Child Maltreatment Research Articles

The recognition and the initial reaction to children's signals after experiencing maltreatment during childhood

AbstractMaltreatment during childhood has many long‐lasting effects. Victims often become parents who experience parenting difficulties, therefore contributing to the intergenerational cycle of maltreatment. This paper highlights the consequences of severe trauma during childhood on two processes critical for a sensitive response, namely the recognition of and the initial reaction to emotional signals. We argue that most interventions focus on the observed parental response to children's behaviors or on parental interpretation of children's signals, that is, the attribution of meaning or intent to the signal. Interventions should better integrate research indicating that a history of childhood maltreatment could impair the capacity to correctly identify the emotion and the immediate reaction to these signals. By failing to acknowledge these long‐lasting consequences of childhood maltreatment, scholars and practitioners might never achieve true success in intervening with families in the hope of breaking the intergenerational cycle of maltreatment.

Examining the role of the parent-caseworker relationship in child maltreatment decision-making

ABSTRACT Child welfare (CW) professionals are charged with investigating reports of alleged child maltreatment and determining whether and what type of maltreatment has occurred. Multiple factors contribute to the difficulty of making maltreatment-related decisions. The Decision-Making Ecology (DME) as developed to capture the various factors – beyond child safety-related information – that influence CW decision-making, ranging from family-to community-level factors. This study examined how the relationship between CW-involved parents and child protective caseworkers affects maltreatment-related decision-making. We propose that this relationship independently influences CW decision-making processes and should be included in the DME framework. Finally, we make recommendations to CW agencies that would improve maltreatment decision-making processes.

Bibliometric Analysis of Studies on Child Abuse and Negligence

The aim of the research is to determine and analyze the research trends of studies on child abuse and neglect from a bibliometric perspective. The data of the study were obtained by using the SCOPUS database on 04.12.2022 without any year limitation. The research was searched using the keywords "child", "maltreatment", "abuse", "neglect", "violence" "physical abuse", "emotional abuse",. "sexual abuse", "physical neglect", "emotional neglect". As a result of the search, 97.703 studies were reached. 84.376 studies that were not related to the subject and included different disciplines were excluded. Within the scope of the study, 13.327 research articles covering psychology, social sciences and nursing disciplines were evaluated. VOSviewer, a mapping and visualization program, was used in the analysis of the data. It was determined that the most frequently used keywords related to the subject were “Child abuse” and “Child maltreatment”. It was determined that the countries, universities and journals with the highest number of publications were in Unites States (59.54%), and author collaborations were mostly made in the USA, England and Australia. However, it is predicted that the estimated number of studies will be 1407 in 2030. Bibliometric indicators show that studies on child abuse and neglect have increased considerably in recent years. In this context, distinguishing whether the factors causing the increase are related to increased awareness or abuse and neglect will guide the planning of protective preventive interventions.

An Ecological Exploration of Addressing Child Maltreatment

This commentary examines the cases of “Bashiir” and “Jaquann” (Singer, Deboard-Lucas, & Fuentes, 2024) through an ecological lens as it pertains to addressing child maltreatment. The authors of these case studies offered a robust case formulation that provided an enhanced understanding of culturally informed treatment in cases where child maltreatment was a factor. This commentary explores ways in which the authors skillfully illustrated the theoretical tenets that shaped the treatment interventions, and offers an examination of key elements for further consideration related to child maltreatment.

Addressing Child Maltreatment by Infusing Multicultural, Feminist Tenets to Standard Clinical Approaches: The Cases of “Bashiir” and “Jaquann”

