Types Of Abuse Research Articles

School nurse's screening for child maltreatment facilitates disclosure – A Swedish intervention study

Early identification of child maltreatment (CM) is essential for children to receive support. The aim was to develop and evaluate a screening instrument for CM to be used by the school nurse in the health dialogue. The research questions included if victimisation could be disclosed by screening, if disclosure led to support measures, and the pupils' and the school nurses' experiences of the screening. A screening instrument to identify CM was developed. A total of 140 pupils and eleven school nurses participated. Mixed methods were used for analysis. Results showed that 29.7% of the participants disclosed CM victimisation and support was given when needed. Girls disclosed exposure to all types of maltreatment to a greater extent than boys. Pupils expressed the importance of screening and it created a trustful relation with the school nurse. No school nurses or pupils were distressed by the screening. Screening for CM facilitated disclosure.

Impact of child maltreatment on bulimic behaviors among the tunisian general population

IntroductionChild maltreatment (CM) refers to all forms of physical or psychological violence, sexual abuse, and neglect of a person under the age of 18, resulting in actual or potential harm to their health, survival, development, or dignity. It is recognized as a predictor of psychological difficulties in adulthood, such as bulimic behavior.ObjectivesThe aim of our study was to assess the link between CM and bulimic behaviors in the Tunisian general population.MethodsWe conducted a cross-sectional, descriptive, and analytical study among Facebook group members, using an online questionnaire, from February 17, 2023, to May 26, 2023. All respondents over the age of 18 were included in the study. CM was assessed using the Childhood Trauma Questionnaire (CTQ), which provides information on five types of maltreatment: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). The Bulimic Investigatory Test, Edinburgh (BITE) was used to screen and assess the intensity of bulimic behavior.ResultsA total of 528 responses were included in the study. The mean age of the sample was 33.3±11.95 years. Mean AE, AP, AS, NE, NP, and overall CTQ scores were 8.30; 6.58; 6.38; 10.14; 7.26, and 49.72, respectively. A history of severe AE, AP, AS, NE, or NP was reported by 13.1%, 10.8%, 8.5%, 11.6% and 8.3% of respondents, respectively. The mean BITE score was 10.76 ±6.85 and 6.6% of our population were at high risk of developing bulimic behavior.In the bivariate study, the BITE score was significantly correlated with all forms of MI. The strongest correlation was with AE (r=0.310; p<0.001).In the multivariate study, only AE was associated with bulimic behaviors.ConclusionsThis study highlighted a positive association between various forms of child neglect and abuse, and bulimic behaviors. It is therefore worth noting that interventions for these disorders may be more effective if they target not only the behavior itself but also underlying risk factors such as maltreatment.Disclosure of InterestNone Declared

Reports of Maltreatment in a Children's Hospital: Evaluation of the Epidemiological Profile and Its Relationship with the Outcome in Fractures.

Objective To describe suspected/confirmed cases of child maltreatment related to fractures in a pediatric hospital in southern Brazil. Method Study of the Information System of Notifiable Diseases notifications and the victims' medical records between January/2016 and December/2020. Variables related to the victim, the perpetrator, the type of abuse, the presence of fractures, and their anatomical location and death were evaluated. Logistic regression was performed to identify fracture-related variables, adjusted for sex and age. The results were expressed in odds ratios and their respective 95% confidence intervals. It was considered significant p < 0.05. Results There were 276 cases, 73 infants (26.4%), male predominance (151, 54.7%), with authorship of the mistreatment by relatives (245, 96,0%), 85 (31,5%), they presented fractures, with five deaths (1.9%). Factors related to the presence of fracture: age of the victim (less than two years old; n = 82; or 2.48; 95% CI: 1.45 - 4.25), having more than two aggressors involved ( n = 144; or 2.09; 95% CI: 1.16-3.75), the medium being traffic/automobile accident, ( n = 52; or 2.65; 95% CI: 1.04-6.75), consult an orthopedist ( n = 91; or 6.77 / 95% CI: 3.66-12.51), and the need for surgical intervention ( n = 15; OR 36.72; 95% CI: 8.22-164.03). Conclusions The importance of suspicion, early identification of aggression, and the correct completion of notifications for activating the system of guaranteeing rights and removal of the aggressor was emphasized.

Childhood maltreatment and somatic symptoms: Examining the role of specific types of childhood maltreatment and alexithymia.

