Childhood Experiences Research Articles

Adverse childhood experiences, subsequent negative life events, and their impact on health in occupational rehabilitation patients: a mixed-methods study

IntroductionAdverse childhood experiences (ACEs) are prevalent globally and can negatively impact an individual's lifespan by not only increasing the likelihood of encountering other negative life events (NLEs), but also escalating the risk of illness, absenteeism due to sickness, unemployment, and reliance on disability benefits in adulthood. Therefore, the objective of this study was to explore the prevalence of ACEs and NLEs, as well as their health impacts among patients undergoing occupational rehabilitation.Materials and methodsA total of 80 participants diagnosed with musculoskeletal disorders and/or common mental disorders who participated in two occupational rehabilitation programs in Norway were included. Data were collected by questionnaire and in-depth interviews (39 participants) at the start of the intervention. Comparative quantitative and qualitative analysis was conducted between individuals with a history of ACEs and those without these experiences. Thematic analysis was used to identify the impact of ACEs and NLEs on the health of the informants.ResultsHalf of the participants reported ACEs. Of these, 18% reported one ACE, 22% reported 2–3 ACEs and 9% reported 4 or more ACEs. Also, 25% were categorized as revictimized. The two groups with ACEs had more NLEs in adulthood compared to those without ACEs (p < 0.001), revictimized the most (mean numbers between groups 3.1, 4.5 and 5.9). Furthermore, a history of ACEs was associated with a higher number of reported mental health issues compared to those who had not experienced ACEs (p < 0.01). However, there were no significant differences between the two ACE groups. NLEs had a substantial impact on the participants’ current health status, whether they occurred in childhood or adulthood. In adult life, a high workload (psychologically or physically), interpersonal challenges, and financial struggles had an especially negative impact. Additionally, accidents and complications related to surgeries were also significant NLEs causing health problems. For most, there were complex interactions between NLEs and health.ConclusionsThe prevalence of ACEs and NLEs is high among occupational rehabilitation patients. ACEs are associated with subsequent victimization, interpersonal challenges, financial struggles, and increased mental health issues in adulthood. These findings highlight the need for systematic screening and a holistic, individualized approach in occupational rehabilitation programs to potentially mitigate the adverse effects of NLEs on health and work participation.

Transforming Summer Literacy: How Innovative Programs Cultivate a Passion for Reading and Stronger Student Connections

This study examines the perspectives of children enrolled in a six-week summer literacy program and its impact on their attitudes toward books and reading. Specifically, the research aimed to explore how culturally relevant pedagogy and engaging literacy activities influenced children’s motivation to read by addressing the following two research questions: What are participants’ perspectives on the benefits of a summer literacy program? and What are participants’ perspectives on reading and books after immersion in a summer literacy program? The sample consisted of 21 children in grades 1–6. Using a mixed-methods approach, including surveys and open-ended questions, the study investigated participants’ perceptions of the program’s content, structure, and the quality of relationships with instructors and peers. The research focused on how the use of culturally relevant literature and enrichment activities shaped children's reading experiences and the role of child-staff relationships in fostering engagement. Outcomes revealed that the program's diverse literature, coupled with interactive activities, significantly contributed to cultivating a passion for reading. A supportive, nontraditional learning environment and positive relationships between children and staff further enhanced participants’ perceptions of reading and learning. This study highlights the effectiveness of innovative summer literacy programs in fostering a love for reading and strengthening student engagement.

Leadership capacity development in the Australian early childhood sector. Re-energising through mentoring

Mentoring is a leadership capacity development strategy for experienced early childhood teachers (ECTs). Being a well-trained mentor, who is supported to undertake the role can contribute to re-energising experienced ECTs and enhance the early childhood sector workforce. However, little is known about the benefits of outsourcing mentoring as most research refers to in-house mentoring. This paper reports on the mentors’ experience of a two-phase on-line mentoring program in Australia supporting new early childhood teachers. The study design was framed by the theory of Community of Practice involving academic mentors, experienced teacher mentors and novice teachers as mentees. Mentors’ reflections indicated that knowledge and skills accumulated during this program shifted their understanding of mentoring and contributed towards creating short and long-term service-level changes. This paper offers a provocation for new possibilities in mentoring in the early childhood sector.

