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1.
Child Abuse Negl ; 147: 106591, 2024 01.
Article in English | MEDLINE | ID: mdl-38128374

ABSTRACT

BACKGROUND: Childhood sexual abuse (CSA) is a form of maltreatment that involves a child in sexual activity that she or he cannot fully comprehend or is unable to give informed consent to. The empirical link between child neglect and contact child sexual abuse is well established but little research examines mediators that explain this link. OBJECTIVE: This study tests online risk behaviors and unwanted sexual experiences online as sequential mediators of the neglect - CSA relationship. PARTICIPANT AND SETTING: The study uses a representative cross-sectional sample of 1097 Hong Kong adolescents. METHODS: Preacher and Hayes' (2008) non-parametric bootstrap approach was used to test three mediation hypotheses. RESULTS: Baseline logistic regression models showed neglected children had 11.2 times higher odds of reporting contact CSA (p < .001). Similarly, neglect was associated with 3.5 times higher odds of more online risk behavior (p < .001), which in turn was associated with 2.7 times higher odds of more online invasive exploitation (p < .001). Online invasive exploitation was associated with 2.7 times higher odds of reporting offline contact CSA (p < .001). The study found online risk behaviors to be a significant mediator of the relationship between neglect and online invasive exploitation (unwanted online sexual experiences). Online invasive exploitation, in turn, mediated the relationship between online risk behaviors and offline contact CSA. CONCLUSION: The findings highlight the importance of intervening against neglect as it appears to play a vital role in the etiology of contact CSA in Hong Kong.


Subject(s)
Child Abuse, Sexual , Child Abuse , Female , Adolescent , Humans , Child , Hong Kong/epidemiology , Cross-Sectional Studies , Sexual Behavior
2.
Child Abuse Negl ; : 106588, 2023 Dec 02.
Article in English | MEDLINE | ID: mdl-38044251

ABSTRACT

BACKGROUND: Research on the conditions under which perpetrators desist from child maltreatment has seen greater attention as part of the efforts to break the cycle of maltreatment. New theoretical insights suggest that informal actions (herein protective informal social control of child maltreatment) by network members which communicate warmth, empathy with victim distress, and promote the modeling of positive parenting practices are more likely to increase maltreatment desistance. Likewise, parents' desistance from maltreatment is theorized to impact on adolescents' (victim) cognition and self-compassion. OBJECTIVE: This study examined the relationship among protective informal social control of child maltreatment (protective ISC_CM) by social networks, physical abuse desistance, and adolescent self-compassion. PARTICIPANTS AND SETTING: A nationally representative sample of 1100 mothers and their adolescent children (aged 11-15) in Nepal was obtained. METHODS: Questionnaires were administered to mothers and their adolescent children independently. Hypotheses were tested using regression models with standard errors corrected for clustering within wards. RESULTS: More than 1 in 7 mothers reported perpetrating physical abuse in the past year, and 1 in every 5 adolescents reported being victims of physical abuse. Odds of abuse desistance increase by roughly 10 % for each act of protective ISC_CM reported by the mother. Also, odds of abuse desistance associated with higher adolescent self-compassion, and acts of protective ISC_CM associated with higher levels of adolescent self-compassion. CONCLUSION: The findings suggest that interventions to boost desistance from maltreatment and break the cycle of abuse in Nepal, should focus on promoting protective informal social control actions.

3.
Dev Psychopathol ; : 1-9, 2023 Sep 08.
Article in English | MEDLINE | ID: mdl-37680182

ABSTRACT

While many studies have found an association between childhood emotional abuse and alcohol use disorders (AUD) during adulthood, underlying psychological mechanisms linking the two remain inadequately understood. Drawing on the developmental psychopathology perspective, this study examined the relationship between childhood emotional abuse and AUD during adulthood with a national sample of women in Nepal (N = 1,100, M age = 37.73), focusing on the mediating role of borderline personality traits. Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method and bootstrapping confidence intervals. Results indicated that Nepali women's borderline personality traits significantly mediated the relationship between childhood emotional abuse and AUD. Hence, emotional abuse in childhood increases the risk for AUD during adulthood for Nepali women by increasing the risk of borderline personality traits. Findings underscore the necessity of continued emphasis on developing and implementing early interventions for childhood emotional abuse and therapeutic interventions for borderline personality traits in reducing AUD among vulnerable women in Nepal.

