Childhood Maltreatment and Immune Cell Gene Regulation during Adolescence: Transcriptomics Highlight Non-Classical Monocytes.

Childhood maltreatment has been repeatedly linked to a higher incidence of health conditions with an underlying proinflammatory component, such as asthma, chronic obstructive pulmonary disease, stroke, and cardiovascular disease. Childhood maltreatment has also been linked to elevated systemic inflammation prior to the onset of disease. However, childhood maltreatment is highly comorbid with other risk factors which have also been linked to inflammation, namely major depression. The present analysis addresses this issue by assessing the association of maltreatment with genome-wide transcriptional profiling of immune cells collected from four orthogonal groups of adolescents (aged 13-17): maltreated and not maltreated in childhood, with and without major depressive disorder. Maltreatment and psychiatric history were determined using semi-structured clinical interviews and cross-validated using self-report questionnaires. Dried whole blood spots were collected from each participant (n = 133) and assayed to determine the extent to which maltreatment in childhood was associated with a higher prevalence of transcriptional activity among differentially expressed genes, specific immune cell subtypes, and up- or down-regulation of genes involved in immune function after accounting for current major depression. Maltreatment was associated with increased interferon regulatory factor (IRF) transcriptional activity (p = 0.03), as well as nuclear factor erythroid-2 related factor 1 (NRF1; p = 0.002) and MAF (p = 0.01) among up-regulated genes, and increased activity of nuclear factor kappa beta (NF-κB) among down-regulated genes (p = 0.01). Non-classical CD16+ monocytes were implicated in both the up- and down-regulated genes among maltreated adolescents. These data provide convergent evidence supporting the role of maltreatment in altering intracellular and molecular markers of immune function, as well as implicate monocyte/macrophage functions as mechanisms through which childhood maltreatment may shape lifelong immune development and function.

The mediating role of trait mindfulness and dissociative experiences in the relationship between childhood emotional abuse and problematic internet use in Italian adolescents.

There is clear evidence linking trauma, mindfulness, dissociation and problematic internet use (PIU). Nonetheless, little is known about the role trait mindfulness and dissociative experiences may have in the relationship between childhood emotional abuse (CEA) and PIU, as well as the role that gender may have in such relationships. In the current research, self-report questionnaires on CEA, trait mindfulness, dissociative experiences and PIU were administered to 1074 Italian adolescents (50% females) aged 14-17 years old, to test whether trait mindfulness and dissociative experiences mediated the relationship between CEA and PIU, and whether the proposed mediation was invariant across genders. Furthermore, the main analyses were controlled for background variables. The findings highlighted significant associations between all direct and indirect paths and invariance of the mediation model across boys and girls. The results of this study highlight that emotionally abused boys and girls with high levels of dissociation and inadequate mindful skills may be more exposed to dysfunctional online activities. Hence, developing dissociation-focused and mindfulness-based interventions for emotionally abused adolescents may be clinically effective when building tailored approaches for the prevention and management of PIU. Further implications are discussed.

[Medical Child Abuse - A Guideline to Detecting this Particular Form of Child Maltreatment]. / Medical Child Abuse ­ Ein Leitfaden zur Diagnostik dieser Sonderform der emotionalen und körperlichen Gewalt.

The term Medical Child Abuse (MCA) describes a form of child abuse in which the medical system is "abused" by carrying out unnecessary medical procedures on a child. This abuse of the medical system occurs through misrepresentation, non-disclosure, fabrication, misinterpretation or active causation of symptoms by a parent. In this article, the construct ofmedical child abuse is defined and predisposing and motivational factors are examined. It also provides an overview of terms that are used synonymously or comparably in the literature and discusses the connection between MCA and Munchausen-by-proxy-syndrome.The core of the article is the presentation of an internal guideline, which was created by the interdisciplinary working group on MCA of the Clinics for Paediatric and Adolescent Medicine, the Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, the Child Protection Outpatient Clinic and the Social Services at the Charité. It also outlines possible interventions.

The association between child maltreatment and health risk behaviours and conditions throughout life in the Australian Child Maltreatment Study.