Given the strong association between a history of childhood maltreatment and somatic symptoms, identification of therapeutically modifiable intervention targets is warranted. Alexithymia, or difficulty identifying and describing emotions, may be playing an important role. The present study examined contributions of alexithymia and childhood maltreatment as related to somatic symptoms. Participants (N = 447) completed measures of childhood maltreatment, alexithymia, and somatic symptoms. Two three-step hierarchical linear regressions were conducted to examine the unique contribution of alexithymia after accounting for demographic characteristics and childhood maltreatment. The first regression utilized total scores, and the second explored five domains of childhood maltreatment, a trauma validity index, and three domains of alexithymia. In the first linear regression, childhood maltreatment and alexithymia were significantly associated with higher somatic symptoms. In the second linear regression, childhood maltreatment and alexithymia both significantly added to the model; however, only emotional abuse was significantly associated with somatic symptoms. In line with previous research, childhood maltreatment and alexithymia are associated with somatic symptoms. Given specific domains of alexithymia were nonsignificant in this relationship, it appears no single aspect of alexithymia is of greater importance. Future research should examine these associations longitudinally, as improving alexithymia may help improve outcomes in individuals with childhood maltreatment history experiencing somatic symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Frequency of early childhood trauma in psychiatric patients: an investigation with the Early Trauma Inventory–Self Report

IntroductionChildhood trauma is an important public health problem but there are limitations in our ability to measure childhood trauma. Early Trauma Inventory is a self-report instrument for the assessment of childhood trauma that is valid but simple to administer.ObjectivesWe aimed to assess the frequency of childhood trauma in patients of a large sample of the Crisis Intervention and Psychiatric Ward in Budapest, Hungary.MethodsData from 279 patients referred to Péterfy Alexander Hospital, Crisis Intervention and Psychiatric Ward, Budapest, Hungary, were analyzed. Most participants were female (n = 202, 72.4%) between the ages of 17 and 86 (M = 38.37 yrs). Half of the participants were diagnosed with major depressive disorder (n = 138, 49.5%) or anxiety disorder (n = 149, 53.4%), while 47 of the participants suffered from bipolar disorder (16.8%). One hundred thirty-eight participants had at least one suicide attempt in their life (49.5%). Childhood traumas were assessed by the Early Trauma Inventory– Self Report (ETI-SR), an instrument for the assessment of physical, emotional, and sexual abuse, as well as general traumas, which measures frequency, onset, emotional impact, and other variables. We assessed the most frequent traumas in the physical, emotional, and sexual abuse, as well as general trauma domains.ResultsFamily mental illness (n = 136, 58.1%), witnessing violence (n = 129, 54.7%), divorce/separation of parents (n = 114, 48.3%), and observing death/serious injury of others (n = 112, 47.5%), were the most frequently experienced general traumas. Out of physical traumas, most of the participants experienced being slapped in the face (n = 169, 73.2%), being spanked with a hand (n = 152, 65.5%), being hit or spanked with an object (n = 93, 40.3%), and being pushed or shoved (n = 81, 33.4%). Among emotional traumas, being often put down or ridiculed (n = 170, 74.2%), the needs being failed to be understood by parents (n = 164, 72.7%), often shouted at or yelled at (n = 154, 67.5%), and being often ignored or made feel like they do not count (n = 109, 46.2%) were the most frequent. From the sexual abuse domain, being exposed to flashing (n = 72, 32.9%), being touched in intimate parts in an uncomfortable way (n = 63, 29.2%), being exposed to inappropriate comments about sex (n = 61, 28.5%), and being rubbed by someone’s genitals (n = 44, 20.3%) were the most common. Further results will be presented at the conference.ConclusionsIt is already recognized and our study also confirms that childhood maltreatment, especially sexual abuse can lead to suicidal behaviour. The precise role of particular types of childhood maltreatment and the mediators of the relationship between childhood maltreatment and suicide is yet to be investigated in more details.Disclosure of InterestNone Declared

A preliminary analysis of clinical characteristics of patient with alcohol use disorder and suicidal ideation

