Background: Child maltreatment has been associated with substance use later in life, but few studies have used repeated measures. Objective: To assess the association between child maltreatment and ...use of psychoactive substances from adolescence to early adulthood, and whether this differs by sex. Participants and setting: 3641 participants from the 1993 Pelotas Birth Cohort, Brazil. Methods: Child maltreatment (psychological, physical and sexual abuse, and physical neglect) was assessed up to age 15 and use of psychoactive substances (smoking, harmful use of alcohol and use of illicit drugs) was assessed at ages 15, 18, and 22 years. Associations between child maltreatment and use of substances at each time point were analyzed using logistic regression, adjusted for confounders. Results: Overall, child maltreatment was associated with substance use, and the strength of the associations decreased over time. E.g., the association between psychological abuse and harmful use of alcohol was OR 2.17 (95%CI 1.80, 2.62; p-value < 0.001) at 15 years, OR 1.61 (95%CI 1.31, 1.97; p-value < 0.001) at 18 years, and OR1.55 (95%CI 1.22, 1.96; p-value < 0.001) at 22 years. When sex differences were evident, stronger associations were observed among females. E.g., the association between physical abuse and smoking at 15 years was OR 3.49 (95%CI 2.17, 5.62) in females and OR 0.87 (95%CI 0.30, 2.52) in males (p-value for sex interaction = 0.041). Conclusions: Child maltreatment was associated with psychoactive substance in adolescence and early adulthood. Strategies to prevent use of substances could benefit those who suffered maltreatment in childhood.
Child maltreatment through physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, causes substantial adverse health, educational and behavioural consequences ...through the lifespan. The generation of reliable data on the prevalence and characteristics of child maltreatment in nationwide populations is essential to plan and evaluate public health interventions to reduce maltreatment. Measurement of child maltreatment must overcome numerous methodological challenges. Little is known to date about the extent, nature and methodological quality of these national studies. This study aimed to systematically review the most comprehensive national studies of the prevalence of child maltreatment, and critically appraise their methodologies to help inform the design of future studies.
Guided by PRISMA and following a published protocol, we searched 22 databases from inception to 31 May 2019 to identify nationwide studies of the prevalence of either all five or at least four forms of child maltreatment. We conducted a formal quality assessment and critical analysis of study design.
This review identified 30 national prevalence studies of all five or at least four forms of child maltreatment, in 22 countries. While sound approaches are available for different settings, methodologies varied widely in nature and robustness. Some instruments are more reliable and obtain more detailed and useful information about the characteristics of the maltreatment, including its nature, frequency, and the relationship between the child and the person who inflicted the maltreatment. Almost all studies had limitations, especially in the level of detail captured about maltreatment, and the adequacy of constructs of maltreatment types.
Countries must invest in rigorous national studies of the prevalence of child maltreatment. Studies should use a sound instrument containing appropriate maltreatment constructs, and obtain nuanced information about its nature.
In the 1960s, as illegal drug use grew from a fringe issue to a pervasive public concern, a new industry arose to treat the addiction epidemic. Over the next five decades, the industry's leaders ...promised to rehabilitate the casualties of the drug culture even as incarceration rates for drug-related offenses climbed. In this history of addiction treatment, Claire D. Clark traces the political shift from the radical communitarianism of the 1960s to the conservatism of the Reagan era, uncovering the forgotten origins of today's recovery movement.Based on extensive interviews with drug-rehabilitation professionals and archival research,The Recovery Revolutionlocates the history of treatment activists' influence on the development of American drug policy. Synanon, a controversial drug-treatment program launched in California in 1958, emphasized a community-based approach to rehabilitation. Its associates helped develop the therapeutic community (TC) model, which encouraged peer confrontation as a path to recovery. As TC treatment pioneers made mutual aid profitable, the model attracted powerful supporters and spread rapidly throughout the country. The TC approach was supported as part of the Nixon administration's "law-and-order" policies, favored in the Reagan administration's antidrug campaigns, and remained relevant amid the turbulent drug policies of the late twentieth and early twenty-first centuries. While many contemporary critics characterize American drug policy as simply the expression of moralizing conservatism or a mask for racial oppression, Clark recounts the complicated legacy of the "ex-addict" activists who turned drug treatment into both a product and a political symbol that promoted the impossible dream of a drug-free America.
