Childhood Experiences Research Articles

“I’m a Monster, but I’m Not a Monster”: Symbolic and Social Identity Work Among Child Sexual Exploitation Material Users

Child sexual exploitation material (CSEM) users elicit strong negative reactions from society and people within their networks. There are symbolic and social boundaries that these individuals have transgressed, and subsequent identity work involves the negotiation of self and self-presentation. This article combines results from two studies to explore negotiation of identity, symbolic and social boundaries, and associated narratives among 103 CSEM users. One study was an anthropological ethnography with 17 months of UK fieldwork in community-based group programs, and the other involved four months of interviews in sexual offense treatment units of a US prison. Participants’ identity work had commonalities: distinguishing between acts vs identities; differentiating crimes from identities; comparing offenses to others viewed as worse; framing childhood experiences as influencing offending; and situating both offending and post-offending identities within larger society. Results are discussed in the context of debates about risk, treatment, prevention, harm, denial/downplay/minimization, and reintegration. Furthermore, we highlight how identity work occurs within potentially competing/contrasting personal, judicial, treatment, media, and societal reactions to and expectations of individuals who have committed sexual offenses. Finally, we demonstrate the methodological and analytical value of cross-disciplinary comparative qualitative research by showing similarities across participants from different countries, settings, timeframes, and interventions.

What aspects of outcome measurement instruments are important to parents and caregivers in child health trials: Survey protocol

Background Trials of interventions to prevent illness and/or improve health outcomes in children play a crucial role in the advancement of paediatric healthcare, research, and policy. It is important for researchers and trialists involved in such trials to understand factors which are important to parents/caregivers when deciding to participate and provide data about their child. There is little evidence to date surrounding the impact of outcome measurement instruments (OMIs) on parents/caregivers’ decisions about participation and provision of data in trials. The aim of this project is to examine what characteristics of OMIs are important in parents/caregivers’ decisions to engage with and participate in trials of interventions to prevent childhood illness and/or improve child health outcomes. Methods An online cross-sectional survey is being conducted. Survey recruitment began July 2024 and will be completed in October 2024. Parents/caregivers are eligible to participate if they have at least one child up to 12 years of age; there are no restrictions based on factors such as gender or nationality. Survey participants are being recruited using convenience sampling via social media, parenting websites, and online forums. This survey includes questions about parents/caregivers’ preferences for how, when, where, and with whom data is collected in child health research, as well as the types of OMIs parents/caregivers would be most comfortable using. Data will be analysed using descriptive statistics. Conclusions Findings from this study will address the current gap in knowledge related to preferences of parents/caregivers in how data are collected in trials of interventions to improve health outcomes in children. Study findings will inform trialists in the design and conduct of child health research in the future. Implementation of study findings in future trials can also improve experiences of children and their caregivers engaged in research and enhance the quality and quantity of data being collected.

Lifetime Violence and Perinatal Sleep Quality: A Scoping Review

Abstract Introduction In-utero experience of violence through maternal experience of intimate partner violence (IPV) is a risk factor for adverse pregnancy outcomes via ‘biological programming,’ whose effect can be mediated by sleep. We conducted a scoping review to synthesize the current evidence of the association between experiences of violence and sleep in women. Methods Between August and October 2023, we conducted a search in four databases (PubMed, APA PsycInfo, Embase, and Web of Science) for peer-reviewed articles, using 11 inclusion and exclusion criteria. Any study published in English in peer-reviewed journals that conducted original research on the association between exposure to violence (lifetime IPV, IPV during the previous year, during and 1 year after pregnancy, as well as adverse childhood experiences) and poor sleep outcomes (sleep disturbances, insomnia, poor sleep quality, and longer time to fall asleep) in the perinatal population were included. Results The synthesis of the 12 included studies revealed a positive association between exposure to violence and poor sleep, and between adverse childhood experiences and sleep disturbances or poor sleep during pregnancy. Moreover, IPV in the postpartum period was associated with poor sleep. Conclusion Most of the evidence synthesized comprises data from high-income countries, resulting in lack of cultural context. However, it is evident that the experience of violence throughout life is a risk for poor perinatal sleep quality. Thus, there is a growing need to study this association, especially in resource-limited settings, where data on sleep health is largely absent, inform pregnancy care and maternal and child health policies.

