Survivors Of Child Maltreatment Research Articles

Closure for Survivors of Abusive Relationships

This article presents a five-step clinical approach that describes a process for child sexual abuse survivors, who are now adults, to initiate a statement with their abuser, whereby the survivor can explain the abuse and its impact on their lives. This method may also have applicability for survivors of general child maltreatment. The timing of this intervention needs to be carefully assessed in a partnership between the survivor and clinician. Clinicians might consider this approach if they are conducting long-term psychotherapy with adult survivors of child maltreatment and child sexual abuse, in particular. In addition to delineating steps to be taken, the authors suggest a measurement path. This closure process provides a unique and unduplicated opportunity for personal and professional growth.

Admissions for psychosis following agency-notified child maltreatment at 40-year-follow-up: Results from the Childhood Adversity and Lifetime Morbidity (CALM) cohort

There is substantial evidence of an association between self-reported child maltreatment (CM) and subsequent psychosis in retrospective data. Such findings may be affected by recall bias. Prospective studies of notifications to statutory agencies address recall bias but are less common and subject to attrition bias. These studies may therefore be underpowered to detect significant associations for some CM types such as sexual abuse. This study therefore linked administrative health data to a large birth cohort that included notifications to child protection agencies. We assessed psychiatric outcomes of CM as measured by inpatient admissions for non-affective psychoses (ICD10 codes F20-F29) to both public and private hospitals in Brisbane, Australia. Follow-up was up to 40 years old. There were 6087 cohort participants whose data could be linked to the administrative health data. Of these, 10.1 % had been the subject of a CM notification. Seventy-two participants (1.2 %) had been admitted for non-affective psychosis by 40-year follow-up. On adjusted analysis, all notified and substantiated types of CM were associated with admissions for non-affective psychosis. This included neglect, physical, sexual or emotional abuse, as well as notifications for multiple CM types. For instance, there was a 2.72-fold increase in admissions following any agency notification (95 % CI = 1.53–4.85). All maltreatment types therefore show a significant association with subsequent admissions for psychosis up to the age of 40. Screening for CM in individuals who present with psychosis is, therefore, indicated, as well as greater awareness that survivors of CM may be at higher risk of developing psychotic symptoms.

Expert survey: safer research with parent survivors of child maltreatment

ABSTRACT Intergenerational trauma research typically focuses on parent survivors. No specific guidelines are available for conducting research with parent survivors despite potentially unique risks. To investigate research safety with parent survivors, we conducted an online survey of 38 researchers regarding experiences of parent survivors in their research, precautions taken, ethical review experiences, and researchers’ mental health during the project(s). Most researchers felt that parent survivors are a unique population that require extra support. However, the response rate was low. Findings show the need for specific research guidelines informed by parent survivors’ lived experiences, and to support researchers against vicarious traumatic stress.

Characteristics of health and well-being in former Jehovah’s Witnesses in Austria, Germany, and Switzerland

ABSTRACT Background: This study collected quantifiable data on the characteristics, health, and well-being of individuals who left or were expelled from a fundamentalist Christian faith community in Austria, Germany, or Switzerland. Methods: Data were collected using an online survey. Results: This study assessed a sample of former Jehovah’s Witnesses (N = 424, M age = 42.14, SD age = 12.57, 65% female). Most participants (66%) were born into this faith community. Half the sample left voluntarily, 21% were expelled, and 31% left due to having experienced abuse or maltreatment. One third reported suicidal thoughts; 10% had attempted suicide. The sample (especially women) reported relatively high levels of child maltreatment, moderate current health, clinically significant symptoms, high levels of stress, and low quality of life. Participants who left due to abuse or maltreatment reported more symptoms and child maltreatment. Discussion: Women and survivors of child maltreatment may represent particularly vulnerable sub-groups of former Jehovah’s Witnesses.

Differential Pathways from Child Maltreatment Types to Insecure Adult Attachment Styles via Psychological and Social Resources: A Bayesian Network Analysis.