IntroductionSuicidal behaviors are frequently observed among patients with substance use disorder, including suicidal ideation (SI) (1). Alcohol use disorder (AUD) is one of the most prevalent addictions and may be related to suicidal behaviors (2,3). However, the association between AUD and SI requires a deeper analysis which includes several clinical features observed among AUD patients.ObjectivesTo analyze the clinical characteristics and features associated with lifetime SI among patients who had AUD.MethodsThis is a cross-sectional study performed in an outpatient center for addiction treatment in patients seeking treatment who met the criteria for AUD between 01/01/2010 and 12/31/2021. Patients were evaluated with an ad-hoc questionnaire and the European addiction severity index (EuropASI). SI was evaluated by using the item for SI in EuropASI.ResultsFrom a potential sample of n=3729 patients, only n=1082 (73.8% males; mean age 42.82±12.51) met inclusion criteria and had data for the current analysis. Lifetime SI was present in 50.9% of the AUD patients. Several clinical features were related to SI, including: sex differences, any type of lifetime abuse, polyconsumption, benzodiazepine use disorder, any psychiatric diagnosis aside of SUD, and higher addiction severity according to the EuropASI (See table)Image:ConclusionsSI among AUD patients is related to several clinical features which indicate a higher addiction severity, more polyconsumption, and a higher prevalence of psychiatric comorbidities. These findings may contribute to the understanding of suicidal behaviors in AUD patients but it is required further investigations, including longitudinal studies.REFERENCES1. Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-445. doi:10.1016/j.psychres.2017.09.022. MacKillop J, et al. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers. 2022;8(1):80. doi:10.1038/s41572-022-00406-1 3. Darvishi N, et al. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis [published correction appears in PLoS One. 2020;15(10):e0241874]. PLoS One. 2015;10(5):e0126870. doi:10.1371/journal.pone.0126870Disclosure of InterestR. Palma-Alvarez Speakers bureau of: RFPA has received speaker honorariums from Angelini, Cassen Recordati, Exeltis, Lundbeck, MSD, Rubió, Servier, and Takeda., A. Rios-Landeo: None Declared, G. Ortega-Hernandez Speakers bureau of: GOH has received speaker honorariums from Rubió., E. Ros-Cucurull Speakers bureau of: ERC has received speaker honorariums from Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Lilly, Servier, Rovi, Juste., C. Daigre: None Declared, M. Perea-Ortueta: None Declared, L. Grau-Lopez Speakers bureau of: LGL has received fees to give talks for Janssen-Cilag, Lundbeck, Servier, Otsuka, and Pfizer., J. Ramos-Quiroga Speakers bureau of: JARQ has been on the speakers’ bureau and/or acted as consultant for Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogi, Sincrolab, Novartis, BMS, Medice, Rubió, Uriach and Raffo.

Реализация обвиняемым права на защиту и злоупотребление правами на стадии предварительного расследования

The article examines possible options for abuses committed by the accused at the stage of preliminary investigation when exercising the right to defence, and substantiates the means to counter these abuses. The author systematises the types of possible abuses, highlights several aspects of activity that limit the abuses of a given participant in criminal legal relations or create obstacles, which include doctrinal, regulatory, and law enforcement, justifying the advisability of taking measures taken to eliminate abuses of law in criminal proceedings.

A preliminary analysis of clinical characteristics of patient with alcohol use disorder and suicidal ideation

IntroductionSuicidal behaviors are frequently observed among patients with substance use disorder, including suicidal ideation (SI) (1). Alcohol use disorder (AUD) is one of the most prevalent addictions and may be related to suicidal behaviors (2,3). However, the association between AUD and SI requires a deeper analysis which includes several clinical features observed among AUD patients.ObjectivesTo analyze the clinical characteristics and features associated with lifetime SI among patients who had AUD.MethodsThis is a cross-sectional study performed in an outpatient center for addiction treatment in patients seeking for treatment who met the criteria for AUD between 01/01/2010 and 12/31/2021. Patients were evaluated with an ad-hoc questionnaire and the European Addiction Severity Index (EuropASI), SI was evaluated using the item for SI in EuropASI.ResultsFrom a potential sample of n=3729 patients, only n=1082 (73.8% males; mean age 42.82±12.51) met inclusion criteria and had data for the current analysis. Lifetime SI was present in 50.9% of the AUD patients. Several clinical features were related to SI, including: sex differences, any type of lifetime abuse, polyconsumption, benzodiazepine use disorder, any psychiatric diagnosis aside from SUD, and higher addiction severity according to the EuropASI.Image:ConclusionsSI among AUD patients is related to several clinical features which indicate a higher addiction severity, more polyconsumption, and a higher prevalence of psychiatric comorbidities. These findings may contribute to the understanding of suicidal behaviors in AUD patients but it is required further investigations, including longitudinal studies.REFERENCES1 Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-445. doi:10.1016/j.psychres.2017.09.0212. MacKillop J, et al. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers. 2022;8(1):80. doi:10.1038/s41572-022-00406-13.Darvishi N, et al. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis [published correction appears in PLoS One. 2020;15(10):e0241874]. PLoS One. 2015;10(5):e0126870. doi:10.1371/journal.pone.0126870Disclosure of InterestNone Declared

