Little is known about the associations between various types of childhood maltreatment and multiple forms of intimate partner violence victimization in early adulthood. This study examines the extent ...to which childhood experiences of maltreatment increase the risk for intimate partner violence victimization in early adulthood. Data for the present study are from 3322 young adults (55 % female) of the Mater Hospital-University of Queensland Study of Pregnancy with the mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first antenatal clinic visit at Brisbane’s Mater Hospital from 1981 through to 1983. Participants completed the Composite Abuse Scale at 21-year follow-up and linked this dataset to agency recorded substantiated cases of childhood maltreatment. In adjusted models, the odds of reporting emotional intimate partner violence victimization were 1.84, 2.64 and 3.19 times higher in physically abused, neglected and emotionally abused children, respectively. Similarly, the odds of physical intimate partner violence victimization were 1.76, 2.31, 2.74 and 2.76 times higher in those children who had experienced physical abuse, sexual abuse, neglect and emotional abuse, respectively. Harassment was 1.63 times higher in emotionally abused children. The odds of severe combined abuse were 3.97 and 4.62 times greater for emotionally abused and neglected children, respectively. The strongest associations involved reports of child emotional abuse and neglect and multiple forms of intimate partner violence victimization in young adulthood. Childhood maltreatment is a chronic adversity that is associated with specific and multiple forms of intimate partner violence victimization in adulthood.
Adverse childhood experiences (ACEs) increase the risk of mental health difficulties in general, but the link to panic disorder (PD) has received comparatively little attention. There are no data for ...the magnitudes between ACEs and PD. This systematic review and meta-analysis estimated the overall, as well as the subgroups, odds ratio of having PD in adults who report ACEs, compared to adults who do not.
The study was pre-registered on PROSPERO CRD42018111506 and the database was searched in June 2021. In order to overcome the violation of independent assumptions due to multiple estimations from the same samples, we utilized a robust variance estimation model that supports meta-analysis for clustered estimations. Accordingly, an advanced method relaxing the distributional and asymptotic assumptions was used to assess publication bias and sensitivity.
The literature search and screening returned 34 final studies, comprising 192,182 participants. Ninety-six estimations of 20 types of ACEs were extracted. Pooled ORs are: overall 2.2, CI (1.82-2.58), sexual abuse 1.92, CI (1.37-2.46), physical abuse 1.71, CI (1.37-2.05), emotional abuse 1.61, CI (0.868-2.35), emotional neglect 1.53, CI (0.756-2.31), parental alcoholism 1.83, CI (1.24-2.43), and parental separation/loss 1.82, CI (1.14-2.50). No between-group difference was identified by either sociolegal classification (abuse, neglect, household dysfunction) or threat-deprivation dimensions (high on threat, high on deprivation and mixed).
There are links of mild to medium strength between overall ACEs and PD as well as individual ACEs. The homogeneous effect sizes across ACEs either suggest the effects of ACEs on PD are comparable, or raised the question whether the categorical or dimensional approaches to classifying ACEs are the definitive ways to conceptualize the impact of ACEs on later mental health.
Physical, sexual and psychological abuse were examined as risk factors for pregnancy-related anxiety with resilience and social support as mediators. Pregnant women (n = 638) completed measures of ...pregnancy-related anxiety, resilience, perceived social support and childhood abuse. Women with an abuse history had higher pregnancy-related anxiety scores (m = 64.40) than other women (m = 55.36). All abuse types independently predicted pregnancy-related anxiety; resilience and social support were mediators. Results highlight the value of antenatal screening for pregnancy-related anxiety including specific risk factors such as child abuse. Programs such as the Midwife Continuity of Care are useful in encouraging disclosure.
Child sexual abuse (CSA) is associated with a range of negative consequences for victims that are compounded when it recurs. We used the National Child Abuse and Neglect Data System to study a cohort ...of 42,036 children in 45 U.S. states with sexual abuse reports first confirmed by child protective services (CPS) during 2010 in order to identify children with increased risk for recurrence. A small proportion (3.6%) had a second confirmed sexual abuse report through 2015. In multivariate models, female gender, family hearing and vision problems, other child maltreatment, and other family violence were associated with increased risk of recurrence, while younger children, Hispanic families, and those with substance abuse tended to have less risk. One fourth of recurrence involved the same offender, usually a parent or caretaker. One fourth of cases were referred for any CPS services, which were more likely to be provided for families with poverty, drug or alcohol problems, or other violence. Only substance abuse services significantly reduced recurrence in multivariable models. Those trying to reduce CSA recurrence should recognize that certain case characteristics are associated with greater recurrence, and most CPS services do not significantly reduce CSA recurrence.