Optimal functioning after early mild traumatic brain injury: Evolution and predictors

Abstract Introduction and objectives: Early mild traumatic brain injury (mTBI or concussion sustained between 0 and 5 years old) can lead to post-concussive symptoms, behavioral changes, and cognitive difficulties. Although school-age children (6–17 years old) experience similar consequences, severe neuropsychological deficits are not common, and the majority have no persisting symptoms after one month. Thus, there may be value in focusing on what characterizes optimal functioning (or wellness) after mTBI, but this has not been explored in young children. This study documents the evolution and predictors of optimal functioning after early mTBI. Method: Participants were 190 children aged 18 – 60 months with mTBI (n = 69), orthopedic injury (OI; n = 50), or typical development (TDC; n = 71). Optimal functioning was defined as: (1) no clinically significant behavioral problems; (2) no cognitive difficulties; (3) no persisting post-concussive symptoms; (4) average quality of life or better. Predictors related to sociodemographic, injury, child, and caregiver characteristics included number of acute symptoms, child sex, age, temperament, maternal education, parent-child attachment and interaction quality, and parenting stress. Results: Fewer children with mTBI had optimal functioning over 6 and 18-months post-injury compared to those with OI and TDC. Higher parent-child interaction quality and lower child negative affectivity temperament independently predicted optimal functioning. Conclusion: Children who sustain early mTBI are less likely to exhibit optimal functioning than their peers in the long-term. Parent-child interaction quality could be a potential intervention target for promoting optimal function.

High Rates of Obesity and Chronic Diseases Among North Carolina United Methodist Clergy: An Updated Analysis

Background Varied demands and stressors experienced by clergy can contribute adversely to their overall well-being. Data from United Methodist Church (UMC) clergy in North Carolina in 2008 revealed that clergy had significantly higher non-communicable disease (NCD) rates than their fellow North Carolinians. Methods Using data from the Clergy Health Initiative and Behavioral Risk Factor Surveillance Survey, the present study provided an updated analysis of obesity and 6 other NCDs among North Carolina UMC clergy compared to the general North Carolina population. First, we described the prevalence of each health condition among North Carolina UMC clergy and the general North Carolina population across multiple waves from 2008 to 2021. Then, we compared the predicted probabilities of each health condition in 2021 using logistic regressions to adjust for age, sex, and race. Results Comparing the unadjusted prevalence of health conditions between 2008 and 2021, we found that North Carolina UMC clergy have higher rates of obesity, hypertension, hypercholesterolemia, diabetes, angina, arthritis, and asthma than North Carolinians overall. Adjusting for age, sex, and race, we found that significantly higher rates of obesity, severe obesity, hypercholesterolemia, and asthma persisted among UMC clergy in 2021 compared to all North Carolinians, with the higher rates of severe obesity being particularly concerning. Limitations While the current study is limited to an update of health prevalence among UMC clergy, pastors across denominations are influential leaders in their communities, shaping the physical and social health environments of their congregations. Conclusions Further research is needed to investigate risk factors, such as relocation and adverse childhood experiences, which may influence the higher prevalence of NCDs within and potentially beyond the UMC.

Strengths-Based, Resilience-Enhancing Services: Key Components for Treating Youth Impacted by Adverse Childhood Experiences

ABSTRACT There is growing awareness and empirical support for targeting strengths and resilience when providing services to youth and families who have been impacted by adverse childhood experiences (ACE) and trauma. The purpose of this article is to highlight strengths-based, resilience-enhancing (SBRE) clinical applications that can be incorporated into ACE-informed therapeutic services. Twenty treatment components are described and organized into six main categories that chronicle the course of therapy: Relationship Development, Stabilization, Engagement, Assessment, Intervention, and Prevention. SBRE services assist youth in adaptively coping with life adversity, and acquiring the knowledge, skills, and strengths for leading psychologically healthy, resilient lives. It is hoped this article will stimulate interest from both clinicians and researchers regarding the SBRE model, which is being introduced here for the first time.

