While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research ...commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.
To summarize the relationship between abuse during childhood and physical health outcomes in adulthood and to examine the role of potential moderators, such as the type of health outcome assessed, ...gender, age, and the type of abuse. Studies using self-report assessment methods were compared with studies using objective or independently verifiable methods.
The current study is a quantitative meta-analysis comparing results from 78 effect sizes across 24 studies including 48,801 individuals.
Experiencing child abuse was associated with an increased risk of negative physical health outcomes in adulthood (effect size d = 0.42, 95% Confidence Interval = 0.39-0.45). Neurological and musculoskeletal problems yielded the largest effect sizes, followed by respiratory problems, cardiovascular disease, gastrointestinal and metabolic disorders. Effect sizes were larger when the sample was exclusively female and when the abuse was assessed via self-report rather than objective, independently verifiable methods.
Child abuse is associated with an increased risk of poor physical health in adulthood. The magnitude of the risk is comparable to the association between child abuse and poor psychological outcomes. However, studies often fail to include a diverse group of participants, resulting in a limited ability to draw conclusions about the population of child abuse survivors as a whole. Important methodological improvements are also needed to better understand potential moderators.
Child abuse is a major public health problem. In order to establish the prevalence of abuse exposure among children, measures need to be age-appropriate, sensitive, reliable and valid. This study ...aimed to investigate the psychometric properties of the Adverse Childhood Experiences Questionnaire Abuse Short Form (ACE-ASF). The ACE-ASF is an 8-item, retrospective self-report questionnaire measuring lifetime physical, emotional and sexual abuse. Data from a nationally representative sample of 15-year-old, school-going adolescents (n=1733, 55.5% female) from the Romanian Health Behavior in School-Based Children Study 2014 (HBSC) were analyzed. The factorial structure of the ACE-ASF was tested with Exploratory Factor Analysis (EFA) and confirmed using Confirmatory Factor Analysis (CFA). Measurement invariance was examined across sex, and internal reliability and concurrent criterion validity were established. Violence exposure was high: 39.7% physical, 32.2% emotional and 13.1% sexual abuse. EFA established a two-factor structure: physical/emotional abuse and sexual abuse. CFA confirmed this model fitted the data well χ2(df)=60.526(19); RMSEA=0.036; CFI/TLI=0.990/0.986. Metric invariance was supported across sexes. Internal consistency was good (0.83) for the sexual abuse scale and poor (0.57) for the physical/emotional abuse scale. Concurrent criterion validity confirmed hypothesized relationships between childhood abuse and health-related quality of life, life satisfaction, self-perceived health, bullying victimization and perpetration, externalizing and internalizing behaviors, and multiple health complaints. Results support the ACE-ASF as a valid measure of physical, emotional and sexual abuse in school-aged adolescents. However, the ACE-ASF combines spanking with other types of physical abuse when this should be assessed separately instead. Future research is needed to replicate findings in different youth populations and across age groups.
Background and aims
Most studies of the association between child maltreatment and subsequent problem alcohol use are retrospective. We studied the association of prospectively substantiated child ...maltreatment with problem alcohol use in adulthood.
Design
We used a prospective cohort record linkage correlational design using data from a statutory child protection agency of prospectively substantiated child maltreatment linked to a birth cohort from a major metropolitan maternity hospital.
Setting
The Mater‐University of Queensland Study of Pregnancy in Brisbane, Australia.
Participants
Of the 3762 young people at the 21‐year follow‐up, 169 (4.5%) had a history of substantiated maltreatment by 16 years. This was most commonly emotional abuse (n = 90).
Measurements
The main outcome was heavy alcohol use at the 21‐year follow‐up, defined as four or more standard drinks per day. Secondary outcomes were life‐time and 12‐month diagnoses of alcohol use disorders in 2531 participants who completed the Composite International Diagnostic Interview‐auto (CIDI‐auto) version. Predictor variables were physical, sexual and emotional abuse, as well as neglect.