Clinical features and factors related to suicidal ideation in adult patients with benzodiazepine use disorder

IntroductionBenzodiazepine use disorder (BUD) has been associated with the presence of suicidal ideation (SI) in general population. It seems there is an overall increase in the risk of attempting suicide due to the increase of impulsivity, rebound and withdrawal of those who use benzodiazepines(1). However, this association has been scarcely studied.ObjectivesTo explore the prevalence, clinical features and factors related to lifetime SI in adults with BUD.MethodsA cross-sectional study was conducted in an outpatient center for addiction treatment between 01/01/2010 and 12/31/2021. Adult patients who met criteria for active BUD were included. Patients with language barriers, cognitive impairments and those who were participating in any clinical trial were excluded. All patients were evaluated with an ad-hoc questionnaire, EuropASI (European Addiction Severity Index), BDI (Beck Depression Inventory) and HRQoL SF-36 (Health-related quality of life according to SF-36). Univariate and bivariate analyses were performed comparing BUD patients with or without SI.Results554 patients were included (65.2% males; M age 42.6±12.6 years). SI was reported in 57.2% of the patients. Regarding the sociodemographic variables, any type of lifetime abuse was correlated with SI (67.8%, 73.5% and 77.8% of the patients with emotional, physical and sexual abuse respectively). Considering the different psychiatric features studied, having any psychiatric diagnosis increased SI up to 64%. Depressive and cluster B personality disorders were the ones with a higher presence of SI (67.1% and 68.1% respectively). Anxiety and cluster A personality disorders had also higher proportions of SI (56.1% and 58,7% respectively). Regarding the different assessment instruments used, a higher punctuation on BDI score was seen in the group of patients with SI (23.73±12.86). The scores also showed a worse perception of the mental quality of life of those people with SI, measured by HRQoL (13.76 and 36.82±31.93 in patients with SI and no SI respectively). Considering the EuropASI, there was an increased proportion of SI in those patients with a worse familiar situation (0.44±0.30), a higher alcohol consumption (0.26±0.28) and a worse psychological condition (0.48±0.24).ConclusionsThe prevalence of SI in patients with BUD is significative and is related to several clinical factors. Those factors should be taken into account in daily clinical practice, research, and any health policies on suicide. Further research should be developed.1. Dodds, T.J. ‘Prescribed benzodiazepines and suicide risk’, The Primary Care Companion For CNS Disorders 2017; 19(2).Disclosure of InterestNone Declared

Злоупотребления правом на досудебных стадиях уголовного процесса: виды и способы их преодоления

The article analyses the concept and signs of abuse of law in criminal proceedings. Among such signs the author names: the presence of a person with a specific subjective right; the implementation of law in contradiction with its purpose, or the purpose of criminal proceedings in general; inconsistency of a person’s behaviour with the criteria of good faith and reasonableness; causing harm to the interests of other participants in criminal proceedings, society and the state. Analysing the signs of abuse of right, the article indicates some types of abuse of right by private individuals or government entities, and makes a distinction between abuse of subjective right and abuse of discretionary powers. In conclusion, the author proposes to provide a legislative mechanism for overcoming abusive behaviour in criminal proceedings in the form of applying specific response measures to individuals and officials.

The Failure to Recognize Continuing Harm: Post-Separation Domestic Abuse in Child Contact Cases.

This article presents findings from a case file review of post-separation parenting cases in England and Wales. It first outlines that jurisdiction's legal framework relevant to these cases, before providing an overview of the findings relating to the profile of the cases and their outcomes. It then describes the types of abuse most frequently encountered in these cases, and examines the attitude of the courts to post-separation abuse by looking at both interim and final court orders. The study finds that key legal provisions governing these cases are not being followed, with little understanding shown for the nature of post-separation abuse.

