exposure, and NSSI and explore the mediating role of positive coping strategies.

Method: A multi-center, cross-sectional, descriptive study was conducted in eight provinces in China, involving 2052 adolescents with mental illness. The Adverse Childhood Experiences Questionnaire, the Simplified Coping Styles Questionnaire, and the Non-Suicidal Self-Injury Screening Scale were utilized for data collection. All data analyses were performed using R version 4.4.2.

Results: A survey of adolescents found that 83.8% had experienced at least one ACE. The prevalence of non-suicidal self-injury among these adolescents was 67.9%. All types of exposure to ACEs increased the likelihood of NSSI among adolescents with mental illness (aOR: 1.409-3.007). Types of violence-related ACEs demonstrated a cumulative effect (aOR: 3.494, 6.246). Positive coping strategies mediate the relationship between ACEs and NSSI (aOR: 1.017-1.039).

Conclusion: Exposure to ACEs increases the likelihood of non-suicidal self-injurious behavior in adolescents with mental illness. In particular, it is important to focus on the effects of bullying, emotional neglect, and domestic violence. Developing and employing positive coping strategies can effectively lower the risk of NSSI in adolescents facing mental health challenges. Early screening for adolescents who have experienced ACEs, along with targeted psychological crisis intervention, are future initiatives.

Background: Juvenile delinquency remains a major concern. While adversity is linked to delinquency, less is known about how different operationalizations of adversity compare in predicting delinquency. Many studies overlook key features including type, co-occurrence, timing, and chronicity.

Objective: This study compared three approaches to operationalizing adversity across two developmental periods-childhood and adolescence-by examining individual adversities, cumulative adversity scores, and latent class analysis (LCA), and examining their associations with delinquency.

Participants and setting: Data were drawn from the Millennium Cohort Study, a nationally representative UK longitudinal sample (N = 9980).

Methods: Linear regression analyses assessed associations for individual adversities measured separately in childhood and adolescence, cumulative adversity scores calculated for each period, and LCA-derived adversity patterns spanning both periods.

Results: Several childhood adversities (parental divorce/separation, maternal alcohol and drug use) and several adolescent adversities (maternal drug use, accidents or injuries, conventional criminal victimization, sexual victimization, and electronic victimization) predicted higher delinquency. LCA identified four groups: low adversity with moderate childhood physical threat, high deprivation with childhood threat, maternal substance use with adolescent threat, and high general adversity. Individuals in the low-adversity class reported less delinquency than average, whereas those in the high-adversity class reported more. Cumulative scores were also positively associated with delinquency, with adolescent cumulative adversity showing the stronger effects.

Conclusions: Deprivation-related adversities in childhood and threat-related adversities in adolescence were particularly influential. Individuals exposed to high cumulative adolescent adversity or chronic multi-domain adversities were most vulnerable. Each operationalization provided distinct insights, underscoring the importance of how adversity is conceptualized.