Association between adverse childhood experiences and current use of e-cigarettes or electronic vaping products across sex race ethnicity and age based on 2020–2022 BRFSS data

IntroductionThe use of e-cigarettes or other electronic vaping products (EOEVP) has been on the rise since their introduction. Concurrently, Adverse Childhood Experiences (ACEs) have been linked to various negative behavioral health outcomes. We explore the association between ACEs and current EOEVP use, with a focus on variations across sex, race/ethnicity, and age.MethodsUtilizing data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2020–2022, we analyzed responses from 202,126 adults in the United States in a cross-sectional study. Multivariable logistic regression models were used to evaluate the adjusted odds ratios (aORs) of current EOEVP use for different levels of ACEs. Stratified and interaction analyses were used to examine potential effect modification.ResultsAmong adults 54 years of age and younger, even a lower number of ACEs [1 (aOR 1.52), 2 (aOR 2.01), and 3 (aOR 1.51)] was associated with higher odds of current EOEVP use. Stratified analyses revealed significant differences in the odds of current EOEVP use among Non-Hispanic White adults between 1 ACE (95% CI 1.75–2.28) and 4 ACEs (2.34–3.17). Hispanic adults with ≥ 1 ACEs (p-value 0.001) and 8 ACEs (p-value 0.005) showed strong associations compared to Non-Hispanic White adults. The influence of ACEs on current EOEVP use was observed to decrease with age, particularly in older adults with fewer ACEs. The aORs did not very by sex.ConclusionThe findings emphasize the importance of considering any number of ACEs in public health strategies targeting current EOEVP use, especially among younger adults and specific minority groups. These insights are crucial for tailoring interventions and policies to address the nuanced impacts of early life adversities on health risk behaviors.

Cochlear implantation for children with single-sided deafness: parents’ perspectives

ABSTRACT Historically, cochlear implantation is reserved for those with bilateral severe to profound hearing loss. However, indications have expanded to include Single-Sided Deafness (SSD) because of the known benefits of binaural hearing and the limitations of unilateral hearing, especially for children developing linguistic and cognitive skills. This study aimed to provide a qualitative perspective of lived experiences of children with SSD who use a cochlear implant (CI), as perceived and reported by their parents. An online questionnaire was developed and distributed to evaluate outcomes of cochlear implantation in children with SSD residing in New Zealand and the United States. Qualitative content analysis of open-ended questions identified themes, including: (1) motivating factors; (2) benefits of amplification; (3) challenges associated with the CI journey; and (4) advice to parents. Parents described benefits and challenges as a result of cochlear implantation, such as access to sound and academic and psychosocial development, as well as subjective improvements in spatial hearing, reduced listening fatigue, enhanced academic performance, and changes in quality of life. The difference that bilateral hearing makes to a child’s development is difficult to precisely define but parental insights offer valuable perspective to healthcare providers when considering what some consider an elective procedure.

Association Between Positive Childhood Experiences and Caregiver-Reported ADHD Diagnosis and Severity.

Little is known about the prevalence of positive childhood experiences (PCEs), a counter to adverse childhood experiences, in children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. The purpose of this study was to examine the relationship between PCEs and ADHD diagnosis and severity, adjusting for child, family, and household characteristics, using a nationally representative data set. Using the 2020 to 2021 National Survey of Children's Health, our sample included children 6 years of age or older, as this is the age at which PCE questions are asked (n = 56,224). Multivariable logistic regression was used to examine the association between PCE type and ADHD diagnosis and severity, controlling for child and household characteristics. In multivariable regression analyses, children who had volunteered in their community had lower odds of a reported ADHD diagnosis than children who had not volunteered in their community (adjusted odds ratio [aOR] 0.83; 95% confidence interval [CI], 0.73-0.95). Children with a connected caregiver had a lower likelihood of ADHD diagnosis than children without a connected caregiver (aOR 0.66; 95% CI, 0.58-0.74). Children reporting moderate to severe ADHD were less likely to report exposure to any of the 7 PCEs examined, when compared with children reporting mild ADHD. The findings from this study can be important for clinicians and families to mitigate the negative social and academic outcomes that children with ADHD may face.