영유아 장애아동을 대상으로 한 보육교사 행위의 신체적 학대 성립 여부에 관한 판례연구

The purpose of this study was to examine the judgment criteria used in the legal system for physical abuse by childcare teachers for infants and toddlers with disabilities by analyzing the relevant precedents; this is also expected to contribute to the ongoing discussions regarding this topic. The research method analyzes the judgment criteria using a qualitative research method, ➀ the important legal applications of the judgment, and it also ➁ selects two cases in which the behavior of childcare teachers around infants and toddlers with disabilities was established as physical abuse and finally examines the effect of the presence of direct tangible force on the court judgment of physical abuse. As a result, it was confirmed that criteria that are at the discretion of the judge are applied to the judgment of innocence even if there is a direct exercise of tangible power. It was also confirmed that the discretion of the judge plays an important role in determining the final inclusion of judgment criteria that take into account various situations that can be considered as physical abuse harming the health and development of the body, even without a direct exercise of tangible power. On the other hand, the judge's discretionary judgment showed that the characteristics of the disability were applied as a major factor. The results of this research present implications that can contribute to ongoing discussions about the judicial, legislative, and administrative aspects of this type of physical abuse.

Some aspects of the abuse of rights in civil and economic proceedings

The article is devoted to the analysis of abuse of procedural rights in civil and economic proceedings. The views and approaches to the problem of abuse of rights available in the legal literature are considered.&#x0D; Based on the review of scientific literature, the conclusion has been made that there are two general theoretical constructs for understanding the concept of “abuse of procedural rights” within the framework of two approaches. The first approach involves the definition of abuse of procedural rights as misuse of procedural rights, and the second approach – as a type of procedural offence. The article analyses the national legislation on the subject matter of the study.&#x0D; It is argued that the abuse of procedural rights is a certain situation which participants to court proceedings find themselves in, whose rights are violated and are directly related to the rights of the person who abuses them. The exercise of procedural rights is carried out by one party to the dispute within certain limits, as long as it does not contradict the interests of the other party. Violation of these limits leads to the emergence and existence of such a legal phenomenon as abuse of rights.&#x0D; It is established that abuse of procedural rights means that one of the parties to a dispute, which formally has certain rights, unlawfully exercises them, violating the extent and type of behaviour defined by the procedural law, while taking advantage of the fact that these rights cannot be objectively clearly defined by means of direct prohibitions. In other words, when exercising their rights, the parties to the dispute do not take into account all the actual circumstances and do not take into account the possible harm to each other’s interests.&#x0D; Attention is drawn to the fact that the diversity of procedural rights in civil and commercial proceedings gives rise to a corresponding number of types of their abuse by the parties to a case. Due to the absence of a clear list in current legislation of the types of abuse of procedural rights and the existence of certain judicial practice in resolving this category of cases, it should be noted that there are various classifications by scholars.

Sex differences in the association between (sexual) abuse and lower urinary tract symptoms.

To study the possible association between (sexual) abuse and lower urinary tract symptoms (LUTS) in men and women. To study the differences in this association between men and women, and between the timing of the abuse. A Dutch observational population-based cross-sectional study was used, based on self-administered questionnaires. Respondents were included if they had answered all questions about abuse and LUTS. Logistic regression was used to analyse the data. Included were 558 men and 790 women, of whom 29% and 37%, respectively, reported a history of one of more types of abuse. Abuse was significantly associated with LUTS in both men (odds ratio [OR] 1.7; 1.2-2.5) and women (OR 1.4; 1.1-2.1). This association, testing by two-way interaction, was significantly stronger in men. No association was found between childhood abuse or adulthood abuse and LUTS, in men or women. The association of sexual abuse with LUTS was significant in both men (2.7; 1.4-5.2) and in women (1.5; 1.1-2.2), and this association (testing by two-way interaction) was significantly much stronger in men. In men more than in women, a history of any type of abuse is associated with LUTS, regardless of whether the abuse occurred during childhood or adulthood. In both sexes, a history of sexual abuse is also associated with experiencing LUTS, with a much stronger association in men than in women. Patients, in particular male patients, presenting with LUTS should therefore be asked about sexual abuse in the past.