Multicultural psychology emphasizes the role of social, cultural, and gender forces in creating an individual’s identity; the social and cultural world in which they live; and the psychological strengths that different cultures have to offer. In a complementary way, feminist psychology highlights the importance of collectivist alternatives to mainstream, individualistic thinking in the U.S.; and the identification and dismantling of patriarchal power structures that oppress women. Combining these two in a multicultural, feminist approach to psychotherapy highlights the importance of relating to clients with an understanding of, sensitivity to, respect for, and responsiveness to their cultural identities and life situations. This also involves the therapist building on strengths that come from some cultures bringing a collectivist rather than an individualist orientation to life’s challenges, such as combating child maltreatment. To illustrate the potential of a multicultural, feminist approach to psychotherapy in cases of child maltreatment among minority individuals, the present article offers two highly successful case studies. The first involves “Bashiir,” a 16-year-old African, first-generation immigrant young man from Somalia; and the second involves “Jaquaan,” a 15-year-old African American young man. Both clients were referred to therapy because of poor school attendance and academic difficulties, and associated symptoms consistent with a Post-Traumatic Stress Disorder (PTSD) diagnosis. These symptoms derived from the clients having lived in poor, dangerous, high crime communities. A crucial component in both cases was the process by which the therapist employed the multicultural feminist approach to cross age, racial, gender, and socioeconomic-class lines to establish a very strong, trusting relationship between the therapist and the client; and between the therapist and the clients’ families.

Working with Siblings in the Treatment of Traumatized Youth

In their manuscript, “Addressing Child Maltreatment by Infusing Multicultural, Feminist Tenets to Standard Clinical Approaches: The Cases of ‘Bashiir’ and ‘Jaquann,’” Dr. Rachel Singer, Dr. Renee DeBoard-Lucas, and Dr. Milton Fuentes (2024) exemplified how clinicians can be cognizant and respectful of the many familial, socio-cultural, and systemic contexts that contribute to a client's difficulties and that must be considered for successful treatment. As such, they made relevant clinical adjustments to overcome possible barriers to treatment and to foster safe, culturally responsive therapeutic environments. In this Commentary, I propose another clinical adjustment, congruent with a multicultural feminist lens, that has the potential to be beneficial to families that face barriers to parental involvement in treatment: working with the sibling subsystem. While interventions with siblings have received minimal attention in the clinical literature, work with the sibling subsystem has the potential of benefiting individuals and families alike, particularly in the context of trauma-focused therapy with youth. To illustrate how clinicians can work jointly with siblings, I propose pivotal themes and junctures in therapy with Bashiir and Jaquann where sibling involvement may be beneficial.

Types of childhood maltreatment as predictors of posttraumatic stress disorder severity and complex posttraumatic stress disorder in patients with substance use disorders

ABSTRACT Background: Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD). Objective: This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD. Method: Participants (N = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age. Results: Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD. Conclusions: These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.

Social Workers’ Perceptions of the Nature of Child Neglect: A Systematic Literature Review

Abstract Neglect is the most common form of child maltreatment in the UK and the USA. This article reviews research about how child neglect is perceived by social workers. We conducted a systematic review and identified fifty relevant studies, using a range of methodologies, published since the 1989 Children Act. The themes were identified iteratively and synthesised using a narrative method. The review found that despite evidence that neglect is associated with several adverse outcomes, neglect is a lower priority for social work intervention compared to other forms of maltreatment. This is particularly true for emotional neglect and neglect of older children. The review found that social workers conceptualise poverty and neglect as being distinctly different and try to address poverty through practical, non-punitive interventions. However, assessments could better recognise how deprivation exacerbates other risk factors for neglect. The review found a lack of knowledge about perceptions of neglect in adolescents and children with a disability and about the threshold for intervention when neglect is cumulative. Practice may be improved by better recognising and addressing the societal context to neglect allegations and the risk of long-term harm. Achieving this may have resource and training implications.

Adaptation of SafeCare, an evidence-based parenting program, for caregivers of infants in the neonatal intensive care unit