Associations of adverse childhood experiences with blood pressure among early adolescents in the United States

The associations of adverse childhood experiences (ACEs) with blood pressure in adulthood are inconclusive. Similarly, the association between ACEs and blood pressure earlier in the life course is understudied. This study aims to assess the associations of ACEs with blood pressure among early adolescents. We utilized data collected at baseline (age: 9–10 years) and Year 2 follow-up from 4077 participants in the Adolescent Brain Cognitive Development (ABCD) Study. We used adjusted multiple linear regression models to estimate the associations of ACEs (cumulative score and subtypes) at baseline with systolic blood pressure (SBP) and diastolic blood pressure (DBP) at year 2 of follow-up. Experiencing ≥4 ACEs (compared to 0) was significantly associated with higher SBP (B = 3.31, 95 % CI 0.03, 6.57, p = 0.048). Of the ACEs subtypes, household substance use (B = 2.28, 95 % CI 0.28, 4.28, p = 0.028) and divorce or separation (B = 2.08, 95 % CI 0.01, 4.15, p = 0.048) were both significantly associated with a higher SBP while household mental illness (B = 2.57, 95 % CI 1.32, 3.81, p < 0.001) was significantly associated with a higher DBP. Our findings suggest that exposure to multiple ACEs is associated with higher blood pressure in adolescence.

Adverse Childhood Experiences and Resilience: Racial Differences and Coping Style as a Mediator

Adverse Childhood Experiences and Resilience: Racial Differences and Coping Style as a Mediator

Effects of adverse childhood experiences on observed parenting and children's behavior problems among Jewish and Arab Muslim families in Israel.

Research points to the substantial impact of parents' exposure to adverse childhood experiences (ACEs) on parents and their children. However, most studies have been conducted in North America, and research on ACEs effects on observed parenting or on intergenerational transmission of ACE effects is limited. We therefore studied families from diverse ethnocultural backgrounds in Israel and examined whether mothers' ACEs hampered maternal sensitivity and the quality of the home environment and whether mothers' psychological distress mediated these links. We also explored whether mothers' ACEs predicted children's behavior problems indirectly through maternal psychological distress and whether maternal sensitivity and the home environment attenuated this mediating path. Participants were 232 mothers (Mchild age = 18.40 months, SD = 1.76; 63.36% non-ultra-Orthodox Jewish, 17.24% ultra-Orthodox Jewish, 19.40% Arab Muslim). Results showed mothers' ACEs were directly associated with decreased maternal sensitivity. Mothers' ACEs were indirectly associated with more behavior problems in children through mothers' higher psychological distress, and maternal sensitivity moderated this indirect link; it was significant only for mothers who showed lower sensitivity. Findings emphasize the significant role ACEs play in early mother-child relationships. The importance of including ACE assessment in research and practice with families of infants and toddlers is discussed.

Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

Adverse Childhood Experiences, maladaptive coping behaviours and protective factors in undergraduate students: A cross-sectional study

Objectives: The purpose is to examine the relationship between Adverse Childhood Experiences (ACEs), protective factors, and select maladaptive coping behaviors in postsecondary students. Participants: Undergraduate students attending Dalhousie University. Methods: An online anonymous survey was conducted. Zero order one-tailed correlations were computed to measure relationships between ACEs, levels of maladaptive coping behaviors and protective factors. A structural equation mediation model examined direct and indirect pathways between measures. Results: 42.5% of respondents (n = 327) reported ≥3ACEs. Higher ACEs were associated with higher expression of maladaptive coping behaviors. Respondents with high ACEs and low levels of protective factors reported lower levels of hope and forgiveness and higher levels of stress and rumination. Conclusion: Higher levels of protective factors were associated with lower levels of maladaptive coping behaviors in students with high ACEs.

