Disentangling the Associations Between Attention Deficit Hyperactivity Disorder and Child Sexual Abuse: A Systematic Review.

BACKGROUND: An association between child sexual abuse (CSA) and attention deficit hyperactivity disorder (ADHD) has been documented. However, the temporal relationship between these problems and the roles of trauma-related symptoms or other forms of maltreatment remain unclear. This review aims to synthesize available research on CSA and ADHD, assess the methodological quality of the available research, and recommend future areas of inquiry. METHODS: Studies were searched in five databases including Medline and PsycINFO. Following a title and abstract screening, 151 full texts were reviewed and 28 were included. Inclusion criteria were sexual abuse occurred before 18 years old, published quantitative studies documenting at least a bivariate association between CSA and ADHD, and published in the past 5 years for dissertations/theses, in French or English. The methodological quality of studies was systematically assessed. RESULTS: Most studies identified a significant association between CSA and ADHD; most studies conceptualized CSA as a precursor of ADHD, but only one study had a longitudinal design. The quality of the studies varied greatly with main limitations being the lack of (i) longitudinal designs, (ii) rigorous multimethod/ multiinformant assessments of CSA and ADHD, and (iii) control for two major confounders: trauma-related symptoms and other forms of child maltreatment. DISCUSSION: Given the lack of longitudinal studies, the directionality of the association remains unclear. The confounding role of other maltreatment forms and trauma-related symptoms also remains mostly unaddressed. Rigorous studies are needed to untangle the association between CSA and ADHD.

Sexual abuse and sleep in children and adolescents: A systematic review.

Childhood sexual abuse has pervasive effects on well-being and psychosocial functioning in children and adolescents, including negative impacts on sleep. This study aimed to systematically review and assess the literature documenting associations between childhood sexual abuse and sleep in minors (0-18 years old) and provide recommendations for future studies and clinical practice. A systematic search was conducted independently by two researchers in six databases. Inclusion criteria included English or French published articles and dissertations/theses/abstracts reporting original quantitative data examining at least a bivariate association between childhood sexual abuse and sleep. A total of 5031 titles and abstracts and 70 full articles were screened. The final sample included 26 studies. Most studies (88%) reported a significant association between childhood sexual abuse and several sleep dimensions (such as difficulty falling asleep, complaints of poor sleep, nightmares). Studies' quality, as rated using the National heart, lung, and blood institute's quality assessment tool, varied greatly: 23% were rated as good, 38.5% as fair, and 38.5% as poor. Childhood sexual abuse negatively impacts sleep in childhood and adolescence. These results inform future research, ideally with strong prospective/longitudinal designs and using more specific sleep measures, aiming to promote optimal sleep in sexually abused minors.

Intergenerational Cycles of Maltreatment: A Scoping Review of Psychosocial Risk and Protective Factors.

Child maltreatment tends to show intergenerational continuity. However, a significant proportion of maltreated parents break these cycles. Since several studies have investigated risk and protective factors associated with the intergenerational continuity of child maltreatment over the past decades, and no systematic review of the literature is available, this scoping review aimed to summarize studies documenting associated psychosocial risk and protective factors. A secondary objective was to document the prevalence of this phenomenon. A search in six major databases (PsycINFO, Scopus, Medline, Social Work Abstracts, ProQuest Dissertations/Theses, and Web of Science) was conducted. Studies involving human participants, presenting original findings, written in French or English, and of any type of design were included. There was no limit regarding the date of publication, except for theses/dissertations (5 years). A final sample of 51 papers was retained, 33 providing data on risk and protective factors and 18 providing only prevalence data. Results indicate that parents' individual characteristics (e.g., mental health, age), childhood adversity (e.g., multiple forms of adversity), relational (e.g., couples' adjustment, attachment, social support), and contextual factors (e.g., disadvantage, community violence) are relevant to the intergenerational continuity of child maltreatment. Prevalence rates of continuity ranged from 7% to 88%. Major limitations of reviewed studies are discussed. Continued efforts to uncover the mechanisms associated with the intergenerational continuity of child maltreatment using strong methodological designs are necessary. Knowledge in this area could lead to the development of effective prevention strategies (e.g., mental health services for parents, family/dyadic interventions) to break harmful intergenerational cycles of violence.

Operationalization of skin self-examination in randomized controlled trials with individuals at increased risk for melanoma: A systematic review.

OBJECTIVE: To investigate how skin self-examination was operationalized and the psychometric properties of the scales used to assess this behavior in randomized controlled trials (RCTs) testing interventions that promote SSE among individuals at increased risk for melanoma. METHOD: Eight scientific databases (e.g., Medline, EMBASE, CINAHL, PsycINFO) and four trial registries (e.g., Clinicaltrials.gov, UK Clinical Trails Gateway) were searched from inception through April 2, 2019. Three reviewers carried out the selection of relevant trials and conducted data extraction. RESULTS: The review identified 13 unique RCT's. The definition of skin self-exams, extrapolated from instructions provided to participants during the trials and reported in only 6/13 trials, included periodically checking the skin of the entire body, individually or with partners/mirrors, with or without tracking or monitoring tools, and using the ABCDE criteria to identify early signs of melanoma. There was variability in how skin self-examination behavior was measured with respect to item content, number of items, response format, and type of outcome variable used: continuous or binary). No validity evidence and minimal reliability evidence for the measures were identified. CONCLUSIONS AND PRACTICE IMPLICATIONS: Future studies are needed to establish the psychometric properties of measures assessing skin self-examination.

Are MEDLINE searches sufficient for systematic reviews and meta-analyses of the diagnostic accuracy of depression screening tools? A review of meta-analyses.

OBJECTIVE: Database searches for studies of diagnostic test accuracy are notoriously difficult to filter, highly resource-intensive, and a potential barrier to quality evidence synthesis. We examined published meta-analyses of depression screening tool accuracy to evaluate the (1) proportion of included primary studies found in any online database in the original meta-analyses that were indexed in MEDLINE; (2) the proportion of patients from MEDLINE-indexed studies; and (3) the proportion of depression cases from studies indexed in MEDLINE. METHODS: MEDLINE and PsycINFO were searched from January 1, 2005 through October 31, 2014 for meta-analyses in any language on the accuracy of depression screening tools. RESULTS: We identified 16 eligible meta-analyses that included 398 primary study citations, which had been identified via an online database in the original meta-analyses, including 257 unique citations and 234 unique patient samples. The 234 unique patient samples included 69,957 total patients and 11,867 depression cases. Of these, 220 samples (94%) were from studies indexed in MEDLINE, including 97% of all patients and 96% of all depression cases. When applying a peer-reviewed search strategy in MEDLINE, 91% of all samples, 96% of patients and 95% of depression cases were retrieved. Results were similar for total and unique citations. CONCLUSIONS: Restricting searches to MEDLINE may capture almost all eligible studies, patients and depression cases. Although not examined in the present study, MEDLINE may not be indexed as quickly as other databases. Thus, MEDLINE searches should be complemented by date-limited searches of other databases for recent citations.