Child maltreatment has been linked to insecure adult attachment. However, it is not yet clear how different child maltreatment types are associated with attachment-related anxiety and avoidance in adulthood; and whether resilience against these insecure attachment styles is dependent on risk-specific resources. Therefore, this study explored differential pathways from child maltreatment types to attachment-related anxiety and avoidance in adulthood and examined whether psychological resources (self-esteem) and social resources (perceived social support) show risk-specific effects. An online survey retrospectively assessed experiences of child maltreatment, the level of attachment-related anxiety and avoidance in adulthood, self-esteem, and perceived social support in N = 604 former members of fundamentalist Christian faith communities (mean age = 41.27 years, SD = 12.50; 65.90% female). Cross-sectional data was analyzed using Bayesian network analysis. Only emotional child maltreatment showed direct relationships to insecure adult attachment. Specifically, emotional abuse and emotional neglect were associated with anxious and avoidant adult attachment, respectively. The effects of other child abuse types on adult attachment were mediated through emotional abuse, which indicated patterns of complex traumatization. Self-esteem mediated the effect of emotional abuse on anxious attachment, while perceived social support mediated the effect of emotional neglect on avoidant attachment. Social support was also linked to self-esteem and was therefore also important for individuals with experiences of emotional abuse. This study showed that child maltreatment types and their interactions are meaningfully linked to attachment-related anxiety and avoidance in adulthood. Interventions for survivors of child maltreatment should focus on risk-specific resources to support their resilience.

Mentorship in adolescence and subsequent depression and adiposity among child maltreatment survivors in a United States nationally representative sample

Child maltreatment (CM) is associated with multiple adverse health outcomes. Hence, there is a great need to identify factors that promote resilience in CM survivors. Mentorship may promote positive coping in CM survivors, but this may vary by health outcome and mentor/mentee characteristics. Among participants in a United States nationally representative sample, the National Longitudinal Study of Adolescent to Adult Health, who retrospectively reported any CM before age 18 (sexual, emotional or physical, abuse or neglect; N = 3364), we examined associations between mentorship during adolescence and body mass index (BMI), obesity, and depressive symptoms at ages 24–32 (in 2008–2009). We utilized linear regression and predictive margins with complex sample weighting. Models were stratified by sex and race/ethnicity. Thirty-one percent and 40% of participants' most influential mentor was inside and outside the family, respectively, and 29% reported no mentor. Any mentorship was associated with decreased depressive symptoms in females (adjusted beta for any mentor = −0.78, 95% CI:-1.54,-0.02). By contrast, any mentorship was associated with increased adiposity, namely among Latinas (adjusted beta for BMI = 2.23, 95% CI:0.45,4.02, adjusted risk ratio for obesity = 1.42, 95% CI:1.03,1.97). The influence of mentorship in CM survivors is heterogeneous. While mentorship was associated with reduced psychopathology, it was also linked with worse physical health, underscoring that mentoring does not necessarily promote long-term resilience to physical health outcomes, particularly in minorities. A better understanding of how mentors influence specific mentee behaviors may be important in informing how mentors can promote better physical health and lower obesity risk among CM survivors.

Child and family-focused interventions for child maltreatment and domestic abuse: development of core outcome sets

BackgroundThe current evidence for child maltreatment (CM) and domestic violence and abuse (DVA) interventions is limited by the diversity of outcomes evaluated and the variety of measures used. The result...

Examining the Mental Health Needs of Post-secondary Students with Child-maltreatment Histories Seeking Campus Counseling Services

ABSTRACT Our study sought to provide a more nuanced understanding of the significant issues experienced by young adult survivors of child-maltreatment (CM) prior to seeking counseling services. More specifically, we examined differences between survivors of CM and participants with no CM histories related to non-suicidal self-injury (NSSI), suicidal ideation, and suicide attempt, and scores on the Counseling Center Assessment of Psychological Symptoms (CCAPS). In our sample of N = 2604 post-secondary students seeking counseling services, CM histories were significantly associated with higher frequencies of NSSI, suicidal ideation, and suicide attempt. Further, results indicated that survivors of CM reported significantly higher mean scores on all CCAPS subscales and were more likely to report scores that were considered “elevated” when compared to peers with no reported CM history. Implications for college counseling centers and college mental health providers are discussed.