OBJECTIVE: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. DESIGN, SETTING, PARTICIPANTS: Nationally representative survey of Australian residents aged 16 years and older conducted by computer-assisted telephone interviewing. MAIN OUTCOME MEASURES: Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self-harm in past 12 months, and suicide attempt in past 12 months. RESULTS: A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16-24-year-olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self-harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. CONCLUSIONS: Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.

The influence of childhood maltreatment on trait depression in patients with major depressive disorder: A moderated mediation model of rumination and mindful attention awareness.

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders. Individuals who were exposed to childhood maltreatment might be an especially vulnerable group and were more likely to meet the diagnostic criteria for depression than those who were not. Trait depression refers to a personality trait predisposition to depression, expressed as the frequency of symptoms rather than a transient depressive mood state. Clarifying the relationship between childhood maltreatment and trait depression in patients with MDD has therefore become an important field of research. Childhood Trauma Questionnaire-Short Form (CTQ-SF), Ruminative Responses Scale (RRS), State-Trait Depression Scale (ST-DEP), and Mindful Attention Awareness Scale (MAAS) were used as research instruments. SPSS 23.0 statistical software was used for statistical analysis and examined the moderated mediation models. A total of 288 patients with MDD were included in this study. After standardization of the variables, the model revealed childhood maltreatment was positively associated with trait depression (ß = 0.215, p < 0.001) and that rumination partially mediated the effect between childhood trauma and trait depression. Mindfulness moderated the association between rumination and trait depression in depressed patients (ß = 0.171, p < 0.001). Simple slope tests showed that rumination significantly predicted trait depression in patients with high levels of mindfulness (bsimple = 0.460, p < 0.001, 95%CI = [0.339, 0.581]), while this predictive effect was not significant in patients with low levels (bsimple = 0.119, p = 0.097, 95%CI = [-0.022, 0.261]). After adding mediating variables, we found that the negative impact of childhood maltreatment on trait depression was both directly and indirectly through the patients' own ruminative levels. However, mindfulness performed a critical moderating role in the overall mediating model, aggravating the negative impact of childhood maltreatment on trait depression. There are several limitations in this study: the history of childhood maltreatment was reviewed and reported; the MAAS was a single-dimensional questionnaire that fails to measure the content of other mindfulness factors; cross-sectional data could not be used to infer the causal relationship between variables.

Childhood maltreatment and suicidal ideation in Chinese children and adolescents: the mediating role of mindfulness.

BACKGROUND: Childhood maltreatment (CM) has been associated with suicidal ideation (SI) in children and adolescents, yet the mediating role of mindfulness in this association remains unclear. This study aims to test the mediation of mindfulness in CM-SI association among a large sample of Chinese children and adolescents. METHODS: A population-based cross-sectional study of 3455 children and adolescents aged 10-17 years from southwest China Yunnan province was conducted. Information from the participants was collected by using a comprehensive self-administered questionnaire. The Chinese version of the Childhood Trauma Questionnaire (CTQ), Five Facet Mindfulness Questionnaire (FFMQ), and the Beck Scale for Suicidal Ideation (BSSI) were used to measure CM, mindfulness and SI. Univariate and multivariate binary logistic regression models were used to estimate the crude and adjusted associations between CM, mindfulness and SI (one-week, one-year, lifetime). Pathway analysis was subsequently performed to test the mediation of mindfulness in CM-SI association. RESULTS: The findings showed that mindfulness, CM and SI were significantly correlated with each other (p < 0.05). Mindfulness is a significant mediator in CM-SI association, accounted for 7.5, 11.4, and 17.6% of the total associations for one-week SI, one-year SI, and lifetime SI, respectively. For the five types of CM, the highest level of mediation via mindfulness had been found for physical neglect (PN) and one-year SI (34.3%), followed by emotional neglect (EN) and one-year SI (30.2%), sexual abuse (SA) and one-year SI (25.4%). CONCLUSIONS: Our study findings highlight the intervention potential of mindfulness in preventing CM associated suicidal risk. Future longitudinal studies are warranted to corroborate the effectiveness of mindfulness-based intervention for Chinese children and adolescents.

Psychoanalytic Interventions with Abusive Parents: An Opportunity for Children's Mental Health.