Objective: The opioid crisis has had devastating effects on individuals and communities, and it has rapidly increased in severity. However, we still lack nationally representative information on the ...diversity of comorbidity patterns among prescription opioid use disorder (P-OUD), other substance use disorders (SUDs), and psychopathology using the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). This impedes planning for multiple aspects of intervention, including society-wide allocation of treatment resources, program design at individual treatment centers, and personalized care to individual patients. Method: To address this critical gap in information, we evaluated clinical profiles of American adults via latent class analysis in a large, recently collected epidemiological dataset that uses structured diagnostic assessment for DSM-5 psychopathology (National Epidemiologic Survey on Alcohol and Related Conditions-III; N = 36,309). Variables considered for profiles included lifetime diagnosis for multiple SUDs, various externalizing and internalizing conditions, and demographic variables. We then associated clinical profiles with demographic variables and functional impairment. Results: Comorbid psychopathology and other SUDs were common in latent classes with elevated and very high rates of P-OUD. To illustrate, alcohol use disorder rates were greater than 45%, and posttraumatic stress disorder rates were greater than 28% in classes with higher P-OUD rates. Higher P-OUD rates were associated with White/non-Hispanic and American Indian/Alaska Native populations. Relationships between P-OUD rates and functional impairment were inconsistent. Conclusion: Many current treatment delivery systems are not designed to accommodate the heterogeneous profiles associated with high P-OUD rates. We provide specific suggestions for improvements to the mental health service system, individual clinical care programs, and future research approaches.
What is the public health significance of this article?
A number of distinct clinical profiles are associated with elevated rates of prescription opioid use disorder. We highlight specific profiles that can include other substance use disorders, depression, anxiety, posttraumatic stress disorder, and externalizing conditions. These profiles can be used to guide public policy, resource allocation, and the design of personalized care strategies for patients in need.
Psychological or emotional maltreatment of children may be the most challenging and prevalent form of child abuse and neglect. Caregiver behaviors include acts of omission (ignoring need for social ...interactions) or commission (spurning, terrorizing); may be verbal or nonverbal, active or passive, and with or without intent to harm; and negatively affect the child's cognitive, social, emotional, and/or physical development. Psychological maltreatment has been linked with disorders of attachment, developmental and educational problems, socialization problems, disruptive behavior, and later psychopathology. Although no evidence-based interventions that can prevent psychological maltreatment have been identified to date, it is possible that interventions shown to be effective in reducing overall types of child maltreatment, such as the Nurse Family Partnership, may have a role to play. Furthermore, prevention before occurrence will require both the use of universal interventions aimed at promoting the type of parenting that is now recognized to be necessary for optimal child development, alongside the use of targeted interventions directed at improving parental sensitivity to a child's cues during infancy and later parent-child interactions. Intervention should, first and foremost, focus on a thorough assessment and ensuring the child's safety. Potentially effective treatments include cognitive behavioral parenting programs and other psychotherapeutic interventions. The high prevalence of psychological abuse in advanced Western societies, along with the serious consequences, point to the importance of effective management. Pediatricians should be alert to the occurrence of psychological maltreatment and identify ways to support families who have risk indicators for, or evidence of, this problem.
•The majority of cocaine users consume alcohol concurrently or simultaneously.•Concurrent cannabis use in cocaine users is estimated at 64%.•Alcohol or cannabis intake with cocaine enhances ...subjective responses to cocaine.•Research with human subjects consistently involves PSU; animal research does not.
Polysubstance use (PSU) is prevalent among individuals with substance use disorders, but the vast majority of preclinical substance use research has focused on individual substances in isolation. Cocaine has been prevalent in the repertoire of persons who use more than one illicit substance.