The role of maternal child maltreatment history and unsupportive emotion socialization in the intergenerational transmission of emotion regulation difficulties

BackgroundMaternal mental health problems and poor parenting are thought to account for the intergenerational transmission of poor outcomes to offspring of mothers who have experienced child maltreatment. ObjectiveGiven that emotion regulation (ER) difficulties have been linked to adult psychopathology and maladaptive parenting, the goal of the present study was to examine the mechanisms through which a maternal history of child maltreatment, and subsequent difficulties with ER, might contribute to unsupportive emotion socialization and the intergenerational transmission of ER difficulties. Participants and settingMothers and their young adult children (aged 18–25) were recruited from across Canada to participate in an online study (N = 185 dyads). MethodsMothers responded to questionnaires assessing their child maltreatment histories and ER difficulties. Young adults retrospectively reported on their mothers' emotion socialization behaviours in adolescence as well as their own difficulties with ER. ResultsA moderated mediation analysis revealed that mothers who endorsed more types of child maltreatment were described as using more unsupportive contingencies, but only in the context of high levels of maternal ER difficulties. The indirect effect of maternal child maltreatment on young adults' ER difficulties was only significant for mothers with high levels of ER difficulties. More specifically, maternal difficulties with impulse control and emotional clarity contributed to more unsupportive contingencies. ConclusionsMothers who have experienced multiple forms of child maltreatment may be more likely to struggle with ER and engage in unsupportive emotion socialization behaviours, which may increase the risk of emotional difficulties in their children. Survivors of child maltreatment should have access to interventions that promote ER skills to improve their own well-being and to prevent the transmission of ER difficulties to future generations.

Abstract MP44: Adolescent Team Sports Participation, Adiposity, And Inflammation Among Young Adult Child Maltreatment Survivors

Background: A body of literature shows that child maltreatment (CM) is associated with subsequent adiposity and inflammation, but few studies examine factors that buffer against these outcomes among survivors of CM. Child and adolescent team sports participation has been associated with positive mental and physical health outcomes, including decreased risk of obesity. However, it is unclear if these benefits extend to longer-term cardiometabolic outcomes in maltreated individuals, given that CM survivors often have impaired stress coping and may use obesogenic behaviors as a coping mechanism. The goal of this study was to assess, within a nationally representative sample of CM survivors, if sports team participation during adolescence is associated with decreased adiposity and inflammation in young adulthood. Methods: The analytic sample consisted of individuals who retrospectively self-reported CM (sexual, emotional, and physical abuse and neglect) in the National Longitudinal Study of Adolescent to Adult Health (N=3,298). We examined associations between intended team sports participation in grades 7-12 and BMI (kg/m2), waist circumference (cm), log transformed high-sensitivity C-reactive protein (hsCRP; mg/L), obesity (>30 kg/m2), high waist circumference (>88.9 cm for women, >101.6 cm for men), and elevated hsCRP (>3 mg/L) at ages 24-32 using linear regression and predictive margins. Models adjusted for age, sex, race/ethnicity, childhood household education, if raised by both biological parents, school type and size, subclinical infectious disease symptoms (hsCRP only), and BMI during adolescence. All analyses incorporated complex sample weighting. Results: 57% (1883/3298) of the sample reported plans to participate in sports teams during the school year as adolescents. The mean young adult BMI, waist circumference, and hsCRP values were 29.35 kg/m2 (SD=0.21), 98.64 cm (SD=0.50), and 4.73 mg/L (SD=0.17), respectively. In the overall sample, adolescent sports participation was inversely associated with waist circumference (B=-1.73,95% CI:-0.13, -2.13), log hsCPR (B=-0.25,95% CI:-0.13,-4.01), and elevated hsCRP (PR= 0.82,95% CI:0.74,0.92). When examining specific sports, the protective impact was especially pronounced among women who participated in track (BMI B=-2.37, 95% CI,-1.62,-3.13; waist circumference B=-5.11,95% CI:-3.14,-7.08; log hsCRP B=-.52,95% CI:-0.30,-0.74). Conclusions: There is evidence that team sports participation is associated with decreased adiposity and inflammation in men and women with histories of CM. Although intervention studies are needed to establish a causal relationship, these findings suggest that team sports participation during adolescence may help promote cardiometabolic health in survivors of CM.