Impact of Sexual Abuse on Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review

Child sexual abuse (CSA), the most common type of maltreatment, is any action of a sexual nature by one or more adults towards a minor without the minor’s consent. This abuse represents one of the most damaging forms of trauma, has a severe impact on mental health and psychopathology, and can lead to several disorders, including post-traumatic stress disorder (PTSD). PTSD is characterized as a disorder that encompasses physical symptoms resulting from traumatic experiences that are experienced or witnessed by the victim. This systematic review aims to understand the impact of sexual abuse on post-traumatic stress disorder in children and adolescents. Studies focusing on the relationship between these two variables were obtained through multiple databases. Of the 940 documents collected, 24 were retained for further analysis and the objectives, methodologies, results, and main conclusions were registered. One of the main conclusions was that the earlier the abuse starts and the more severe and long-lasting it is, the symptomatology of PTSD will be aggravated and remain in the long term.

The mediating effect of social support and body appreciation between child abuse and disordered eating symptoms among Lebanese adolescents

ObjectiveThe current study examines the mediating effect of social support and body appreciation between child abuse and disordered eating symptoms among Lebanese adolescents.MethodsThis study, involving 403 participants, was cross-sectional and conducted between August and September 2022. Lebanese adolescents from all of Lebanon’s governorates were recruited through the “Snowball Sampling” method. The measuring instruments composing the questionnaire included the Eating Attitudes Test (EAT-7) which identifies the presence of risk for eating disorders based on eating-related attitudes, behaviors and feelings; the “Multidimensional Scale of Perceived Social Support (MSPSS)” which measures, from three separate sources, the extent of one’s perception of social support; the “Body Appreciation Scale (BAS)” which assesses the care and respect one has for their own body, along with the acceptance and protection of one’s body from unrealistic beauty ideals; and the “Child Abuse Self-Report Scale (CASRS-12)” which detects lifelong child abuse.ResultsParticipants’ mean age was 16.63 ± 1.46 years with 57.3% of females. The results highlight the effect of mediation of social support and body appreciation in the association between all types of child abuse and disordered eating symptoms. Additionally, a significant association was indicated between more abuse and lower social support and body appreciation, whereas another was underscored between higher social support and body appreciation and more appropriate eating attitudes. Lastly, all types of child abuse were observed to be notably associated with further inappropriate eating attitudes.ConclusionThe current mediation findings preliminarily indicate that experiences of all forms of child abuse may have possibly triggered perceived lack of social support and low levels of body appreciation, which have in turn resulted in more severe disordered eating symptoms in predisposed adolescents. This cautiously suggests that both social support and body appreciation may be regarded as key targets for community-based prevention and intervention strategies aiming at reducing the risk of developing severe eating disorders in adolescents.

Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses

BackgroundChildhood maltreatment is common globally and impacts morbidity, mortality, and well-being. Our understanding of its impact is constrained by key substantive and methodological limitations of extant research, including understudied physical health outcomes and bias due to unmeasured confounding. We address these limitations through a large-scale outcome-wide triangulation study.MethodsWe performed two outcome-wide analyses (OWAs) in the UK Biobank. First, we examined the relationship between self-reported maltreatment exposure (number of maltreatment types, via Childhood Trauma Screener) and 414 outcomes in a sub-sample of 157,316 individuals using generalized linear models (“observational OWA”). Outcomes covered a broad range of health themes including health behaviors, cardiovascular disease, digestive health, socioeconomic status, and pain. Second, we examined the relationship between a polygenic risk score for maltreatment and 298 outcomes in a non-overlapping sample of 243,006 individuals (“genetic OWA”). We triangulated results across OWAs based on differing sources of bias.ResultsOverall, 23.8% of the analytic sample for the observational OWA reported at least one maltreatment type. Of 298 outcomes examined in both OWAs, 25% were significant in both OWAs and concordant in the direction of association. Most of these were considered robust in the observational OWA according to sensitivity analyses and included outcomes such as marital separation (OR from observational OWA, ORo = 1.25 (95% CI: 1.21, 1.29); OR from genetic OWA, ORg = 1.06 (1.03, 1.08)), major diet changes due to illness (ORo = 1.27 (1.24, 1.29); ORg = 1.01 (1.00, 1.03)), certain intestinal diseases (ORo = 1.14 (1.10, 1.18); ORg = 1.03 (1.01, 1.06)), hearing difficulty with background noise (ORo = 1.11 (1.11, 1.12); ORg = 1.01 (1.00, 1.01)), knee arthrosis (ORo = 1.13 (1.09, 1.18); ORg = 1.03 (1.01, 1.05)), frequent sleeplessness (ORo = 1.21 (1.20, 1.23); ORg = 1.02 (1.01, 1.03)), and low household income (ORo = 1.28 (1.26, 1.31); ORg = 1.02 (1.01, 1.03)). Approximately 62% of results were significant in the observational OWA but not the genetic OWA, including numerous cardiovascular outcomes. Only 6 outcomes were significant in the genetic OWA and null in the observational OWA; these included diastolic blood pressure and glaucoma. No outcomes were statistically significant in opposite directions in the two analyses, and 11% were not significant in either OWA.ConclusionsOur findings underscore the far-reaching negative effects of childhood maltreatment in later life and the utility of an outcome-wide triangulation design with sensitivity analyses for improving causal inference.