Does Play-Based Learning Support Children’s Everyday Resiliency? A Cross-Case Analysis of Parents’ and Kindergarten Teachers’ Perceptions of Play-Based Learning as a Precedent to Young Children’s Coping During the Pandemic-Affected 2020–2021 School Year

Background: Play has long been credited with fostering self-regulation in young children, though few studies have examined how children draw upon early childhood experiences with play to navigate adversity later in childhood. The purpose of this study is to describe the facets of the children’s everyday resiliency that were attributed to their play-based experiences by parents and teachers as they reflected on the children’s kindergarten experiences during the COVID-19 pandemic. Methods: We used a cross-case study design to examine the positive coping strategies parents and teachers observed in three five-year-old girls and one six-year-old boy entering kindergarten during the 2020–2021 pandemic-affected school year. We recruited parent participants based on their child’s enrollment at a Reggio Emilia-inspired, play-based early childhood center in Northern Colorado for three or more years prior to entering kindergarten. Once parents enrolled in the study, we extended an invitation to their child’s kindergarten teacher to participate. Data included three one-hour interviews with each participant, field visits during remote learning, and artifact collection over the course of the school year. Results: Cross-case analysis revealed four themes: “Willing to Adjust”, “Understands the Situation”, “Uses Advanced Language”, and “Embraces Challenge”. Participants describe these children as willing to adjust to public health orders, having a deep understanding of the pandemic’s societal repercussions, using sophisticated language to process adversity, and embracing the challenge of becoming kindergarteners. Conclusions: Participants believed these children’s experiences with play-based learning promoted the interdisciplinary development of their social language, persistence, altruism, and cognitive flexibility; these traits fostered the children’s positive coping strategies throughout the pandemic-affected kindergarten year.

Electrocortical Profiles in Relation to Childhood Adversity and Depression Severity: A Preliminary Report

Objective: Assessment of electroencephalographic (EEG) activity in depression has provided insights into neural profiles of the illness. However, there is limited understanding on how symptom severity and risk factors, such as childhood adversity, influence EEG features. Methods: Eyes-closed EEG was acquired in N = 28 depressed individuals being treated in a tertiary psychiatric setting. Absolute alpha, beta, theta, and delta power and inter-/intra-hemispheric coherence were examined. Relations between the Montgomery-Åsberg Depression Scale (MADRS) and Adverse Childhood Experience (ACE) Questionnaire and EEG features were assessed. Results: Individuals in the high (MADRS≥30) versus lower (MADRS ≤ 29) symptom severity group exhibited greater overall beta power, and lower Fp1-Fp2 delta and theta coherence. Those with high (≥3) versus lower (≤2) ACE scores exhibited greater T7-T8 beta coherence. Lowest F3-F4 beta coherence was observed in those with high ACE/high depression severity. A negative correlation existed between F8-P8 alpha coherence and symptom severity. Conclusions: Those with higher depression severity exhibit increased beta power, possibly reflecting a hyper-vigilant state. Depression severity and ACE history may produce subtle alterations in frontal delta/theta and temporal/frontal beta coherence regions. Significance: This is the first study to examine the neural impact of depression severity and ACE-assessed childhood trauma in depressed individuals receiving treatment in a tertiary setting, accounting for the clinical reality of the prevalence of their co-occurrence.

Elementary Preservice Teachers’ Experiences at the Intersection of Culturally Sustaining and Historically Responsive Pedagogy, Early Literacy, and the Science of Reading

This phenomenological study reports findings related to preservice teachers’ experiences mentoring early elementary readers. Preservice teachers in this study were enrolled in a literacy methods course designed to develop their understanding of early literacy, including knowledge of the written code and culturally sustaining and historically responsive pedagogy, and prepare them for the Texas’ Science of Teaching Reading exam. Within this context, we explored how preservice teachers worked to bridge multiple approaches to literacy instruction. Thematic results illustrate how preservice teachers sustained the lifeways of children through literacy as a social practice, created space for code-based and meaning-making skills, and learned to teach responsively. These results provide implications for a comprehensive approach to preparing teachers of elementary literacy: one that fosters knowledge of the written code while contextualizing knowledge in children's cultures, communities, and experiences.