Why do prospective and retrospective measures of childhood maltreatment differ? Qualitative analyses in a cohort study

BackgroundResearch indicates that prospective and retrospective measures of maltreatment often identify different groups of individuals, yet the reasons for these discrepancies remain understudied. ObjectiveThis study explores potential sources of disagreement between prospective and retrospective measures of maltreatment, utilising qualitative data from interviewers' notes. Participants and settingThe Environmental Risk Longitudinal Twin Study includes 2232 children followed from ages 5–18. Prospective measures relied on caregiver interviews and researcher observations from ages 5–12, while retrospective measures involved self-reports via the Childhood Trauma Questionnaire at age 18. MethodsWe purposively sampled written interviewer notes from 36 participants who reported more types of maltreatment retrospectively than prospectively (‘new reports’ group) and 31 participants who reported fewer types retrospectively than prospectively (‘omitted reports’ group). We conducted a framework analysis of the notes, comparing between the two groups to explore explanations for measurement disagreement. ResultsThree categories of themes emerged related to measurement discrepancies: challenges with prospective measures, highlighting reasons given by the ‘new reports’ group for why maltreatment went undetected or was not adequately responded to prospectively; challenges with retrospective measures that highlight difficulties with openness and accuracy of self-reports; and differences in appraisals of violence or distressing childhood experiences between the two groups that might lead to new or omitted retrospective reports. ConclusionsOur findings underscore potential mechanisms underlying the disagreement between prospective and retrospective measures, contributing to better understanding of these different constructs and more balanced interpretation of related findings.

Investigating the Impact of Caregiver Adverse Childhood Experiences Screening and Pediatrician-Led Discussions on Posttraumatic Stress Disorder Symptoms in a Majority-Hispanic Pediatric Primary Care Clinic Setting

Background: Evidence suggests that screening and provider-led discussions of parental adverse childhood experiences (ACEs) may help identify at-risk families and be linked to positive health outcomes in caregivers and their children. However, the direct effect of ACEs screening and discussions on posttraumatic stress disorder (PTSD) has yet to be studied. Objectives: To determine if screening or provider-led discussions of parental ACEs are associated with inadvertent worsening of PTSD symptoms 1 week after screening. Research Design: Data was obtained as part of a cluster randomized controlled trial to examine the effects of ACEs screening and provider-led discussions on child health care utilization outcomes. Baseline surveys were completed before scheduled infant well child checks (WCCs). Providers were randomized into the standard of care or intervention (discussion) conditions. Intervention providers were trained in delivering brief trauma-informed discussions about the impact of ACEs on parenting during WCCs. Subjects: Caregivers in a pediatric primary care clinic serving predominantly Hispanic and low socioeconomically resourced families (N=179, 93% female, 87% Hispanic). Measures: The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Brief Resilience Scale (BRS), and ACEs screening were completed at baseline. PC-PTSD-5 was repeated 1-week after screening. Results: Mixed-effects ordinal logistic regression analysis of PTSD scores from baseline to 1-week postscreening with the full sample showed no significant effect of time [odds ratio (OR)=1.21, P=0.68], group (OR=1.68, P=0.33), or their interaction (OR=0.48, P=0.21). Conclusions: Screening or brief discussion of ACEs with providers trained in trauma-informed care were not associated with worsening PTSD symptoms.

Implementing an Adverse Childhood Experiences Screening Tool With Migrant Children: A Quality Improvement Project Using the PEARLS Screening Tool

BackgroundImmigrants, asylum seekers, and refugees live with extreme stress, consistent vulnerability, and life-long health consequences. Children in these populations face increased risk of poor mental health due to adverse childhood experiences (ACEs) and related healthcare barriers, such as lack of screening, that limit their ability to receive appropriate mental health care. AimTo implement an ACEs screening questionnaire for all migrant children 19 and under in a community shelter. MethodsThe Model for Improvement. InterventionThe Pediatric ACES and Related Life Events Screener (PEARLS) was implemented over a 10-week period in a community shelter. ResultsAll children screened had at least 1 ACE. Initiation of PEARLS screening led to recognition of adverse experiences thus allowing for mental health support and referrals to mental health specialists. ConclusionsThis QI project supports implementation of screening for adverse childhood experiences within populations of migrant children in order to uncover potential mental health concerns and provide targeted support, recognizing the long-term effects of trauma on their wellbeing.