Abstract Background Few studies have examined the associations between childhood sexual abuse (CSA), co-occurrence with other types of maltreatment and adult mental health outcomes, specifically ...among males. The objectives of this study were to: 1) determine the prevalence of males who have experienced a) childhood maltreatment without CSA; b) CSA without other forms of childhood maltreatment; and c) CSA along with other forms of childhood maltreatment; and 2) determine the relationship between CSA among males and mood, anxiety, substance and personality disorders and suicide attempts. Methods Data were drawn from the 2004–2005 National Epidemiological Survey on Alcohol and Related Conditions (NESARC) and limited to males age 20 years old and older ( n = 14,564). Child maltreatment included harsh physical punishment, physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect and exposure to intimate partner violence (IPV). Results Emotional abuse, physical abuse, and exposure to IPV were the most common forms of maltreatment that co-occurred with CSA among males. A history of CSA only, and CSA co-occurring with other types of child maltreatment, resulted in higher odds for many mental disorders and suicide attempts compared to a history of child maltreatment without CSA. Conclusions Child maltreatment is associated with increased odds of mental disorders among males. Larger effects were noted for many mental disorders and suicide attempts for males who experienced CSA with or without other child maltreatment types compared to those who did not experience CSA. These results are important for understanding the significant long-term effects of CSA among males.
Despite the high prevalence, evidence-based treatments for abuse-related posttraumatic stress disorder (PTSD) in adolescents have rarely been studied.
To examine whether developmentally adapted ...cognitive processing therapy (D-CPT) is more effective than a wait-list condition with treatment advice (WL/TA) among adolescents with PTSD related to childhood abuse.
This rater-blinded, multicenter, randomized clinical trial (stratified by center) enrolled treatment-seeking adolescents and young adults (aged 14-21 years) with childhood abuse-related PTSD at 3 university outpatient clinics in Germany from July 2013 to June 2015, with the last follow-up interview conducted by May 2016. Of 194 patients, 88 were eligible for randomization.
Participants received D-CPT or WL/TA. Cognitive processing therapy was enhanced by a motivational and alliance-building phase, by including emotion regulation and consideration of typical developmental tasks, and by higher session frequency in the trauma-focused core CPT phase. In WL/TA, participants received treatment advice with respective recommendations of clinicians and were offered D-CPT after 7 months.
All outcomes were assessed before treatment (baseline), approximately 8 weeks after the start of treatment, after the end of treatment (posttreatment), and at the 3-month follow-up. The primary outcome, PTSD symptom severity, was assessed in clinical interview (Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV CAPS-CA). Secondary outcomes were self-reported PTSD severity, depression, borderline symptoms, behavior problems, and dissociation.
The 88 participants (75 85% female) had a mean age of 18.1 years (95% CI, 17.6-18.6 years). In the intention-to-treat analysis, the 44 participants receiving D-CPT (39 89% female) demonstrated greater improvement than the 44 WL/TA participants (36 82% female) in terms of PTSD severity (mean CAPS-CA scores, 24.7 95% CI, 16.6-32.7 vs 47.5 95% CI, 37.9-57.1; Hedges g = 0.90). This difference was maintained through the follow-up (mean CAPS-CA scores, 25.9 95% CI, 16.2-35.6 vs 47.3 95% CI, 37.8-56.8; Hedges g = 0.80). Treatment success was greatest during the trauma-focused core phase. The D-CPT participants also showed greater and stable improvement in all secondary outcomes, with between-groups effect sizes ranging from 0.65 to 1.08 at the posttreatment assessment (eg, for borderline symptoms, 14.1 95% CI, 8.0-20.2 vs 32.0 95% CI, 23.8-40.2; Hedges g = 0.91).
Adolescents and young adults with abuse-related PTSD benefited more from D-CPT than from WL/TA. Treatment success was stable at the follow-up and generalized to borderline symptoms and other comorbidities.
German Clinical Trials Register identifier: DRKS00004787.
Background: The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood ...has not previously been described. Methods: A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0–7) and risk factors for the leading causes of death in adult life. Results: More than half of respondents reported at least one, and one-fourth reported ≥2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. Conclusions: We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
Preventing Child Maltreatment: Multicultural Considerations in
the United States is the first book in a concentrated series
that examines child maltreatment across minoritized, cultural
groups. ...Specifically, this volume examines core multicultural
concepts (e.g., intersectionality, acculturation, spirituality,
oppression) as they relate to child maltreatment in the United
States, while the other books take a closer look at particular
ethnic or racial communities in this country. Additionally, this
book examines child maltreatment through the intersection of
feminist, multicultural, and prevention/wellness promotion lenses.