Findings
At follow‐up, 407 of the 3762 participants reported heavy alcohol use (10.8%). On adjusted analyses, participants who had experienced emotional abuse were significantly more likely to report heavy alcohol use at the time of interview (adjusted odds ratio = 1.856; 95% confidence interval = 1.038–3.319; P = 0.037). Neglect was associated with a life‐time CIDI diagnosis of an alcohol use disorder. Other types of child maltreatment were not significantly associated with any of the outcomes.
Conclusions
Prospectively identified experience of childhood emotional abuse and neglect appears to be positively associated with problem alcohol use at age 21.
To describe how child maltreatment chronicity is related to negative outcomes in later childhood and early adulthood.
The study included 5994 low-income children from St Louis, including 3521 with ...child maltreatment reports, who were followed from 1993-1994 through 2009. Children were 1.5 to 11 years of age at sampling. Data include administrative and treatment records indicating substance abuse, mental health treatment, brain injury, sexually transmitted disease, suicide attempts, and violent delinquency before age 18 and child maltreatment perpetration, mental health treatment, or substance abuse in adulthood. Multivariate analysis controlled for potential confounders.
Child maltreatment chronicity predicted negative childhood outcomes in a linear fashion (eg, percentage with at least 1 negative outcome: no maltreatment = 29.7%, 1 report = 39.5%, 4 reports = 67.1%). Suicide attempts before age 18 showed the largest proportionate increase with repeated maltreatment (no report versus 4+ reports = +625%, P < .0001). The dose-response relationship was reduced once controls for other adverse child outcomes were added in multivariate models of child maltreatment perpetration and mental health issues. The relationship between adult substance abuse and maltreatment report history disappeared after controlling for adverse child outcomes.
Child maltreatment chronicity as measured by official reports is a robust indicator of future negative outcomes across a range of systems, but this relationship may desist for certain adult outcomes once childhood adverse events are controlled. Although primary and secondary prevention remain important approaches, this study suggests that enhanced tertiary prevention may pay high dividends across a range of medical and behavioral domains.
Background: Substance abuse is one of the most common health outcomes associated with adverse childhood experience, and poses a significant public health threat. Objectives: The purpose of this study ...is to demonstrate a relationship between adverse childhood experience and a substance use disorder using nationally representative data as well as to test whether religion moderates this relationship. Methods: We conducted a secondary analysis using data from the National Longitudinal Study of Adolescent to Adult Health (n = 11,279). Three types of adverse childhood experiences were considered; physical, emotional, and sexual abuse. Logistic regression was used to determine whether risk for developing an alcohol use, cannabis use, or other drug use disorder in adulthood increased as exposure to multiple types of adverse childhood experiences increased while controlling for prior substance use and other demographic variables that have shown associations with substance use. In addition, religiosity was investigated as a possible moderator of the relationship between adverse childhood experience and substance abuse. Results: The likelihood of developing a substance use disorder later in life increased as the score on the adverse childhood experience index increased. While religiosity did significantly reduce the likelihood of developing a substance use disorder, no moderating effects were observed. Conclusions/importance: This study underscores the long-term consequences of exposure to childhood adversity.
Objective
The aim of this meta‐analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across ...case–control, epidemiological and prospective cohort studies.
Method
Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD were entered into three search engines. Random‐effects meta‐analysis synthesised the size and consistency of the effects.
Results
A total of 97 studies compared BPD to non‐clinical (k = 40) and clinical (k = 70) controls. Meta‐analysis of case–control studies indicated that individuals with BPD are 13.91 (95% CI 11.11–17.43) times more likely to report childhood adversity than non‐clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI 0.93–7.30) and epidemiological (OR: 2.56, 95% CI 1.24–5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99–55.88) and neglect (OR: 17.73, 95% CI = 13.01–24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62–3.79) times more likely to report childhood adversity than other psychiatric groups.
Conclusions
This meta‐analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD.