BackgroundWhile there are several parenting programs for NICU caregivers, no studies, to our knowledge, have developed parenting programs aimed at preventing child maltreatment that specifically address these parental factors: parental stress, parental self-efficacy, and positive parent-infant interaction. ObjectivesThe objectives of this study were to: 1) Identify adaptations and/or augmentations needed to optimize SafeCare® for NICU caregivers, and 2) Examine the acceptability and preliminary effects of the adapted SafeCare NICU (SCNC) program with NICU caregivers. MethodsThis study consisted of two phases: formative (phase one) and pilot (phase two). For phase one, 5 NICU former caregivers and 5 NICU staff were interviewed to make relevant, NICU-specific adaptations for SCNC. Phase two consisted of a pilot study, where 13 current NICU caregivers were enrolled in the adapted SCNC program. Outcomes included acceptability and preliminary effects of parental stress, parental self-efficacy, and parent-infant interaction. ResultsAdaptations to SafeCare consisted of adding a pre-session to discuss individualized experiences, incorporation of adjusted developmental milestones, a NICU-specific resource sheet, and individualized adaptations to activities based on relevant medical concerns. Out of the 13 participants, 8 completed SCNC (61.5 % retention rate). Participants indicated significant reductions in stress after SCNC (Parental stress index score = 61.7) compared to baseline (79.2, p = 0.02). Among participants who completed SCNC (n = 8), all stated they supported this program for implementation among NICU caregivers. DiscussionThe adapted SCNC demonstrated acceptability among NICU caregivers.

Gender-Specific Trajectories of Non-Suicidal Self-Injury among Adolescents: Predictive Roles of Distal and Proximal Risk Factors.

Non-suicidal self-injury (NSSI) is considered a strong risk factor for suicide. Although NSSI is prevalent among adolescents and varies by gender, few studies have examined the gender-specific trajectory of NSSI and its predictors. This study examined the trajectory of NSSI among Chinese adolescent boys and girls separately, and the roles of distal (i.e., childhood maltreatment and its specific subtypes) and proximal risk factors (i.e., emotional dysregulation, peer victimization) on their trajectories. A total of 3290 Chinese adolescents (Mage = 13.08; SD = 0.84; 57.6% boys) participated in assessments at three time points. Latent class growth models identified three trajectories for boys: Low stable (92.5%), moderate increasing (5.0%) and high decreasing (2.5%). Four trajectories were identified for girls: Low stable (87.9%), moderate increasing (7.6%), high decreasing (3.0%) and high stable (1.5%). Multinomial logistic regression analyses revealed that both emotional dysregulation and emotional abuse predicted the trajectories of moderate increasing, high decreasing and high stable for girls, as well as predicted moderate increasing and high decreasing trajectories for boys. Peer victimization served as a significant risk factor predicting the moderate increasing and high decreasing trajectories only for girls, while overall childhood maltreatment was a remarkable predictor for the moderate increasing and high decreasing trajectories of boys. The findings highlighted the importance of gender differences in understanding the progression of NSSI and the key predictors, informing effective strategies for prevention and intervention.

Child Maltreatment Profiles among Children and Adolescents in the Spanish Child Welfare System

Maltreatment is a complex and multidimensional construct. Several types of maltreatment exist, but not all of them necessarily co-occur. In the last decades, researchers have tried to untangle the heterogeneity of maltreatment. However, few studies have been carried out outside the U. S. and none of the previous studies had considered all stages of maltreatment. In this study, we aimed at exploring latent profiles of maltreatment in a sample of 635 children and adolescents enrolled at different intervention plans within the Child Protective Services (CPS) in the Valencian Community, Spain. Latent Profile Analysis (LPA) was performed. Profiles were based on the five types of maltreatment (physical abuse, emotional abuse, sexual abuse, emotional neglect and physical neglect), as measured by the Chilhood Trauma Questionnaire-Short Form. Moreover, associations between the emerging profiles and sociodemographic, health- and school-related variables were also examined. Three profiles of maltreatment were found: “Relative low maltreatment” (58.58%), “Neglected” (35.92%), and “Severely abused and neglected” (5.5%). Then, profiles were contrasted with the reasons why court dictated maltreatment status of the child/adolescent to validate the maltreatment profiles. Results regarding the cumulative nature of maltreatment and its severity suggest tailoring public policies by level of risk of maltreatment. This study further proposes moving the focus of action from individuals themselves to the elements that characterize different maltreatment profiles, with the aim of protecting them. Future research ought to expand knowledge on maltreatment profiles in other European countries so as to promote generalization of results.