Unlocking Insights: Harnessing Primary School Children's Experiences and Reflections on Emergency Remote Learning to Shape K-12 e-Learning in the Post-Pandemic Era

The study aimed to investigate the impact of the COVID-19 pandemic on primary education in Cyprus and to discern the implications for the post-pandemic era, specifically focusing on the Emergency Remote Learning (ERL) experiences and reflections of upper primary students (ages 9-12). Grounded in socio-constructivist learning theory, which emphasizes the importance of active student engagement and social interaction in the learning process, the research explored the challenges students faced during the rapid shift to remote education. A mixed-methods design was employed, using an in-depth online survey that incorporated both quantitative and qualitative questions. Data were collected from a sample of 204 students selected through non-probability, convenience sampling. The analysis revealed that students experienced several challenges, including technology constraints, lack of interaction, and difficulty maintaining concentration, which are consistent with global findings on K-12 ERL. Among demographic factors, the type of school attended (public vs. private) had a significant influence on most aspects of students' ERL experience. Private school students reported more favourable conditions than their public school counterparts, which facilitated a smoother shift to both asynchronous and synchronous ERL, resulting in a more positive overall ERL experience. Regardless of the type of school attended, students overwhelmingly expressed a strong preference for face-to-face learning. Comparisons with other studies conducted in Cyprus during the same period involving older student age cohorts suggest significant age-related differences. The young students in our study encountered greater challenges during the transition to ERL, which can be attributed to their heightened need for scaffolding and external regulation to learn in the virtual space, as well as the higher importance they attached to the social aspects of school life taken away by ERL. Despite their largely negative experiences with ERL, a high proportion of the children advocated integrating the e-learning tools and technologies they got acquainted with during ERL into the normal context of schooling. These findings underscore the importance of further research into effective instructional strategies tailored to young learners in both online and blended learning settings. They also highlight the potential benefits of incorporating e-learning tools into conventional classrooms to enhance the teaching and learning process.

Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin‐differences study

BackgroundAdverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.MethodsWe used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.ResultsAmong children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.ConclusionsThe apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.

Psychological Pathways from Adverse Childhood Experiences to Cigarette, Marijuana, and Excessive Alcohol Use in Early Middle Adulthood: A Longitudinal Examination

Psychological Pathways from Adverse Childhood Experiences to Cigarette, Marijuana, and Excessive Alcohol Use in Early Middle Adulthood: A Longitudinal Examination

Prevalence of Adverse Childhood Experiences in Child Population Samples

ImportanceExposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability.ObjectiveTo meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates.Design, Setting, and ParticipantsStudies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024.Main Outcomes and MeasuresACEs.ResultsThe mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90).ConclusionsIn this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.