4.
Violence Against Women ; : 10778012231172708, 2023 May 10.
Article in English | MEDLINE | ID: mdl-37165657

ABSTRACT

Breaking the demand chain for sex from minors would render supply worthless, contributing to the elimination of commercial sexual exploitation of children (CSEC). Using a novel sampling technique, this study reports on actual and potential adult customers of CSEC in two areas in Kathmandu (n = 466). Controlling for refusal conversion, age, education, and income, higher scores on a new Love-Fantasy Scale (LFS) were associated with increased odds of purchasing sex from young girls, as were patriarchal norms emphasizing the power of men. Further research is needed to design interventions that include aspects related to sexual fantasy for young girls to combat demand for CSEC.

5.
J Occup Environ Med ; 65(3): e119-e127, 2023 03 01.
Article in English | MEDLINE | ID: mdl-36729717

ABSTRACT

OBJECTIVE: The current study aims to examine the effects of mental health programs on well-being among highly engaged workers. METHODS: Participants were randomly allocated to body-mind-spiritual or peer support program. Of the whole sample, we examined participants' work engagement and positive affect from the highest quarter and the lowest quarter of work engagement at baseline. Measures were taken at baseline and 1-month intervals during 3-month programs and 3-month follow-up. RESULTS: The programs had decreasing effects on work engagement in the HWE subgroup. There is an increasing trend of positive affect on the HWE group only in the body-mind-spiritual program. The trajectories of work engagement in the HWE group moved toward a moderate level. CONCLUSION: Our results suggest that the work engagement's decrease in the HWE group could be a sign of recovery and relaxation.


Subject(s)
Mental Health , Workplace , Humans , Workplace/psychology , Health Promotion/methods , Work Engagement , Relaxation
6.
J Interpers Violence ; 38(13-14): 8593-8618, 2023 07.
Article in English | MEDLINE | ID: mdl-36843448

ABSTRACT

Although it has become axiomatic to quote an African proverb in discussions of child well-being, attempts to draw concrete and positive lessons from how African communities respond to and mitigate child maltreatment are comparatively few. This study tested the hypothesis that the collective value of Abiriwatia in Ghana, which supports legitimate norms of community obligations to care for children, could be protective against physical abuse. It also examined the claim that knowledge of the familial situation of community members, generated through Abiriwatia, may help them to act to mitigate the risk of caregiver's borderline personality disorder (BPD) features. We obtained a nationally representative sample of 1,100 female caregivers from 22 Ghanaian settlements and tested the hypotheses using multilevel models. Controlling for community-level physical abuse, living in a community with high levels of Abiriwatia childcare and community authority values is associated with lower levels of very severe physical abuse, and Abiriwatia childcare may mitigate risk from the caregiver's BPD features. Within Ghana, encouraging positive and protective aspects of traditional Ghanaian values and working to reinstate respect for these values may have positive outcomes for children. Interventions to reduce child maltreatment should be developed with reference to Abiriwatia childcare values.


Subject(s)
Borderline Personality Disorder , Child Abuse , Child , Humans , Female , Physical Abuse/psychology , Ghana , Mental Health , Child Abuse/prevention & control , Child Abuse/psychology , Borderline Personality Disorder/psychology
7.
Child Abuse Negl ; 138: 106068, 2023 04.
Article in English | MEDLINE | ID: mdl-36764174

ABSTRACT

BACKGROUND: Over the past 20 years, there has been a growing commitment to strengthen community norms-to foster informal support for families and enhance community commitment to protect children from child abuse and neglect. The current study examined the relationship between child neglect and normative interpretations of the dominant cultural value of abiriwatia in Ghana. It was hypothesized that the norms of abiriwatia were associated with lower incidence of child neglect. METHODS: We used a random, stratified four-stage cluster design to select a nationally representative sample of 1100 female caregivers in Ghana. Norms of the cultural value of abiriwatia were measured using a new 11-item Likert scale questionnaire developed by the authors, and child neglect was measured using the Conflict Tactics Scale. RESULTS: Factor analysis of the abiriwatia scale retained three factors, community authority, collective childcare, and lineage, as the core norms of abiriwatia. We found that the abiriwatia norm of community authority was associated with fewer instances of child neglect. Norms of community responsibility for childcare were negatively associated with child neglect frequency (B = -0.31, p < .05). However, the relationship between the abiriwatia norm of lineage and child neglect was positive (B = 0.24, p < .05). CONCLUSION: The protective associations among the norms of community authority and collective childcare and child neglect suggest that traditional practices that strengthen and enforce the collective norms of abiriwatia, including storytelling, family byelaws, community durbars (community meetings), taboos, and reciprocal farming activities (nnoboa) could be protective against neglect.