Research has extensively shown that most people who experience maltreatment in their childhood develop mental disorders, psychosocial adjustment problems, and, in many cases, become maltreating adults themselves. Preventing child maltreatment and treating abused children and abusive parents are, therefore, pressing public health issues. As established by the UK Children Act in 1989, child development is enhanced by remaining in the family whenever the child's safety is assured. Thus, developing prevention and intervention programs for the purpose of repairing, whenever possible, the child-parent relationship should be a social priority. This narrative review focuses on the psychoanalytic studies related to intrapsychic dynamics and therapeutic intervention for physically abusive parents. The role of the transgenerational transmission of abuse and parents' narcissistic fragility is crucial. Psychoanalytic interventions focus on helping the parent work through their past painful experiences and narcissistic vulnerability. Parent-child psychotherapy and mentalization-based treatment have been found to be prevalent, while there is scarce literature regarding intensive individual psychoanalytic treatment. Within the framework of attachment theory, brief interventions were developed; however, they did not prove effective for those parents who suffered experiences of maltreatment or severe neglect in childhood and for whom long-term parent-child psychotherapy resulted, which proved to be the most effective.

Mental imagery in adolescent PTSD patients after child abuse: a comparison with matched healthy controls.

BACKGROUND: Intrusive mental imagery (MI) plays a crucial role in the maintenance of posttraumatic stress disorder (PTSD) in adults. Evidence on the characteristics of MI in adolescents suffering from PTSD is sparse. The aim of this study was to thoroughly assess MI in an adolescent sample suffering from PTSD after the experience of childhood sexual abuse and/or childhood physical abuse (CA). METHODS: Thirty-two adolescents with a primary diagnosis of PTSD after CA and 32 adolescents without any mental disorder and without a history of CA, matched for age and gender, completed questionnaires assessing the characteristics of negative and positive MI, as well as images of injury and death that lead to positive emotions (ID-images). RESULTS: The PTSD group reported significantly more frequent, more vivid, more distressing and more strongly autobiographically linked negative MI compared to the control group. Although positive MI was highly present in both groups (PTSD: 65.6%; controls: 71.9%), no significant differences emerged between the two groups regarding the distinct characteristics of positive MI. The frequency of the ID-images did not significantly differ between the two groups (PTSD: 21.9%; controls: 9.4%), although the ID-images were more vivid in the PTSD group. DISCUSSION: Negative MI appears to be crucial in adolescent PTSD, whilst positive MI are unexpectedly common in both the PTSD and the control group. The role of positive MI as well as that of ID-images remain unclear. Specific interventions for changing negative MI that are tailored to the developmental challenges in adolescents with PTSD should be developed. TRIAL REGISTRATION: Some of the PTSD patients in this study were also part of a randomized controlled trial on Developmentally adapted Cognitive Processing Therapy (D-CPT). This trial was registered at the German Clinical Trial Registry (GCTR), DRKS00004787 , 18 March 2013.

Mindfulness and Attachment as Concurrent Mediators Linking Childhood Maltreatment to Depressive, Anxious, and Dissociative Symptoms.

Childhood maltreatment has been consistently associated with adult symptoms of depression, anxiety, and dissociation, and attachment has been proposed as one mediator. Attachment, however, tends to only partially mediate the association, and mindfulness may be another explanatory pathway. The current study examined mindfulness and attachment in a multiple mediator model linking maltreatment to adult symptoms of depression, anxiety, and dissociation. A sample of 232 adults were recruited from two universities and an online sample who completed an online survey. Using structural equation modeling, childhood maltreatment was indirectly associated to symptoms of depression (ß = .104; 95% CI [.015, .193]), anxiety (ß = .090; 95% CI [.014, .166]), and dissociation (ß = .088; 95% CI [.006, .170]) through mindfulness. Additionally, childhood maltreatment was associated with symptoms of depression (ß = .062; 95% CI [.007, .118]), anxiety (ß = .074; 95% CI [.009, .139]), and dissociation (ß = .069; 95% CI [.017, .121]) through attachment avoidance. No significant indirect effects were found through attachment anxiety. These findings indicate that both mindfulness and attachment may be explanatory pathways linking childhood maltreatment. Inclusion of both attachment and mindfulness provides a more robust theoretical understanding of how maltreatment is associated with adult mental health.