The Impact of Adverse Childhood Experiences on Asthma Severity in US Adults

Background/objectives: The association between adverse childhood experiences (ACEs) and asthma severity among United States (US) adults with asthma has not been well documented. In addition, whether gender differences exist in this association has been underexplored. We aimed to examine the prevalence of asthma severity in the US adult population with asthma and investigate the association between ACEs and asthma severity by using data from non-institutionalized US adults with asthma. Methods: This cross-sectional study used data from the Adult 2019 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Survey (ACBS), a survey of US adults aged 18 years or older in 31 US states and Puerto Rico. A total of 22934 adults with asthma participated in 2019 and 2020 ACBS. The 11 BRFSS ACE variables encompassing abuse and household dysfunction were used as ACE measures. ACE measures were summed up as cumulative ACE scores (continuous) and categorized (zero, one ACE, two ACEs, ≥ three ACEs). Asthma severity was categorized as intermittent or persistent. Weighted logistic regression models were used to assess associations of the cumulative ACE score, categorical ACE measures, and the 11 individual ACE responses with asthma severity controlling confounders. Gender differences were explored by stratifying by gender. Results: The prevalence of persistent asthma among US adults with asthma was 45.3%. The mean cumulative ACE score in adults with intermittent vs. persistent asthma was (2.43 vs. 2.70, p-value < 0.05). About 22% of adults with asthma had no ACEs, 19% had one ACE, 14% had two ACEs, and 45% had three or more ACEs. A one-unit increase in ACEs score was associated with a 5.4% increase in the odds of persistent asthma (adjusted odds ratio, aOR = 1.054 (95% confidence interval, CI = 1.01–1.10). Experiencing ≥ three ACEs compared to no ACEs was associated with 31% increased odds of persistent asthma (aOR = 1.31, 95% CI = 1.01–1.70). Individual ACE items significantly associated with persistent asthma include parent/adult ever touched you sexually (aOR = 1.33, 95% CI = 1.03–1.74), adult tried to make you touch them (aOR = 1.34, 95% CI = 1.01–1.79), any adult forced you to have sex (aOR = 1.44, 95% CI = 1.04–1.20), parental separation/divorce (aOR = 1.31, 95% CI = 1.05–1.63), and household alcohol abuse (aOR = 1.24, 95% CI = 1.01–1.53). In women, experiencing one ACE and ≥ three ACEs (compared to no ACEs) was associated with 51% and 60% increased odds of persistent asthma, respectively (aOR = 1.51, 95% CI = 1.02–2.23; aOR = 1.60, 95% CI = 1.12–2.27). No significant association was observed between ACEs and asthma severity in men; however, experiencing household physical violence (compared to no household physical violence) was associated with persistent asthma in men (aOR = 1.69, 95% CI = 1.18–2.42). Conclusions: In this cross-sectional study of US adults with asthma, exposure to ACEs was associated with higher odds of asthma overall and in women. These findings highlight the importance of preventive strategies and early interventions to reduce ACEs, potentially mitigating asthma’s severity in adulthood.

The chain mediating role of parenting stress and child maltreatment in the association between maternal adverse childhood experiences and executive functions in preschool children: a longitudinal study

Abstract Background Previous researches found that maternal adverse childhood experiences not only affect the psychological behavior of preschool children, but also have direct or indirect negative effects on the executive functions and cognition of offspring. And, the possible social psychological mechanism between maternal adverse childhood experiences and preschool children’s executive functions is still not clear. Objectives This study mainly tries to understand the association between parenting stress and child maltreatment in maternal adverse childhood experiences and children’s executive functions through longitudinal cohort. Participants and setting Participants were 2160 preschool children and their mothers who finally completed baseline and 3 waves of follow-up. Methods Using a cohort study, a baseline survey of junior kindergartens was carried out in June 2021 and followed up every six months, with a total of 3 follow-ups. Results We found that executive functions in preschoolers were significantly positively correlated with maternal adverse childhood experiences, parenting stress, physical assault, psychological aggression, neglect and nonviolent discipline (r = 0.180, 0.386, 0.274, 0.302, 0.189, 0.148, respectively, P < 0.01). Further, parenting stress and child maltreatment showed a chain mediating effect between maternal adverse childhood experiences and executive functions in preschoolers, and the total indirect effects accounted for 70.56%, 78.69%, 65.38%, and 68.07% of the total effect, respectively. Conclusions This study found that maternal adverse childhood experiences have a significant impact on the executive functions of preschool children, and parenting stress and child maltreatment are the mediating factors of their association, revealing the potential mechanism between the two associations from the perspective of social psychology.

“Being, Like, Their Parents Throughout Their Lifetime”—House Parents' Perceptions of Their Role in the Family‐Style Group Care

ABSTRACTBased on the concepts in Katz and Kahn's role theory model this qualitative research examines the role perception and experience of house parents in the family‐style group care, a type of out‐of‐home placement model for at‐risk children who cannot reside with their birth families. Semistructured interviews were conducted with 18 house parents (both men and women) to gain insights into their role perception and experience. The findings revolved around three central themes: motivation for choosing the role (search for meaning, previous exposure to the role and childhood experiences); role perception (parental and administrative); and experiencing the role, in terms of positive and negative emotions. The theoretical significance of this research lies in understanding the unique role perception of house parents, distinct from the corporate world. In comprehending the role of house parents, its nature and its impact on the well‐being of individuals in this role, social workers can improve house parent training and contribute to the mental well‐being of children growing up in these settings.