Young children's perceptions and experiences of school readiness during the transition from preschool to primary school in China

AbstractSchool readiness has a profound educational value for children's positive adjustment to primary school and holistic development. However, little research sufficiently addresses how young children view multifaceted components of learning, such as cognitive, affective and behavioural experiences on school readiness. A timely understanding of children's perceptions and experiences is crucial to shed light on how to promote transition and improve children's school readiness. This study investigated the perceptions and experiences of 41 children in China (5–6 years of age, 23 girls) regarding their school readiness based on Mosaic approach methods. The results indicated that young children have their own unique perceptions, emotional and behavioural experiences of school readiness. The perceptions of school readiness include four aspects of material supplies, subjects knowledge, interests and specialties and behavioural habits, which has similarities to that of adults in aspects of academic knowledge and social rules. Nevertheless, findings revealed young children view interests and strengths as important part of school readiness, reflecting their personal preferences and abilities. The emotional experiences could be considered positive or negative, with positive emotional experiences expressing children's curiosity and expectation, fulfilment and pleasure, and negative emotional experiences expressing academic burden, rules pressure and social worries, which need to be addressed. Young children's behavioural experiences with school readiness present two patterns of passive acceptance and active participation, they are eager to participate in activities and have a strong desire to explore and learn. Our findings extend beyond existing conception of school readiness, and give greater weight to children's interests and strengths, positive experiences and active participation. It is important to focus on children's intrinsic interests and strengths, accept children's ideas and choices, care for their emotional state and provide positive support.

Children’s Plight to Life of Poverty and Injustice Captured in F.H. Batacan’s Smaller and Smaller Circles

This research paper analyzes how children's experiences of poverty and injustice are imagined and articulated in F. H. Batacan's novel Smaller and Smaller Circles. By employing content analysis, passages and excerpts from the novel were identified and subjected to in-depth analysis using sociological and philosophical approaches to literary criticism. The study aims to explore the novel’s portrayal of the causes and effects of these experiences, and how it reflects the broader discourse on the morality of children's suffering. The findings reveal that the novel imagines children's experiences of poverty and injustice as resulting from a complex interplay of societal norms, such as generational responsibility, the culture of silence, and toxic masculinity. Institutional failures, including the church’s complicity, inefficient law enforcement, and barangay deficiencies, further exacerbate these conditions. Additionally, media and societal attitudes, particularly misplaced faith and victim blaming, contribute to the perpetuation of these harmful conditions. The novel portrays these imagined experiences as leading to psychosocial trauma, delayed or denied justice, delinquency, and even suicide. Through this portrayal, the novel positions itself within the discourse on the morality of children's suffering, raising questions about the ethical implications of these societal failures.

Pengembangan Big Book Moderasi Beragama Berbasis Konsep Pratyaksa Pramana di Taman Kanak Kanak

This research highlights the importance of introducing the concept of religious moderation from an early age. Even though its implementation already exists in children's play activities, children are not yet fully aware of the concepts of tolerance, sharing and helping each other. Therefore, the Big Book of Religious Moderation based on the Pratyaksa Pramana concept was developed as a learning medium that introduces the concept of moderation through children's direct experience. This Book contains material on the concept of religious moderation based on the concept of Pratyaksa Pramana, which is knowledge experienced by children through direct experience. This research aims to introduce the concept of moderation to children, describe the development of the Book, and analyze the feasibility of its use through expert validation. The ADDIE development method was used in this research, involving teachers and children at the Taman Kurnia Denpasar Kindergarten as data sources. Data collection techniques using observation and checklist instruments. Data analysis was carried out using Lawshe's descriptive qualitative content validation formula, namely Content Validity Ratio (CVR). The research results show that this book is suitable for use, with a high CVI value of 0.5 and the final CVI calculation (average CVR) is 0.916667 indicating good content validity. The conclusion of the research in accordance with expert validation is that the use of the Big Book Religious Moderation media is very relevant and suitable for use with PAUD children because the material available in it is appropriate to the child's age development.

Prevalence, subtypes, and risk factors of adverse childhood experiences among Chinese residents: a multicenter cross-sectional study.