Factors influencing adult cognitive appraisals of childhood sexual abuse

BackgroundAdult appraisals of their childhood sexual experiences as abusive are associated with increased risk for long-term psychological problems. Factors that underlie whether adults appraise their childhood sexual experiences as abusive remain unknown. ObjectiveTo determine factors associated with adult cognitive appraisals of childhood sexual abuse. Participants and settingParticipants were 1196 adults ages 19–41 (M = 29.23, SD = 3.84) with documented cases of childhood maltreatment (sexual abuse, physical abuse, and neglect) during the years 1967–1971 and demographically matched controls who were followed-up and interviewed in adulthood. MethodsUsing a prospective cohort design, participants were asked to recall whether they had any sexual experiences in childhood, and if so, the frequency of abuse, age at the onset of abuse, relationship to perpetrator, and whether they appraised the experiences as sexually abusive. ResultsOver half of the sample (52%) reported childhood sexual experiences, yet only 44% considered those experiences sexually abusive. Participants with documented cases of child sexual abuse and neglect were more likely to appraise their childhood sexual experiences as abusive compared to controls. Participants who reported more severe abuse, more frequent abuse, younger age at the onset of abuse, and intrafamilial and both intra- and extrafamilial abuse (vs. extrafamilial abuse) were more likely to consider their experiences abusive. Compared to males and Black participants, females and White participants were more likely to appraise their experiences as abusive. ConclusionsUnderstanding factors that determine adult cognitive appraisals of childhood sexual experiences as abusive can inform clinical interventions for maltreated populations.

Childhood maltreatment, genetic risk, and subsequent risk of arrhythmias: a prospective cohort study

ABSTRACT Background: Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented. Purpose: To examine the associations between childhood maltreatment and incident arrhythmias, and whether a genetic predisposition to arrhythmias modifies these associations. Methods: This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident arrhythmias (AF, ventricular arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias. Results: During a median follow-up of 12.21 years (interquartile range, 11.49–12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3–5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09–1.37), VA (HR, 1.39; 95%CI 1.03–1.89), and BA (HR, 1.32; 95%CI 1.09–1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (P overall < .001; P nonlinear = .674) and BA (P overall = .007; P nonlinear = .377) demonstrated a linear pattern. There was a gradient association between childhood maltreatment and AF risks across the intermediate and high genetic risk groups (both P trend < .05) but not within the low genetic risk group (P trend = .378), irrespective of non-significant interaction effect (P interaction = .204). Conclusion: Childhood maltreatment was associated with higher risks of incident arrhythmias, especially AF and BA. Genetic risk of AF did not modify these associations.

The impact of parental acceptance and childhood maltreatment on mental health and physical pain in Burundian survivors of childhood sexual abuse

BackgroundParental support has been suggested to mitigate mental and physical consequences following childhood sexual abuse (CSA). However, many CSA survivors experience parental rejection post-CSA. ObjectiveWe aimed to understand the impact of abuse-specific parental acceptance on post-traumatic stress disorder (PTSD) and physical pain in Burundian CSA-survivors. We further assessed the significance of parental acceptance among known risk factors for predicting PTSD. Methods, participants, and settingsParticipants (N = 131, 80.9 % female, mean age 16.21 years) were recruited via primary health care centers for survivors of sexual violence which survivors approached post-CSA. Survivors reported on PTSD symptoms, daytime/nighttime pain, and adverse childhood experiences in semi-structured interviews. Parental acceptance levels were categorized (acceptance, no acceptance, no contact) for mothers and fathers separately. Kruskal-Wallis tests assessed group differences. Conditional random forests (CRF) evaluated the significance of parental acceptance in predicting PTSD symptom severity. ResultsNo significant differences regarding PTSD symptoms and physical pain between levels of maternal acceptance were obtained. Pairwise comparisons revealed significant differences in PTSD symptom severity between paternal acceptance and no acceptance (d = 1.04) and paternal acceptance and no contact (d = 0.81). The CRF identified paternal acceptance as important variable for the prediction of PTSD symptom severity. Even though results were less conclusive, medium effect sizes hint at less pain perception within the paternal acceptance group. ConclusionsThe results highlight paternal acceptance as a potential risk or protective factor regarding psychological and possibly physical well-being in the aftermath of CSA, even in the context of other known risk factors.