Subject(s)
Child Abuse , Child , Humans , Female , Child Abuse/prevention & control , Surveys and Questionnaires , Caregivers , Factor Analysis, Statistical , Ghana/epidemiology
8.
J Interpers Violence ; 38(7-8): 5404-5429, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36154516

ABSTRACT

Larger households, involving more children, are theorized as potential risk factors for child maltreatment-resource dilution theory. But qualitative evidence shows that in collective societies, like Ghana, more adult family members may act against neglect, through protective informal social control, which helps to reduce the frequency of neglect. Family members intervention in neglect situations will be more consistent and sustained due to the sanctioned collective responsibility to care for children in the community. The purpose of this study is to test the hypothesis that having more adult family members in the household, who have the will and agency to intervene, will predict less chronic neglect. A three-stage probability proportional to size cluster sample of Ghana was collected from 1,100 primary caregiving mothers. One mother was interviewed in each household, and responses were limited to one focal child. When sample was restricted to those with chronic neglect (neglect > 1), 596 mothers remained in the data. The children have experienced 11 times neglect in the past year, and lived in households with average size of 6 members. Chronic neglect was measured using the Conflict Tactics Scale. Dose-response protective informal social control by family members was measured using the newly developed context-based scale for measuring protective informal social control of child neglect (ISC_CM2). Results from the random effects regressions models showed a negative relationship between dose-response protective informal social control and chronic neglect, and the interaction with household size was negative and significant. Ghanaian families should be sensitized to take advantage of the communal living practices, extended family systems and compound housing structures, as traditional mechanisms to promote collectivity and interventions in observed acts of neglect to protect children. The evidence contradicts the resource dilution theory's conceptualization of large household as risks factors of neglect.


Subject(s)
Child Abuse , Female , Adult , Child , Humans , Ghana , Social Control, Informal , Mothers , Family Characteristics
9.
Health Soc Care Community ; 30(6): e5745-e5754, 2022 11.
Article in English | MEDLINE | ID: mdl-36124633

ABSTRACT

Evidence of the protective role of informal social control by community members (family members, friends, and neighbours) in child neglect has received considerable attention. Likewise, the protective effects of informal social control interventions in neglect are theorised to be common and highly efficacious in communities that have sanctioned informal interventions through collective social values and norms. Yet, no research has examined this theoretical postulation within the field of community/neighbourhood research in child maltreatment. We tested the theory-driven hypothesis by examining the interaction effects of protective informal social control of neglect and the collective value of Abiriwatia (a collective value based on lineage with norms on collective childcare duties) against the frequency of child neglect. Data consist of 616 caregivers' self-report of child neglect in the past year, from the Ghana Families and Neighbourhood Study. Hypotheses were tested using random effects regression models with standard errors corrected for settlement/community clusters. Protective informal social control of child neglect was significantly associated with fewer neglect in the past year (B = -0.79, p < 0.05). The interaction between protective informal social control of child neglect and the collective value of Abiriwatia was negative (B = -0.07, p < 0.05). The findings suggest that strengthening the collective normative commitment to childcare would promote family members' intervention to protect against neglect situations, and their intervention can deter further acts of neglect. Community neglect prevention programmes should take advantage of the findings to strengthen community norms that sanction collective childcare duties. Community child protection committees of the Department of Social Welfare should develop social groups and informal associations to strengthen Abiriwatia in Ghana.