Addressing the long-term physical and mental health impacts of adverse childhood experiences (ACEs) remains a significant public health challenge. Additionally, ACEs can contribute to intergenerational transmission, affecting future generations. While previous studies have primarily focused on children and adolescents, there is limited data on ACE subtypes and influencing factors among the general adult population, particularly in China. This study aims to explore the prevalence, subtypes, and factors influencing ACEs among Chinese adults. A total of 1,932 Chinese residents from southwest China (Sichuan, Yunnan, Guizhou provinces, and Chongqing Municipality) participated in the study, consisting of 867 men (44.9%) and 1,065 women (55.1%). Latent class analysis (LCA) was used to identify ACE clusters, and regression analysis examined associations between ACE clusters and demographic factors, physical illness, and mental health outcomes. The findings revealed that 28.7% of participants had experienced at least one ACE, while 13.2% had experienced three or more ACEs. Three distinct ACE clusters were identified: a low ACE group, a high emotional and physical abuse/family dysfunction group, and a high ACE/sexual abuse group. Regression analysis showed significant associations between childhood adversity and demographic factors (age, education, birthplace), as well as physical and mental health outcomes (anxiety, depression). ANOVA further confirmed significant differences in depression and anxiety scores across the clusters. These findings offer critical insights for developing targeted public health interventions. Policymakers should consider strategies to reduce childhood ACEs and mitigate their long-term consequences, with particular attention to high-risk groups.

Tools for Success in Experiential Education for PharmD Students With Trauma and Adverse Childhood Events (ACEs)

In the past 5 years, new priorities for student wellness, burnout prevention, and improved mental health have become top priorities for experiential learning. Individual students' academic resilience is a critical aspect of these student factors. Self-regulatory skills like emotion regulation and executive functioning are vital underlying resilience processes. Preceptors, faculty, and administration should assess threats to academic resilience, such as adverse childhood experiences (ACEs) and trauma, to ensure students' optimal outcomes in experiential learning. This article uses the recognizing, responding, and preventing re-traumatization principles from the Substance Abuse and Mental Health Services Administration (SAMHSA) concept of a trauma-informed approach to provide tools for success for pharmacy students living with trauma and ACEs. Preceptor tools for students living with trauma and ACEs are designed to proactively recognize trauma responses, whether they occur in isolated incidences or of a chronic nature. Screening and assessment can identify students preemptively who may need extra support, resources, and tools for academic resilience. Responding to a student's disclosure with a disclosure plan will lay the groundwork for a safe and productive encounter. During the encounter, prevent re-traumatization by being up to date on sensitive and appropriate language while providing daily logistical tools for success in an experiential practice rotation. Little is known about the specific effects of ACEs on self-regulation, resilience, and executive function in Doctor of Pharmacy students. However, preceptors can provide tools to develop students' academic resilience and improve their educational outcomes in experiential learning.

PSYCHOLOGICAL METHODOLOGY OF CRIME DETECTION (ZIGMUND FREUD ON CRIME)

Sigmund Freud is recognized worldwide as the original psychoanalyst founded to form theories and concepts surrounding the existence of mental illness and its nature in relation to human behavior. Throughout his psychological and psychoanalytic studies, Freud concluded that behavior can be explained through the investigation of one's experiences and traumas by accounting for the motivation of a person's actions. Interpretation of his findings concluded that a person can adapt his/her behavior from childhood experiences to become part of the hidden state of consciousness He studied unobservable behaviors, parts of personality that are not clearly visible within one's nature and at a basic level, cannot be explained. In 1923, Freud created a psychological idea or theory that the human mind had three elements that conceptually make up the "Psyche". The Id (instincts), Ego (reality), and Superego (morality) are not tangible physical areas within the brain, but rather entities that Freud concluded make up the human personality. What Freud called the "psychic apparatus," three elements of the human personality are now established as the unconscious level that dictates biological desires and instincts. Psychoanalytic criminology is a method of studying crime and criminal behavior that is based on Freudian psychoanalysis. This theory or school of thought examines the personality and psyche (especially the unconscious) for motive in crime. Other areas of interest are fear of crime and the act of punishment. Criminal behavior is attributed to maladjustment and dysfunctional personality. According to Buhagiar, "psychoanalytic criminologists were not against the principle of solitary confinement and often favored increased punishment."