A comparison of psychosis-like symptoms following self-reported and agency-notified child abuse in a population-based birth cohort at 30-year-follow-up

There is a strong association between self-reported child abuse and subsequent psychosis in retrospective data. Prospective studies of reports to statutory agencies are less common with limited information on people in their 30s. There have also been no comparisons of the influence of self- and agency-reported abuse on psychosis in adulthood. We therefore compared the prevalence of delusions and hallucinations in 30-year-olds who had experienced either self- or agency-reported childhood maltreatment with that in the remainder of a birth cohort. There were 2427 participants with data on psychosis and child abuse at 30-year follow-up. Information on self-reported abuse came from the Child Trauma Questionnaire (CTQ) and was linked to notifications of child maltreatment reported to statutory agencies. We measured psychotic-like experiences using the Peter's Delusions Inventory (PDI) and screening questions from the Composite International Diagnostic Interview. The prevalence of self- and agency-reported maltreatment was 599 (24.7%) and 141 (5.8%) respectively. At 30-year follow-up, 556 participants had PDI scores in the top two deciles, while 232 had experienced visual hallucinations and 134 auditory phenomena. On adjusted analyses, self-reported maltreatment, apart from sexual abuse, showed a strong association with all three outcomes. Associations were less strong for agency-notified child maltreatment and largely restricted to physical and emotional abuse. These findings suggest that people presenting with psychosis should be screened for child maltreatment, particularly physical and emotional abuse, as well as the possibility of psychosis considered in survivors of child maltreatment.

Associations Between Mentorship and Depressive Symptoms/Adiposity Among Child Maltreatment Survivors

Associations Between Mentorship and Depressive Symptoms/Adiposity Among Child Maltreatment Survivors

Pathways from Childhood Maltreatment to Unsupportive Emotion Socialization: Implications for Children’s Emotional Inhibition

Adults who have experienced child maltreatment report problems with emotion regulation (ER) and parenting difficulties, which have been associated with maladaptation in the next generation. However, parental emotion socialization is understudied in survivors of child maltreatment. The aim of the present study was to examine whether childhood polyvictimization would influence parental ER skills and parents’ use of unsupportive contingencies in response to anger, sadness, and anxiety. A secondary aim was to determine whether these variables would predict children’s emotional inhibition. Parents (n = 175) of children between the ages of 8 and 12 participated in an online study. Participants completed self-report measures assessing their child maltreatment history; their regulation and socialization of anger, sadness, and anxiety; and a measure of their child’s emotional inhibition. A sequential mediation model revealed that childhood polyvictimization predicted lower levels of parental ER skills, which in turn, increased the likelihood of parents reporting unsupportive contingencies. Further, parents’ use of unsupportive contingencies predicted higher levels of emotional inhibition in children. The present study provides preliminary evidence to support the relationship between a history of child maltreatment, parents’ use of unsupportive contingencies, and emotional inhibition in the next generation. Practitioners working with parents who have been maltreated should focus on enhancing parental ER in order to help parents scaffold healthy emotional development in their children.

History of child maltreatment and excessive dietary and screen time behaviors in young adults: Results from a nationally representative study

Child maltreatment is common and has been associated with substance use addictions, yet few studies have examined associations with potentially addictive dietary and screen time behaviors. The goal of this study was to assess associations between retrospectively self-reported child maltreatment (sexual abuse, physical abuse, emotional abuse, and neglect) and excessive self-reported dietary (sugar sweetened beverage and fast food consumption) and screen time behaviors (television/video watching and leisure time computer use) in early adulthood, overall and by sex and race/ethnicity. Associations were examined using data from 10,813 participants 24–32 years old from the National Longitudinal Study of Adolescent to Adult Health. We used predicted marginal proportions accounting for the complex sample design to obtain prevalence ratios (PRs) and adjusted for demographic characteristics and physical activity. In females, exposure to poly-maltreatment (2+ types of child maltreatment) was associated with excessive sugar sweetened beverage consumption, television/video watching, and leisure time computer use; in males, exposure to poly-maltreatment was associated with excessive sugar sweetened beverage consumption, television/video watching, and fast food consumption. Some associations were particularly strong in racial/ethnic minorities, especially Latina females (poly-maltreatment-sugar sweetened beverage association: aPR = 6.14, 95% CI:2.12, 17.75; poly-maltreatment-computer use association: aPR = 3.08, 95% CI:1.44, 6.58). These findings show that child maltreatment is associated with excessive dietary and screen time behaviors into adulthood, and these associations are present in racial/ethnic groups at high risk of cardiometabolic disease. Extension of an addiction paradigm to include dietary and screen time behaviors may inform health risks and disease prevention efforts in child maltreatment survivors.