Patterns of adverse childhood experiences and mental health outcomes among American Indians with type 2 diabetes.

BACKGROUND: Extensive research demonstrates that Adverse Childhood Experiences (ACEs) are highly interconnected and have numerous health consequences well into adulthood. Yet, there is a dearth of focused research that examines ACEs and health inequities for American Indians (AIs). OBJECTIVE: To assesses the prevalence of ten types of childhood adversities, explore constellations of exposures, and examine whether there are differential risks of mental health outcomes according to sub-group classification. PARTICIPANTS AND SETTING: Adult AIs with type 2 diabetes from five reservation-based tribal communities in the Great Lakes region of the U.S. METHODS: Prevalence was estimated using a modified version of the World Health Organization's ACE-International Questionnaire. To examine heterogeneity in ACEs exposures, latent class analysis was used. Risk of mental health outcomes was calculated by class. RESULTS: The four most common ACEs reported were residing with someone who abused substances, witnessing household violence, incarceration of a household member, and sexual abuse. Three latent classes were identified: low risk (56.7%), family maladjustment with high probabilities of household violence, incarceration, and substance abuse (27.1%), and complex trauma (16.3%) with moderate to high probabilities of exposure to all ACEs. The most consistent differences in mental health outcomes were between the low risk and complex trauma classes. CONCLUSIONS: Identification of a high number of participants in the low-risk class helps structure a more wholistic image of AI families, as negative stereotypes of AIs are abundant. For the minority of individuals in the complex trauma class, risk for chronic mental health challenges and co-morbidities appears to be high.

La escucha psicoanalítica y los recursos psicodramáticos en un grupo de hombres que experimentaron violencia infantil en Costa Rica / The Psychoanalytic Listening and the Psychodramatic Techniques in a Group of Men Who Experienced Childhood Violence in Costa Rica

Resumen Objetivo. Sistematizar los aportes de la escucha analítica con elementos psicodramáticos y corporales en un grupo de hombres que experimentaron violencia durante su infancia. Método. Sistematización y análisis por categorías temáticas, a partir de observación participante, registros escritos y de audio, del discurso verbal y corporal de 9 hombres en un grupo de terapia psicoanalítica con técnicas psicodramáticas. Resultados. Se concluye que la violencia promueve una relación de maltrato con el propio sujeto y la experiencia de dolor es inscrita en el cuerpo como posibilidad de expresión. El abordaje grupal facilitó la reelaboración del sufrimiento psíquico mediante el uso del cuerpo para reconocer y verbalizar emociones de la escena traumática en un encuentro de subjetividades.

Abstract Objective. Systematize the contributions of the psychoanalytic clinic with psychodramatic and body techniques in a group of men who experienced violence in their childhood. Method. Systematization and analysis by theme categories, based on participant observation, written and audio recording, from the verbal and body speech of nine men in psychoanalytic group therapy by using psychodramatic techniques. Results. In conclusion, violence promotes an abusive relationship with the person himself, and the experience of pain is inscribed in the body as a possibility of expression. The group approach facilitated the reworking of psychic suffering through the body to recognize and verbalize emotions from the traumatic scene in an encounter of subjectivities.

Reported maternal childhood maltreatment experiences, amygdala activation and functional connectivity to infant cry.

Maternal childhood maltreatment experiences (CMEs) may influence responses to infants and affect child outcomes. We examined associations between CME and mothers' neural responses and functional connectivity to infant distress. We hypothesized that mothers with greater CME would exhibit higher amygdala reactivity and amygdala-supplementary motor area (SMA) functional connectivity to own infant's cries. Postpartum mothers (N = 57) assessed for CME completed an functional magnetic resonance imaging task with cry and white-noise stimuli. Amygdala region-of-interest and psychophysiological interaction analyses were performed. Our models tested associations of CME with activation and connectivity during task conditions (own/other and cry/noise). Exploratory analyses with parenting behaviors were performed. Mothers with higher CME exhibited higher amygdala activation to own baby's cries vs other stimuli (F1,392 = 6.9, P < 0.01, N = 57) and higher differential connectivity to cry vs noise between amygdala and SMA (F1,165 = 22.3, P < 0.001). Exploratory analyses revealed positive associations between both amygdala activation and connectivity and maternal non-intrusiveness (Ps < 0.05). Increased amygdala activation to own infant's cry and higher amygdala-SMA functional connectivity suggest motor responses to baby's distress. These findings were associated with less intrusive maternal behaviors. Follow-up studies might replicate these findings, add more granular parenting assessments and explore how cue processing leads to a motivated maternal approach in clinical populations.