Subject(s)
Child Abuse , Child , Humans , Ghana , Child Abuse/prevention & control , Social Control, Informal , Child Protective Services , Residence Characteristics
10.
Child Abuse Negl ; 133: 105848, 2022 11.
Article in English | MEDLINE | ID: mdl-36044791

ABSTRACT

BACKGROUND: Rational choice deterrence theory suggests that caregiving behavior, which includes abusive and neglectful behavior, can be influenced or manipulated via informal social control strategies enacted by neighbors, family members and friends in the social network. The literature identifies two forms of informal social control that have the potential to influence maltreating caregiver behavior, protective vs punitive, with the latter having more contrasting evidence related to its influence on maltreating caregiving practices. OBJECTIVE: To examine the perceptions and meanings female caregivers associate with protective and punitive informal social control strategies that have been enacted against them. METHODS: 17 female caregivers from Ghana, who self-reported their involvement in neglectful acts, were purposively selected to engage in river of life oral history narrative interviews. Narrative accounts from the caregivers were analyzed thematically using Taguette software package. RESULTS: The findings showed that protective informal social control in child neglect are interpreted via values and norms of childcare that have been institutionalized in the community. Caregivers perceived protective informal social control to have impact on their level of respect/influence, authority in the family or community, and to elicit internal consequences: shame, guilty feelings and embarrassment. Punitive informal social control approaches were considered as misplaced interventions that had ulterior motives of satisfying the neighbors' hatred/dislike of the perpetrator and quest for revenge. CONCLUSION: The findings suggest that the development of a fruitful theoretical framework to explain the effectiveness of informal social control should prioritize the social values and legitimate norms of the community. Implications for practice and theory development are discussed.


Subject(s)
Caregivers , Child Abuse , Child , Child Abuse/prevention & control , Female , Ghana , Humans , Social Control, Informal , Social Support
11.
J Sch Psychol ; 92: 121-135, 2022 06.
Article in English | MEDLINE | ID: mdl-35618365

ABSTRACT

This study examined the conditions for, and mechanisms of, mentoring efficacy against depression symptoms in a random sample of 202 adolescent North Korean refugees living in South Korea. Rhodes (2005) argued that mentoring may benefit adolescents with high parental attachment because social engagement comes easily to them, and that it also may benefit adolescents with weak attachment because of greater need. The present study drew on Rhodes' (2005) theory to postulate curvilinear moderation of the mentoring-depression relationship by parental attachment. Teacher and peer attachment were posited as mediators of the relationship between mentoring and depression. Using fixed effects regression models, Sobel tests, and non-parametric bootstraps to test the hypotheses, a negative association was identified between mentoring and depression symptoms. Results suggested mediation by social withdrawal, and models also found a significant curvilinear moderating effect of parental attachment on the mentoring-depression relationship. These findings suggest that adolescent North Korean refugees with strong parental attachment and adolescent North Korean refugees with weak parental attachment may disproportionately benefit from mentoring as compared with adolescent North Korean refugees who scored in the middle in parental attachment. These results are also consistent with the idea that mentoring may reduce social withdrawal which, in turn, reduces depression.


Subject(s)
Mentoring , Refugees , Adolescent , Democratic People's Republic of Korea , Depression , Humans , Mentors
12.
J Community Psychol ; 50(8): 3760-3777, 2022 09.
Article in English | MEDLINE | ID: mdl-35638505

ABSTRACT

Evidence from a growing research literature on the causes and effects of informal social control (ISC) and bystander interventions carried out by nonprofessionals against intimate partner violence (IPV) shows anomalies and unexplained counterintuitive findings. This study employs a new experimental vignette design to examine the hypothesis: high bystander legitimacy (in the eyes of potential perpetrators) will moderate the effects of (1) incipient ISC and (2) perceived ISC, on parent's self-estimated likelihood of perpetrating IPV. The data consist of 210 rural Korean parents randomly drawn from Kyunggi province using a three-stage cluster probability proportional to size approach. Parents were randomly assigned to low and high incipient ISC, perceived ISC, and collective legitimacy conditions, following a 2 × 2 × 2 experimental vignette approach. Hypotheses were tested using regression models with standard errors corrected for district clusters. Incipient ISC was associated with significantly less self-estimated likelihood of perpetrating IPV. An interaction between high bystander legitimacy and incipient ISC was negative (B = -8.88, p < 0.01). The interaction between perceived ISC and legitimacy was not significant. However, the interaction between perceived ISC and female gender was positively associated with self-estimated likelihood of perpetrating IPV (B = 8.61, p < 0.05). The findings suggest that the presence of a legitimate bystander (whom the potential perpetrator believes has a legitimate right to be concerned about his or her family) may deter parents from perpetrating IPV. Programs to boost ISC and bystander intervention should include modules that strengthen collective legitimacy.