Recommendations for treatment in each book build on a foundation of
prevention and wellness promotion, along with multicultural and
feminist theories. Throughout this book, five case studies, which
are introduced in Chapter One, are revisited to help the readers
make important and meaningful connections between theory and
practice.
•Job loss increases risk for psychological and physical abuse during the pandemic.•Positive cognitive reframing mitigates risk of job loss on physical abuse.•Interventions targeting reframing may ...decrease risk for abuse during COVID-19.
Job loss resulting from the COVID-19 pandemic presents significant risk for child abuse. Protective factors, such as reframing coping, may mitigate the risk of job loss on child maltreatment.
The current study investigated factors associated with child maltreatment during the COVID-19 pandemic, including parental job loss, and whether cognitive reframing moderated associations between job loss and child maltreatment.
A community sample of 342 parents (62% mothers) of 4- to 10-year-olds (M = 7.38, SD = 2.01; 57.3% male) living in the United States completed online questionnaires regarding experiences with COVID-19, the Parent-Child Conflict Tactics Scale, and the Family Crisis Oriented Personal Evaluation Scales.
Two logistic regression analyses evaluated predictors of whether parents psychologically maltreated or physically abused their children during the pandemic controlling for maltreating history, parental depressive symptoms, financial stability, parent age, parent gender, child age, and child gender. Parents who lost their jobs (OR = 4.86, 95% CI 1.19, 19.91, p = .03), were more depressed (OR = 1.05, 95% CI 1.02, 1.08, p < .01), and previously psychologically maltreated their children (OR = 111.94, 95% CI 28.54, 439.01, p < .001) were more likely to psychologically maltreat during the pandemic. Regarding physical abuse, a significant interaction between job loss and reframing coping emerged (OR = 0.76, 95% CI 0.59, 0.99, p = .04). Among parents who lost their jobs, the probability of physical abuse decreased as reframing coping increased.
Job loss during the COVID-19 pandemic is a significant risk factor for child maltreatment. Reframing coping may be an important buffer of this association on physical abuse and presents implications for maltreatment prevention.
Ecologically valid typologies of adverse child experiences (ACEs) were identified to investigate the link between ACEs and adult incarceration. In a nationally representative sample (N = 34,653, age ...20+), latent class analysis (LCA) was conducted with childhood maltreatment (physical, sexual, and emotional abuse, interpersonal violence IPV exposure, physical neglect) and caregiver maladjustment (substance use, incarceration, mental illness, and suicidal behavior) indicators. LCA identified a 5-typology model (1. Low Adversity Risk; 2. Caregiver Substance Use, and Maltreatment Acts of Omission; 3. Physical and Emotional Maltreatment; 4. Severe Cross-Subtype Maltreatment and Caregiver Substance Use; and 5. Caregiver Maladjustment). Controlling for sociodemographics and substance use problems, logistic regression analyses determined that, compared with the Low Adversity Risk typology, all typologies (except Caregiver Maladjustment) had elevated incarceration risk (adjusted odds ratios: 1.76-4.18). Maltreatment experiences were more predictive of incarceration for women versus men. Childhood maltreatment confers risk for incarceration beyond established risk factors, but caregiver maladjustment, alone, does not. Preventative efforts should focus on understanding and targeting pathways to delinquency for individuals with childhood maltreatment.
The literature has been contradictory regarding whether parents who were abused as children have a greater tendency to abuse their own children. A prospective 30-year follow-up study interviewed ...individuals with documented histories of childhood abuse and neglect and matched comparisons and a subset of their children. The study assessed maltreatment based on child protective service (CPS) agency records and reports by parents, nonparents, and offspring. The extent of the intergenerational transmission of abuse and neglect depended in large part on the source of the information used. Individuals with histories of childhood abuse and neglect have higher rates of being reported to CPS for child maltreatment but do not self-report more physical and sexual abuse than matched comparisons. Offspring of parents with histories of childhood abuse and neglect are more likely to report sexual abuse and neglect and that CPS was concerned about them at some point in their lives. The strongest evidence for the intergenerational transmission of maltreatment indicates that offspring are at risk for childhood neglect and sexual abuse, but detection or surveillance bias may account for the greater likelihood of CPS reports.
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