Observed child behavioral self-regulation and maternal supportive parenting are associated with dynamic physiological stress reactivity in preschoolers.

This study sought to advance our understanding of how observed child self-regulation, parenting, and their interaction were associated with children's dynamic physiological stress reactivity indexed by respiratory sinus arrhythmia (RSA) reactivity trajectories. Participants were 85 three-year-old children (54% female) and their mothers oversampled for lower income, higher stressful life events, and higher child maltreatment risk. Child behavioral regulation, assessed as compliance and noncompliance, and maternal supportive parenting were observed during a challenging dyadic puzzle task. Results showed that child RSA exhibited quadratic change across the task on average, characterized by an expected initial decrease and subsequent recovery. Child behavioral regulation and its interaction with maternal supportive parenting were associated with interindividual differences in child RSA reactivity trajectories after controlling for child resting RSA. Children with higher compliance or lower noncompliance showed RSA decreases in response to task stressors but exhibited subsequent RSA recovery only when mothers displayed higher supportive parenting. Children with lower compliance or higher noncompliance displayed negligible RSA changes overall across the task, suggesting blunted or compromised RSA reactivity, regardless of supportive parenting levels. These findings demonstrate novel evidence that preschoolers' better behavioral regulation is related to their more adaptive physiological reactivity to stressors and that supportive parenting is needed to facilitate physiological recovery even in relatively better-regulated preschoolers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Suicide progression and influencing factors in Chinese adolescents: A latent transition analysis

The developmental progression before suicide death is multi-directional and reversible, with differing influencing factors at each stage. However, previous research on this topic is very limited. This study aims to delve into the transitional features of adolescent suicide progression and associated factors. A longitudinal survey of 1,407 adolescents (Mage = 14.64, SD = 0.73) was conducted over six months. Latent transition analysis and logistic regression were employed to explore the transitions in the suicide process and examine the effects of psychache, childhood maltreatment, regulatory emotional self-efficacy, and demographic factors on the transition patterns. Adolescents could be categorized into three subgroups at two time points: Non-Ideators (T1: 83.7 %, T2: 86.7 %), Ideators (T1: 12.0 %, T2: 9.1 %), and Attempters (T1: 4.3 %, T2: 4.2 %). Non-Ideators demonstrated the highest stability, while Ideators and Attempters were more likely to transition to other groups. Psychache positively predicted the emergence of suicide ideation and its transition to suicide attempt, and negatively predicted the diminishment of suicide ideation. Childhood maltreatment positively predicted the transition from suicide ideation to attempt. Regulatory emotional self-efficacy negatively predicted the emergence of suicide ideation. Findings enhance the understanding of the transitional patterns of adolescent suicidality and influencing factors at different stages. More targeted prevention and intervention programs for adolescents’ suicidal thoughts and behaviors can be developed accordingly.

School counsellors’ reporting child maltreatment: A rapid review of empirical evidence

Within schools, school counsellors are often delegated the responsibility for reporting child maltreatment. In this paper, we present findings of a rapid review of empirical studies investigating what is known about school counsellors’ reporting of child maltreatment. Thematic categories identified include school counsellors’ training, knowledge, factors influencing reporting, and reporting experiences. These themes appear to act independently, in overlap, or collectively as facilitators and barriers to school counsellors’ effective reporting practices. The rapid review findings will guide future education and training initiatives to prepare school counsellors for their work in schools. Directions for future research are proposed.

Testing the Spillover Effect of Intimate Partner Violence Victimization on Emotionally Abusive and Harsh Parenting Practices: The Application of Propensity Score Matching.