Subject(s)
Intimate Partner Violence , Female , Humans , Intimate Partner Violence/prevention & control , Male , Parents , Perception , Republic of Korea , Social Control, Informal
13.
Article in English | MEDLINE | ID: mdl-35409766

ABSTRACT

BACKGROUND: Research has established the family as the predominant context for child labor practices. Decisions to involve children in child labor within the family or by a family member (herein family child labor) is strongly motivated by cultural beliefs that normalize child labor. This systematic review sought to synthesize evidence on the social norms that support child labor practices, and the normative interpretation of international child labor legislation/standards. METHODS: We followed the PRISMA procedure for systematic review by reviewing empirical articles published between 2000 to 2021 and contained within the four key databases: Scopus, ISI Web of Sciences, PubMed and Embase. Findings from 13 articles that met the inclusion criteria were analyzed thematically. RESULTS: The review included studies from three continents: Africa, Asia and Europe. Gender norms, informal apprenticeship norm, norms on succession and sustenance as well as obedience, were key social norms that influenced child labor practices in the family. Parents' decision to involve children in child labor was strongly influenced by the collective acceptance of some occupations (e.g., cocoa farming and fishing) as family occupations, which need to be preserved, undertaken and passed on to children. Child rights and the UNCRC principle of children's participation were considered foreign to most non-western countries and interpreted as contravention to the cherished social norm of obedience. The findings underlie the link between social norms and the common social values of resilience, hard work, and respect. CONCLUSION: The results provide foundations and target to develop normative change intervention programs to re-orient the negative interpretations of common social values and provide alternative pathways that prevent child labor within the social context.


Subject(s)
Child Labor , Social Norms , Child , Family , Humans , Social Environment , Social Values
14.
LGBT Health ; 9(3): 169-176, 2022 04.
Article in English | MEDLINE | ID: mdl-35255225

ABSTRACT

Purpose: Obesity is linked to personal behaviors and external stressors. Despite emerging evidence that sexual minority stress (SMS) and adverse childhood experiences (ACEs) are associated with the risk of obesity, little is known about their independent and interactive effects on sexual minority men. This study investigated these relationships using panel data. Methods: Self-identified gay and bisexual adult men in Taiwan were recruited through Facebook advertisements to complete an online questionnaire. This study reports only on data from the gay subsample (n = 731, mean age = 28.05 years, standard deviation = 5.75 years) as the bisexual subsample (n = 132) was insufficient for comparative statistical analysis. Over two time points, respondents reported their body weight and height, experiences with SMS, and ACEs on an online survey platform. Data analysis was conducted using multiple logistic regression to determine the individual and interactive effects of the ACE score, ACE components, and SMS on the odds for obesity. Results: Almost 16% of the respondents met the criterion for obesity (body-mass index ≥27). In the adjusted models, neither SMS nor ACEs had significant associations with the likelihood of obesity. Only the interaction term of SMS and childhood sexual abuse was significant, indicating that victims of sexual abuse have an increased likelihood of obesity that SMS may intensify. Conclusions: This study shows that gay men who experience childhood sexual abuse and SMS accumulatively faced an increased risk of obesity. Healthy weight promotion for these men should address these stressors.


Subject(s)
Adverse Childhood Experiences , Sexual and Gender Minorities , Adult , Bisexuality , Humans , Male , Obesity/epidemiology , Taiwan/epidemiology
15.
Child Abuse Negl ; 127: 105580, 2022 05.
Article in English | MEDLINE | ID: mdl-35255341

ABSTRACT

BACKGROUND: Contrary to evidence from the Western literature, cases of filicide in Ghana are mostly unreported because they are rooted in cultural practices and hidden from the general public. OBJECTIVE: The purpose of this study was to explore the cultural context of filicide in a rural community. Particularly, to provide an understanding of the spirit child (SC) phenomenon, how the killing of a SC is performed and to provide a general understanding of filicide within a particular context. PARTICIPANTS AND SETTING: Four relatives of a family that engaged in a filicide incident took part in the study. The interviews were conducted in a rural community in Ghana where the incident occurred. METHODS: Short written narratives were used to explore the experiences and perceptions of relatives whose family engaged in filicide. RESULTS: Children with severe deformities are likely to be associated with matters of divinity which gives way for the conceptualization of the SC and its attendant filicide. The findings highlight the critical role of traditional healers in rural communities and the consequences of strong community beliefs and expectations that influence parents to commit filicide. CONCLUSION: The study provides directions for child protection workers to address the stigma parents face for having children with severe deformities and to provide education on child welfare legislation.