What type of survey research questions are identified by adults as upsetting? A focus on child maltreatment.

BACKGROUND: Research on child maltreatment is imperative to inform evidence-based prevention and intervention efforts. Nonetheless, researchers continue to face barriers due to the perceived sensitivity and possibility of harm when asking about these experiences. While studies have started to explore reactions to participating in research on sensitive topics, there are notable limitations and fewer have focused on child maltreatment. OBJECTIVE: The objective of this study was to better understand adult respondents' identification of, and reactions to, potentially upsetting questions in the context of a well-being and experiences survey, with a focus on child maltreatment. METHODS: Data were from the first wave of the Well-Being and Experiences Study in Manitoba, Canada: a computerized self-reported community-based survey of adolescents and their parents/caregivers administered individually at a research facility. The current study focused on parents/caregivers' responses (N = 1000). The study utilized a mixed methods approach with descriptive statistics and qualitative thematic analyses of open-ended responses of their perceptions of upsetting questions. RESULTS: Overall, few respondents (15.1 %) identified any questions as upsetting. Ten themes emerged in respondents' recall of upsetting questions, including maltreatment and other themes often perceived as less sensitive. Only 4% identified maltreatment-related questions as upsetting. Among those who identified any questions or maltreatment-specific questions as upsetting, most felt they were important to ask and should not be removed (92.7 %-97.5 %). These findings suggest that retrospective survey questions about experiences of child maltreatment involving adult samples are not associated with major upset and should be included in future health and social surveys.

The impact of neurofeedback training on children with developmental trauma: A randomized controlled study.

OBJECTIVE: Developmental trauma or chronic early childhood exposure to abuse and neglect by caregivers has been shown to have a long-lasting pervasive impact on mental and neural development, including problems with attention, impulse control, self-regulation, and executive functioning. Its long-term effects are arguably the costliest public health challenge in the United States. Children with developmental trauma rarely have a satisfactory response to currently available evidence-based psychotherapeutic and pharmacological treatments. Neurofeedback training (NFT) is a clinical application of brain computer interface technology, aiming to alter electrical brain activity associated with various mental dysfunctions. NFT has shown promise to improve posttraumatic stress disorder (PTSD) symptoms. METHOD: This randomized controlled study examined the effects of NFT on 37 children, aged 6-13 years with developmental trauma. Participants were randomly divided into active NFT (n = 20) or treatment-as-usual control (n = 17). Both groups underwent 4 assessments during equivalent timelines. The active group received 24 NFT sessions twice a week. RESULTS: This pilot study demonstrated that 24 sessions of NFT significantly decreased PTSD symptoms, internalizing, externalizing, other behavioral and emotional symptoms, and significantly improved the executive functioning of children aged 6-13 years with severe histories of abuse and neglect who had not significantly benefited from any previous therapy. CONCLUSIONS: NFT offers the possibility to improve learning, enhance self-efficacy, and develop better social relationships in this hitherto largely treatment-resistant population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma.

INTRODUCTION: Exposure to traumatic stressful events in childhood is an important risk factor for the development of posttraumatic symptomatology. From a mentalization-based developmental perspective, childhood adversity can affect attachment in children and may result in insecure attachment and impaired mentalizing abilities, which increase the lifetime risk for psychopathology. The present cross-sectional study examined the potential mediating role of attachment insecurity and impaired mentalizing on the relationship between childhood trauma and posttraumatic symptomatology. METHOD: Adults who had experienced childhood neglect and abuse (n = 295, 184 patients with personality disorder and 111 community controls) completed self-report measures of posttraumatic stress disorder (PTSD) symptoms, dissociative experiences, adult attachment insecurity, and mentalizing. RESULTS: Structural equation modelling results revealed that attachment insecurity together with lower mentalizing mediated the link between childhood trauma and PTSD symptoms, and lower mentalizing mediated the link between childhood trauma and dissociative experiences. CONCLUSION: The findings show that attachment insecurity and lower mentalizing play significant mediating roles in the reporting of posttraumatic symptomatology among survivors of childhood abuse and neglect, with treatment implications for mentalization-based therapy as beneficial for individuals with a history of childhood trauma.

Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents.

Childhood trauma experience (CT) is negatively associated with many aspects of adult life. Religiosity/spirituality (R/S) are often studied as positive coping strategies and could help in the therapeutic process. Evidence on this is lacking for a non-religious environment. The aim of this study was to assess the associations of different types of CT with R/S in the secular conditions of the Czech Republic. A nationally representative sample (n = 1800, mean age = 46.4, SD = 17.4; 48.7% male) of adults participated in the survey. We measured childhood trauma, spirituality, religiosity and conversion experience. We found that four kinds of CT were associated with increased levels of spirituality, with odds ratios (OR) ranging from 1.17 (95% confidence interval 1.03-1.34) to 1.31 (1.18-1.46). Non-religious respondents were more likely to report associations of CT with spirituality. After measuring for different combinations of R/S, each CT was associated with increased chances of being "spiritual but non-religious", with OR from 1.55 (1.17-2.06) to 2.10 (1.63-2.70). Moreover, converts were more likely to report emotional abuse OR = 1.46 (1.17-1.82) or emotional neglect with OR = 1.42 (1.11-1.82). Our findings show CT is associated with higher levels of spirituality in non-religious respondents. Addressing spiritual needs may contribute to the effectiveness of psychotherapeutic treatment of the victims.

Nurses' perceptions of systems and hierarchies shaping their responses to child abuse and neglect.

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through in-depth interviews with nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational 'rule-centred' culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child-centred approach.

Assistência de enfermagem à criança/adolescente vítima de violência: revisão integrativa / Nursing care for child/adolescent victims of violence: integrative review / Asistencia de enfermería al niño/adolescente víctima de violencia: revisión integrativa

Objetivo: desvelar a produção acerca da assistência de enfermagem prestada às crianças/adolescentes vítimas de violência. Método: trata-se de uma revisão sistematizada realizada com consulta nas bases de dados: LILACS, Scielo e BDENF. Foram selecionados 19 artigos para compor este trabalho. A análise de dados deu-se por meio da proposta de Mendes, Silveira e Galvão. Resultados: os dados foram discutidos através dos tópicos: despreparo dos profissionais frente aos casos de violência infantil; sentimentos dos profissionais envolvidos no cuidado à criança/adolescente vítima de violência; notificação, protocolos e rotinas na assistência à criança/ adolescente vítima de violência; estratégias de assistência à criança/adolescente vítima de violência. Conclusão: os profissionais de enfermagem não se sentem preparados para atuarem frente aos casos de violência infantil. Identificou-se a necessidade de protocolos assistenciais que respaldem a assistência profissional. Ademais, é importante o fortalecimento da rede de atenção intersetorial que garanta a assistência adequada às vítimas e suas famílias

Objective: to explore the literature regarding the nursing care provided to children/adolescents victims of violence. Method: it consists of a systematic review performed on databases such as, LILACS, Scielo and BDENF. 19 articles have been selected to compose this study. The data analysis was developed throughout Mendes, Silveira and Galvão's proposal. Results: the data discussion occurred throughout the following topics: professional unpreparedness to deal with cases of child violence; the feelings of professionals involved on the care provided to a child/adolescent victim of violence; notification, protocols and routines regarding the assistance of children/adolescents victims of violence. Conclusion: nursing professionals do not feel prepared to deal with situations of children violence. It was identified the need of protocols that support the nursing assistance. Furthermore, it is important to enhance the intersectoral attention network in order to ensure the appropriate care to the victims and their families