Prior research reported a significant association between intimate partner violence (IPV) victimization and negative parenting, but there was an overreliance on U.S. samples and families from low socioeconomic status backgrounds. Therefore, this quasi-experimental study examined the association between recent IPV victimization and abusive parenting practices in a sample of community-based women from Poland. Participants were mothers of children aged 2 to 5 years (N = 610) attending an outpatient clinic located in a city in south-eastern Poland. Mothers were asked about their IPV experiences in the past 12 months and were classed as either IPV positive or IPV negative. Outcome measures assessed emotionally abusive and harsh parenting practices. All data were collected online. To reduce bias in background characteristics (i.e., age, education, employment status, financial distress, self-esteem, childhood violence history, alcohol problems, current mental distress, social support, exposure to COVID-19-pandemic-related stressors, and child sex), we applied the propensity score matching (PSM) technique. Group differences before and after matching were examined using independent samples t-tests. Prematching analyses revealed that IPV-positive mothers used significantly more emotionally abusive and harsh parenting practices than IPV-negative mothers. However, the two samples differed substantially on six background characteristics which are known risk factors for IPV and child maltreatment (financial distress, self-esteem, childhood violence history, current mental distress, social support, and exposure to COVID-19-pandemic-related stressors). PSM was successful in reducing those imbalances. Postmatching group comparisons were statistically nonsignificant for emotionally abusive and harsh parenting, disproving the spillover hypothesis. We conclude that IPV victimization is not related to emotionally abusive and harsh parenting practices when controlling for confounding variables.

Evaluation of Virtual Enhanced Child Adult Relationship Enhancement in Primary Care Intervention.

Because of COVID-19 pandemic social distancing requirements, the in-person Child Adult Relationship Enhancement in Primary Care (PriCARE) positive parenting intervention was adapted for virtual delivery. Objective was to evaluate the efficacy of the virtual PriCARE program to improve parenting capacity, decrease child behavioral problems, and decrease child maltreatment risk. Caregivers of children 2 to 6 years old recruited from pediatric primary care were randomized to PriCARE (n = 92) or waitlist control (n = 90). Dysfunctional parenting, positive parenting skills, child behaviors, and child maltreatment risk were measured at baseline and 2 to 3 months after intervention using the Parenting Scale (PS), Dyadic Parent-Child Interaction Coding System (DPICS), Eyberg Child Behavior Inventory (ECBI), and Child Abuse Potential Inventory (CAPI). Kruskal-Wallis test compared median change scores from baseline to follow-up by treatment arm. Of 182 enrolled caregivers, 92% (168) were mothers and 67% (122) completed study measures at baseline and follow-up. The median decrease (improvement) in total PS score was greater in the PriCARE group compared with the control group (-0.3 [IQR 0.69] vs -0.1 [IQR 0.56], p = 0.028) as was the median decrease (improvement) in ECBI problem score (-3 [IQR 9] vs -1 [IQR 7], p = 0.045) and ECBI intensity score (-9 [IQR 21] vs 0 [IQR 25], p = 0.006). Improvements in 4 positive parenting skills measured by DPICS were greater in the PriCARE group compared with the control group (all p< 0.003). Median decrease in CAPI abuse score did not differ significantly by study arm ( p = 0.055). The PriCARE virtual adaptation demonstrated promise in promoting positive parenting and decreasing child behavior problems.

Emergency Department Presentations for Injuries Following Agency-Notified Child Maltreatment: Results From the Childhood Adversity and Lifetime Morbidity (CALM) Study.

Child maltreatment (CM) is associated with negative health outcomes in adulthood, including deliberate self-harm (DSH), suicidal behaviours, and victimisation. It is unknown if associations extend to emergency department (ED) presentations for non-DSH related injuries. Birth cohort study data was linked to administrative health data, including ED presentations for non DSH related injuries and agency-reported and substantiated notifications for CM. Adjusted analyses (n = 6087) showed that any type of agency-reported notification for CM was significantly associated with increased odds of ED presentation for injuries (aOR = 1.57; 95% CI 1.32-1.87). In moderation analyses, women yielded significantly higher odds of notified and substantiated physical abuse, substantiated emotional abuse, and being subject to more than one type of substantiated abuse than males. ED presentations for injuries could be a proxy for risky behaviours, disguised DSH/suicidal behaviours, or physical abuse. The consistent findings in women may point to victimisation via interpersonal violence.