Self-compassion and Fear of Self-compassion: Mechanisms Underlying the Link between Child Maltreatment Severity and Psychological Distress in College Women

Women are at increased risk for depression and anxiety associated with child maltreatment, given higher rates of exposure to childhood maltreatment and a greater sensitivity resulting in maltreatment-related distress. Thus, there is a need to identify mechanisms of resilience among female survivors of child maltreatment. Self-compassion may promote resilience, whereas fear of self-compassion may diminish this protective effect. Moreover, distinct facets of self-compassion (e.g., self-kindness) versus self-coldness (e.g., self-judgment) may differentially explain risk or resilience for child maltreatment outcomes. College women (N = 586) completed anonymous online surveys assessing the severity of different types of child maltreatment, self-compassion, fear of self-compassion, depression, anxiety, and stress. Severity of sexual, physical, and emotional abuse, and emotional and physical neglect, was positively associated with elevated fear of self-compassion and the absence of self-compassion (i.e., self-coldness). In contrast, emotional abuse and neglect severity were the only maltreatment variables negatively associated with self-compassion. Models indicated an indirect relation between increased maltreatment severity and heightened psychological distress via fear of self-compassion and self-coldness (i.e., isolation, overidentification). Statistical patterns indicative of suppression among the positive facets of self-compassion occurred. The centrality of emotional maltreatment, along with fear of self-compassion, isolation, and overidentification, emerged across analyses. Findings suggest the absence of self-compassion (i.e., self-coldness) is associated with specific forms of distress. Additional research with child maltreatment survivors should examine self-compassion components rather than a unidimensional construct.

Varying Cognitive Scars - Differential Associations Between Types of Childhood Maltreatment and Facial Emotion Processing.

BackgroundDistorted cognitive processing has been found among survivors of child maltreatment. However, different types of abuse and neglect may bring about differences in emotion and attention processing. The present study aimed to detect differential associations between various types of childhood maltreatment and attentional biases in facial emotion processing.MethodsA non-clinical sample was recruited on University campus and consisted of 67 individuals with varying degrees of maltreatment. In an evaluative conditioning task, images of faces with neutral emotional expressions were either associated with short videos of intense negative statements, or associated with neutral videos. Subsequently, these faces were used as stimuli in a face in the crowd recognition task in which the familiar faces had to be recognized within a crowd of unfamiliar neutral faces.ResultsIn multiple linear regression analyses controlling for the intercorrelatedness of types of maltreatment, differential relationships between types of maltreatment and attentional bias were found. While emotional abuse was associated with faster detection of negatively associated faces, emotional neglect was associated with an impaired recognition of familiar stimuli regardless of the emotional content.ConclusionResults indicated that interindividual differences in cognitive biases may be due to the activation of diverse cognitive schemas based on differential experiences of maltreatment.

Long term Effects on Adult Survivors of Child Maltreatment

Long term Effects on Adult Survivors of Child Maltreatment

The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

ABSTRACTAlthough the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.

Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi?

BackgroundThe Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as ‘Chikwanekwanes’ - ‘everything under one roof’) to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country’s first Chikwanekwane in the large, urban city of Blantyre.MethodsOne hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services.ResultsAll 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Conclusions: Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.

Religiosity and interpersonal problems explain individual differences in self esteem among young adults with child maltreatment experiences

Child maltreatment can have a lasting impact, which is why it is important to understand factors that may exacerbate or mitigate self-esteem difficulties in adulthood. Although there is tremendous benefit that can come from religion and spirituality, few studies examine religious views after child maltreatment. Subsequent interpersonal difficulties may also affect self-esteem in maltreatment survivors. This study sought to examine interpersonal problems and religiosity as mediators in the link between childhood maltreatment and self-esteem in adulthood. The study recruited 718 women (M = 19.53 years) from a large public university. Participants completed questionnaires related to child abuse and neglect, interpersonal problems, religiosity, and self-esteem. Results demonstrated that all forms of maltreatment were associated with negative views of God and with more interpersonal difficulties. Viewing God as a punishing figure mediated the relationship between childhood emotional abuse and low adult self-esteem, along with several areas associated with interpersonal problems. Further, for both child emotional neglect and physical abuse, viewing God as less supportive mediated the relationship between child maltreatment and low adult self-esteem. The results may help in intervention for child maltreatment survivors by increasing awareness of the importance of religiosity in treatment to self-esteem issues in both childhood and adulthood.