Objetivo: desvelar la producción acerca de la asistencia de enfermería a los niños/adolescentes víctimas de violencia. Método: se trata de una revisión sistematizada realizada con consulta en las bases de datos: LILACS, Scielo y BDENF. Se seleccionaron 19 artículos para componer este trabajo. El análisis de datos se dio através de la propuesta de Mendes, Silveira y Galvão. Resultados: los datos fueron discutidos através de los tópicos: despreparo de los profesionales frente a los casos de violencia infantil; sentimientos de los profesionales envolvidos en el cuidado al niño/ adolescente víctima de violencia; notificación, protocolos y rutinas en la asistencia al niño/adolescente víctima de violencia; estrategias de asistencia al niño/adolescente víctima de violencia. Conclusión: los profesionales de enfermería no se sienten preparados para actuar frente a los casos de violencia infantil. Se identificó la necesidad de protocolos asistenciales que soporten la asistencia profesional. Además, es importante el fortalecimiento de la red de atención intersectorial que promueva la asistencia adecuada a las víctimas y sus familia

Effects of Interviewer Support on Children's Memory and Suggestibility: Systematic Review and Meta-Analyses of Experimental Research.

The accuracy of children's reports of abuse has been hotly debated in the press, academia, and the courtroom. Yet, children's accuracy depends, in part, on the context in which children are interviewed. Guidelines often recommend creating a supportive psychosocial context to promote open, honest responding; however, there is also concern that support promotes social desirability and acquiescence to suggestion, leading children to report more of what they perceive adults want to hear than the truth. The question remains as to whether there is a sufficient body of scientific research to determine whether interviewer supportiveness improves interview outcomes while minimizing children's stress or whether it increases suggestibility and impairs accuracy. Using a systematic search strategy and meta-analyses, this study identifies and reviews findings from experimental studies of the effects of interviewer supportiveness on the accuracy of children's reports. Although the number of studies in the evidence base is small ( n = 15), the studies are of relatively good quality. Results suggest noncontingent interviewer support bolsters children's accuracy. Children are more resistant and less acquiescent to suggestive questions when interviewers are supportive as compared to nonsupportive or neutral. Effects are in the moderate range. Interviewer support is also associated with fewer errors on nonsuggestive questions. Discussion focuses on implications for practice; directions for future research; identifying vulnerable subgroups; and underlying cognitive, social, and emotional mechanisms.

Mindfulness and trauma symptoms predict child abuse potential in risk-exposed, men and women during pregnancy.

BACKGROUND: Nearly a third of adults report childhood trauma in their youth and approximately 700,000 cases of child maltreatment were reported in 2016. Both history of childhood trauma and current trauma symptoms in adults are linked to child maltreatment, although many trauma-exposed individuals are warm and nurturing parents. Identifying resiliency factors in adults with risk factors for harsh parenting may illuminate new pathways to sensitive parenting. Mindfulness is reported to improve trauma and mental health symptoms but the relationship between mindfulness, trauma, and child abuse potential is not yet understood. OBJECTIVE: This cross-sectional study investigated the relationship between mindfulness, childhood trauma experiences, trauma symptoms and child abuse potential. PARTICIPANTS AND SETTING: Our participants were 102 expectant parents recruiting from obstetric clinics and agencies Detroit, MI (58.8% African American, 27.5% Caucasian). METHOD: Bivariate correlations were examined using validated, self-report questionnaires. Significant variables were included in a hierarchical linear regression to identify predicting factors that contribute to child abuse potential scores. RESULTS: Significant correlations between child abuse potential with current trauma symptoms (r = .53, p < .01) and mindfulness (r = -.32, p < .01) were found, but no link with past childhood trauma experiences and child abuse potential were identified. The model significantly predicts child abuse potential (ΔR2 = .10, F(5, 96), = 12.48, p < .001). Trauma symptoms (B = .09, p < .001, 95% confidence interval [CI][-.40, -.07]) and mindfulness nonreactivity (B = -.24, p < .01, 95% CI[.05, .14]) predicted higher potential for child abuse scores. CONCLUSION: Findings suggest increased mindfulness, especially nonreactivity to one's own thoughts, may be an important factor to protect against child abuse potential. Interventions to increase parental mindfulness may reduce child abuse potential and improve child well-being, but further mechanistic research is needed to determine this.