Associations between emotional maltreatment, depression and self-harm among Chinese adolescents: A three-wave longitudinal mediation model

BackgroundSelf-harm seriously endangers adolescents' physical and mental health. However, the longitudinal mechanism of self-harm is not yet clear. ObjectiveThis study explored the inconsistent relationships between two types of emotional maltreatment and self-harm across three waves, regarding depression as a potential mediator and gender as a moderator of these associations. Participants and settingA sample of 588 Chinese adolescents (Mage at T1 = 12.79 years) in a middle school completed the assessment of demographic information, emotional maltreatment, depression and self-harm within one year. MethodsPath analysis models were created to estimate the relationship of emotional maltreatment with self-harm and the mediating effect of depression. A multi-group analysis was applied to investigate the moderating effect of gender. ResultsThere existed positive associations between emotional abuse at T1 and self-harm at T2 and T3 (β = 0.12, SE = 0.05, p = 0.006; β = 0.09, SE = 0.05, p = 0.054), and the mediating effect of emotional abuse at T1 on self-harm at T3 via depression at T2 was significant (Indirect effect = 0.05, SE = 0.02, 95 % CI [0.02, 0.08]). Multi-group analysis of gender revealed no significant differences in the cross-lagged pathways, but there were stronger links for girls than boys among self-harm at T1, T2, and T3 (p < 0.001). ConclusionsEmotional abuse but not emotional neglect could significantly predict self-harm. Furthermore, depression played a mediating role in the longitudinal relationship between emotional abuse and self-harm. Girls who had high levels of self-harm at a previous time point were more inclined than boys to harm themselves at a subsequent time point. These findings provide a different perspective to develop effective prevention and intervention measures.

Suicidal ideation in patients with diabetes and childhood abuse – The mediating role of personality functioning: Results of a German representative population-based study

AimsSuicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning. MethodsIn a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi2-Tests, logistic regression and mediation analyses. ResultsThe prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ2(1) = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ2(1) = 10.892, p <.001). A dose–response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]). ConclusionsDiabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.

Adult self-reported childhood maltreatment types are associated with treatment satisfaction and alcohol relapse in patients with comorbid substance use and mental health disorders.

Individuals with comorbid substance use and mental health disorders (concurrent disorders; CD) report poor treatment outcomes, high prevalence of childhood maltreatment, and mostly negative experiences with treatment. No studies to date have examined childhood maltreatment and treatment outcomes in CD. This study investigated self-reported childhood maltreatment as it relates to treatment satisfaction and substance use relapse among CD patients. The 258 CD inpatients completed a self-report questionnaire package, comprising the Childhood Trauma Questionnaire and the Inpatient Consumer Survey (ICS). Childhood maltreatment was assessed according to five subtypes and self-perceived treatment satisfaction was rated across six ICS domains. Psychiatric diagnoses, substance use status and relapse data were retrieved via patient medical charts. Emotional neglect was associated with lower ratings across all ICS domains and physical neglect was associated with a lower rating for 'outcome of care'. Childhood sexual abuse was associated with a greater likelihood of alcohol relapse. No other relationships were statistically significant. The presence of childhood neglect (but not abuse) was more associated with overall treatment dissatisfaction, and sexual abuse alone increased the likelihood of alcohol relapse. These findings suggest some early adverse experiences in CD patients may increase negative experiences in treatment while others contribute to the risk of substance use. Broader longitudinal research is needed to examine the trajectory leading to negative outcomes. This is the first study to report differential patterns of association by type of childhood maltreatment on negative outcomes in treatment among CD patients.