Subject(s)
Family , Parents , Child , Child Welfare , Ghana , Humans , Rural Population
16.
J Interpers Violence ; 37(23-24): NP22428-NP22452, 2022 12.
Article in English | MEDLINE | ID: mdl-35184579

ABSTRACT

Adverse effects of childhood maltreatment experience and adolescent depression symptoms are theorized to be more profound for adolescents who have suffered multiple maltreatments (polyvictimization). New theoretical insights into the study of polyvictimization suggest that it must be studied using a multiplicative logic, particularly when maltreatment is characterized by invasive exploitation. This study, for the first time, examined the concept of invasive exploitation in the context of polyvictimization and its association with adolescent depression symptoms. The study used a random, three stage probability proportional to size (PPS) cluster sample of 565 mother-adolescent dyads in Kathmandu, Nepal, and also examined the protective effects of maternal empathy. We hypothesized that (a) singly, the empirical categories of maltreatment (neglect, physical abuse, and child sexual abuse) would associate positively with adolescent depressive symptoms and (b) main effects held constant, the interaction effects of a child sexual abuse X neglect and a child sexual abuse X physical abuse would be positive. Regression with clustering corrections found that neglect (B = 3.17, p < .01) and sexual abuse (B = 3.48, p < .05) positively associated with adolescent depression symptoms. Results support the multiplicative invasive exploitation polyvictimization hypothesis (child sexual abuse X neglect interaction; B = 6.14, p < .05). The positive neglect X sexual abuse interaction is consistent with the theory that sexual abuse is distinct as invasive exploitation, and demonstrates that the multiplicative hypothesis can be fruitfully applied to the study of polyvictimization. Interventions targeting polyvictims with experience of invasive exploitation and studies aiming to provide deeper insights into sexual abuse as invasive exploitation are needed.


Subject(s)
Child Abuse, Sexual , Child Abuse , Child , Female , Adolescent , Humans , Depression/epidemiology , Nepal , Physical Abuse
17.
Child Abuse Negl ; 126: 105519, 2022 04.
Article in English | MEDLINE | ID: mdl-35121438

ABSTRACT

BACKGROUND: Hospital-stranded children are defined as children who are left by parents in medical settings for over six months. These children, who legally are not classified as orphans, are excluded from existing permanent placement policies in China. Yet, little is known about this vulnerable population of children. OBJECTIVE: This study explores the experiences of hospital-stranded children and the causes for their plight, and examines the strengths and weaknesses of existing child protection practices in medical settings. METHODS: Using a multiple-case design, 20 hospital-stranded children from three children's hospitals in a first-tier Chinese city were included in this study. Sixteen hospital personnel participated in semi-structured interviews. Interview findings, case records, and field observations were analyzed using a thematic analysis approach. Current child protection practices were analyzed through a child protection system model. RESULTS: The children in this study were well cared for by the hospitals, but their rights to provision, participation, and protection were violated due to the lack of a national child protection system. Three key weaknesses of child protection practices were identified: underreporting of suspected cases, delayed action after reporting, and inadequate follow-up services. The ineffectiveness of the national child welfare system and the family-oriented cultural values in China also created barriers to the protection of hospital-stranded children. CONCLUSIONS: The findings suggest an urgent need for a national child protection system. Professional child protection training for healthcare workers and collaboration among departments within and outside hospitals are also necessary to offer a systematic protective network for hospital-stranded children.