Study identifies eight traumatic and ACEs to psychiatric risk across development

There are eight TRACEs (traumatic and adverse childhood experiences) which can lead to mental health and cognitive problems during adolescents, according to researchers. Using the Adolescent Brain Cognitive Development (ABCD) data from the National Institutes of Health, the researchers drew on reports from youth and their caregivers to look at longitudinal change and how it is moderated by the TRACEs.

Unravelling the complexity of suicidality: a network analysis of theory-driven and culturally relevant suicide risk factors in a country with high suicide rates

Purpose This study aimed to explore whether individual theory-based constructs are sufficient in explaining suicidality in a culture marked by high suicide rates and whether, if any, culturally relevant factors need to be considered additionally. Methods The study used a community sample of 1873 Lithuanian adults (age M = 43.61 SD = 16.96, 69.1% female). A survey using online and pen-and-paper formats was conducted, measuring suicidality, the main constructs from two predominant theories of suicide (thwarted belongingness, perceived burdensomeness, acquired capability for suicide, and defeat and entrapment), and culturally relevant factors (gender role expectations, attitudes towards help-seeking, perfectionism, negative social comparisons, alcohol use, child-parent relationships and childhood experiences). Network analysis method was used in the analysis. Results From the key factors identified in the two theories perceived burdensomeness had stronger links with self-perceived risk for suicide compared to thwarted belongingness and entrapment. Acquired capability to suicide had no direct links with other factors in the network apart from a weak link with history of suicidal behavior. In the network some of the culturally relevant variables (reasons for alcohol use, experience of sexual abuse, emotional neglect, and cultural norms representing restricted emotionality and attitudes towards psychological help) had direct relationships with suicidality, not only via key theory based factors. Conclusions The results suggest the need to consider cultural context when applying universal suicide theories.

Narcissistic female serial killers: A psychobiographical study of Cecilia Johanna Steyn

This article examines the psychobiography of Cecilia Johanna Steyn, a female serial killer from South Africa. The study analysed Cecilia Steyn’s childhood development to suggest possible adverse childhood experiences predisposing her to instigate murders on her demand. Drawing on the narcissistic theoretical frameworks of Heinz Kohut and Robert Hare, we analysed Cecilia Steyn’s childhood development, indicating the occurrence of narcissistic injury. We found that Cecilia Steyn could be considered a highly manipulative, narcissistic female serial killer. The analyses provided a profile of a gendered female serial killer, highlighting similarities and differences based on narcissism and psychopathy.

An 'explosion in the mouth': The oral health experiences of autistic children.

In England, one in four children have tooth decay by the age of 5 years. Tooth decay affects many autistic children. Communication differences, sensory sensitivities and preferred routines can make dental care difficult. Daily toothbrushing, healthy eating and drinking, and attending the dentist may be challenging for autistic children. We do not know much about how autistic children feel about looking after their teeth. Learning from them directly is important to understand their needs and make sure their voices are heard. We interviewed 10 autistic children aged between 7 and 13 years to discover how they care for their teeth, what helped and what did not. We talked about toothbrushing, healthy eating and drinking and visiting the dentist. To support our conversations, we used Talking Mats® - a tool that can help with communication. Autistic children described a wide range of sensory issues related to looking after their teeth. This finding shows how important it is to tailor care to each child's needs. Children wanted to be included in conversations about their teeth at home and at the dentist. This was felt to make a big difference in building trust and making them feel comfortable and supported. Overall, we found Talking Mats® can be used in dental research to engage with autistic children. By understanding children's views, we can better help professionals and parents to support their dental needs. Our research showed that every child's experience is unique, so dental support must be tailored and inclusive to meet children's needs.