Abstract The aim of this study is to examine associations among childhood physical, emotional, or sexual abuse and violence toward self (suicide attempts SA) and others (interpersonal aggression IA). ...Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2 ( n = 34,653). Multinomial logistic regression examined associations between type of childhood abuse and violence categories, adjusting for demographic variables, other childhood adversity, and DSM-IV psychiatric disorders. The prevalence of reported childhood abuse was 4.60% for physical abuse, 7.83% for emotional abuse, and 10.20% for sexual abuse. Approximately 18% of adults reported some form of violent behavior, distributed as follows: IA, 13.37%; SA, 2.64%; and SA with IA, 1.85%. After adjusting for demographic variables, other childhood adversity, and psychiatric disorders, each type of childhood abuse was significantly related to increased risk for each violence category as compared with the no violence category. Furthermore, the odds ratio of childhood physical abuse was significantly higher for SA with IA when compared with IA, and the odds ratio of childhood sexual abuse was significantly higher for SA and SA with IA when compared with IA. Childhood physical, emotional, and sexual abuse is directly related to the risk for violent behaviors to self and others. Both internalizing and externalizing psychiatric disorders impact the association between childhood abuse and violence. The inclusion of suicidal behaviors and interpersonal aggression and internalizing/externalizing psychiatric disorders within an integrated conceptual framework will facilitate more effective interventions for long-lasting effects of child abuse.
Reassesses thirty years of domestic violence research and demonstrates three forms of partner violence, distinctive in their origins, effects, and treatments
Domestic violence, a serious and ...far-reaching social problem, has generated two key debates among researchers. The first debate is about gender and domestic violence. Some scholars argue that domestic violence is primarily male-perpetrated, others that women are as violent as men in intimate relationships. Johnson’s response to this debate—and the central theme of this book—is that there is more than one type of intimate partner violence. Some studies address the type of violence that is perpetrated primarily by men, while others are getting at the kind of violence that women areinvolved in as well. Because there has been no theoretical framework delineating types of domestic violence, researchers have easily misread one another’s studies.
The second major debate involves how many women are abused each year by their partners. Estimates range from two to six million. Johnson’s response once again comes from this book’s central theme. If there is more than one type of intimate partner violence, then the numbers depend on what type you’re talking about.
Johnson argues that domestic violence is not a unitary phenomenon. Instead, he delineates three major, dramatically different, forms of partner violence: intimate terrorism, violent resistance, and situational couple violence. He roots the conceptual distinctions among the forms of violence in an analysis of the role of power and control in relationship violence and shows that the failure to make these basic distinctions among types of partner violence has produced a research literature that is plagued by both overgeneralizations and ostensibly contradictory findings. This volume begins the work of theorizing forms of domestic violence, a crucial first step to a better understanding of these phenomena among scholars, social scientists, policy makers, and service providers.
Adverse childhood experiences (ACEs) are associated with several adulthood health problems, such as self-directed violence. For some individuals, enlistment in the military may be an instrumental act ...to escape adverse household environments; however, to our knowledge prevalence of ACEs among persons with a history of military service has not been documented in the United States using population-based data.
To compare the prevalence of ACEs among individuals with and without a history of military service.
Data are from the 2010 Behavioral Risk Factor Surveillance System. Computer-assisted telephone interviews were conducted with population-based samples of noninstitutionalized US adults from January 1 through December 31, 2010. Analyses were limited to respondents who received the ACE module (n = 60,598). Participants were categorized by history of military service and whether a respondent was 18 years of age in 1973.
History of military service was defined by active duty service, veteran status, or training for the Reserves or National Guard. The ACE inventory assessed 11 negative experiences before the age of 18 years. Weighted χ2 tests and multiple logistic regression analyses were used to examine differences in ACEs by history of military service, era of service, and sex.
Those with military experience had greater odds of any difference in prevalence of ACEs. In the all-volunteer era, men with military service had a higher prevalence of ACEs in all 11 categories than men without military service. Notably, in the all-volunteer era, men with military service had twice the odds of reporting forced sex before the age of 18 years (odds ratio, 2.19; 95% CI, 1.34-3.57) compared with men without military service. In the draft era, the only difference among men was household drug use, in which men with a history of military service had a significantly lower prevalence than men without a history of military service (2.1% vs. 3.3%; P = .003). Fewer differences were observed among women in the all-volunteer and draft eras.
Differences in ACEs by era and sex lend preliminary support that enlistment may serve as an escape from adversity for some individuals, at least among men. Further research is needed to understand how best to support service members and veterans who may have experienced ACEs.
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