We conducted a meta-analysis combining results from literature searches and secondary data analyses to estimate the prevalence of simultaneous and concurrent cocaine + alcohol and cocaine + cannabis use among cocaine users. We next summarized the small body of literature on behavioral, cognitive and neurobiological consequences of cocaine PSU across species, with a focus on alcohol and cannabis. Finally, we used systematic literature searches to assess the extent to which human and animal studies on the neurobiological consequences of cocaine include PSU subjects.
The estimated prevalence of simultaneous and concurrent alcohol use among human cocaine users was 74% and 77%, respectively. The estimated prevalence of simultaneous and concurrent cannabis use among cocaine users was 38% and 64%, respectively. Consumption of alcohol or cannabis with cocaine enhances subjective responses to cocaine, concomitant with changes in cocaine metabolism that increase blood cocaine levels, and, in the case of alcohol, produce the psychoactive metabolite cocaethylene. There is also consistent evidence for neurobiological effects of cocaine + alcohol combinations. However, animal PSU research with cocaine lags behind human research.
Based on the prevalence and known consequences of PSU, consideration of PSU in both human and animal research is vital for understanding patterns of substance use.
Primary care providers need effective strategies for substance use screening and brief counseling of adolescents. We examined the effects of a new computer-facilitated screening and provider brief ...advice (cSBA) system.
We used a quasi-experimental, asynchronous study design in which each site served as its own control. From 2005 to 2008, 12- to 18-year-olds arriving for routine care at 9 medical offices in New England (n = 2096, 58% females) and 10 in Prague, Czech Republic (n = 589, 47% females) were recruited. Patients completed measurements only during the initial treatment-as-usual study phase. We then conducted 1-hour provider training, and initiated the cSBA phase. Before seeing the provider, all cSBA participants completed a computerized screen, and then viewed screening results, scientific information, and true-life stories illustrating substance use harms. Providers received screening results and "talking points" designed to prompt 2 to 3 minutes of brief advice. We examined alcohol and cannabis use, initiation, and cessation rates over the past 90 days at 3-month follow-up, and over the past 12 months at 12-month follow-up.
Compared with treatment as usual, cSBA patients reported less alcohol use at follow-up in New England (3-month rates 15.5% vs 22.9%, adjusted relative risk ratio aRRR = 0.54, 95% confidence interval 0.38-0.77; 12-month rates 29.3% vs 37.5%, aRRR = 0.73, 0.57-0.92), and less cannabis use in Prague (3-month rates 5.5% vs 9.8%, aRRR = 0.37, 0.17-0.77; 12-month rates 17.0% vs 28.7%, aRRR = 0.47, 0.32-0.71).
Computer-facilitated screening and provider brief advice appears promising for reducing substance use among adolescent primary care patients.
Child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a ...unique position to identify and prevent child abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physical abuse of children. The role of the physician may include identifying abused children with suspicious injuries who present for care, reporting suspected abuse to the child protection agency for investigation, supporting families who are affected by child abuse, coordinating with other professionals and community agencies to provide immediate and long-term treatment to victimized children, providing court testimony when necessary, providing preventive care and anticipatory guidance in the office, and advocating for policies and programs that support families and protect vulnerable children.
The commercial sexual exploitation of children (CSEC) is a major global issue that affects over two million children each year (Polaris Project, 2014). Large metropolitan cities, such as Las Vegas, ...have high rates of child prostitution (Shared Hope International, 2009).
The purpose of the current study is to elucidate to what extent interpersonal relationships and contextual factors (e.g. abuse within the home, substance abuse, etc.) influence commercial sexual exploitation.
Participants for this study include 26 CSEC survivors located within the state of Nevada.
The current study utilizes a qualitative content analysis approach to analyze interview transcripts gathered from CSEC survivors. Three stages of analysis were conducted to assess the relationships that influenced the participants’ sexual exploitation, as well as the contextual factors shared by the participants.
Analyses indicated that three types of relationships led to commercial sexual exploitation: friends, family, and boyfriends. Of the three relationship typologies, friends were the most common (n = 14). As for contextual factors, it was common for participants to have been abused within their home (n = 15) or to have run away from home (n = 20).
The narratives provided in this study show that CSEC survivors do not often willingly engage in trading sex; rather this decision is influenced by a need to escape familial abuse or they are forced to trade sex by someone whom they share a relationship.
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