Subject(s)
Child Welfare , Parents , Child , Family , Hospitals, Pediatric , Humans , Vulnerable Populations
18.
Psychooncology ; 31(4): 614-621, 2022 04.
Article in English | MEDLINE | ID: mdl-34704322

ABSTRACT

BACKGROUND: Cancer patients are at risk of suicide. However, no studies have used suicide notes to investigate their expressed reasons for suicide. The objectives of this study were to compare the characteristics between note leavers and non-leavers among cancer suicide cases and to understand the patterns in expressed reasons for suicide using suicide notes. METHOD: Suicide cases (2012-2017) were identified from the Hong Kong Coroner's Court reports, which provide detailed information as well as the content of suicide notes. Bivariate tests and multiple logistic regression were performed to compare the characteristics of note leavers and non-leavers among suicide cases with cancer. Thematic analysis was performed on suicide notes to extract themes of expressed reasons for suicides by cancer status and age group. RESULTS: Among cancer suicide cases and compared to non-leavers, note leavers were younger, more likely to be male, use non-violent suicide methods, have better housing conditions, and live alone. Suffering from physical disease was a major theme identified among cancer note leavers across all age groups. Young and middle-aged non-cancer note leavers had various themes identified. Physical illness was the major theme for elderly non-cancer note leavers. CONCLUSIONS: Cancer note leavers had unique characteristics and suffering from physical illness was the major expressed reason identified in the suicide notes. Healthcare professionals should pay attention to the mental as well as the physical needs of patients. Improving quality of life and regaining control of life are vital for suicide prevention among cancer patients.


Subject(s)
Neoplasms , Suicide Prevention , Aged , Female , Health Services , Hong Kong/epidemiology , Humans , Male , Middle Aged , Quality of Life
19.
Psychol Med ; 52(12): 2342-2351, 2022 09.
Article in English | MEDLINE | ID: mdl-33226318

ABSTRACT

BACKGROUND: Cancer patients had elevated risk of suicidality. However, few researches studied the risk/protective factors of suicidal/self-harm behaviors considering the competing risk of death. The objective of this study is to systematically investigate the risk of suicidal/self-harm behaviors among Hong Kong cancer patients as well as the contributing factors. METHODS: Patients aged 10 or above who received their first cancer-related hospital admission (2002-2009) were identified and their inpatient medical records were retrieved. They were followed for 365 days for suicidal/self-harm behaviors or death. Cancer-related information and prior 2-year physical and psychiatric comorbidities were also identified. Competing risk models were performed to explore the cumulative incidence of suicidal/self-harm behavior within 1 year as well as its contributing factors. The analyses were also stratified by age and gender. RESULTS: In total, 152 061 cancer patients were included in the analyses. The cumulative incidence of suicidal/self-harm behaviors within 1 year was 717.48/100 000 person-years. Overall, cancer severity, a history of suicidal/self-harm behaviors, diabetes and hypertension were related to the risk of suicidal/self-harm behaviors. There was a U-shaped association between age and suicidal/self-harm behaviors with a turning point at 58. Previous psychiatric comorbidities were not related to the risk of suicidal/self-harm behaviors. The stratified analyses confirmed that the impact of contributing factors varied by age and gender. CONCLUSIONS: Cancer patients were at risk of suicidal/self-harm behaviors, and the impacts of related factors varied by patients' characteristics. Effective suicide prevention for cancer patients should consider the influence of disease progress and the differences in age and gender.


Subject(s)
Neoplasms , Self-Injurious Behavior , Humans , Neoplasms/epidemiology , Risk Assessment , Risk Factors , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/psychology , Suicidal Ideation
20.
Child Abuse Negl ; 119(Pt 2): 105075, 2021 09.
Article in English | MEDLINE | ID: mdl-33934894

ABSTRACT

PURPOSE: Polyvictimization is often commonplace for young people living in violent communities. The situation is no different for young people in Ghanaian Zongo communities where poverty, social disorder and social vices are prevalent due to structural reasons. OBJECTIVE: Using the social ecology approach to resilience, the study sought the perspectives of young people about how systemic aspects of community contribute to their positive development in high-risk communities. METHODS: Following the short narrative approach, 23 young people ages 18-24 from two Zongo communities in Ghana were engaged in qualitative interviews. FINDINGS: Cultural values of solidarity and peer support were common systemic enablers that facilitated young peoples' resilience. These enablers provided context and resources which ensured their survival in cases of neglect and abuse. Cultural values of solidarity exemplified by care for each other among residents created a safe environment and cultural capital contributed to the young peoples' resilience. Additionally, the "base" within Zongo communities provided a social structure that enabled peer support and promoted young peoples' resilience in the face of polyvictimization experiences. CONCLUSION AND IMPLICATIONS: The findings shift the resilience discourse from a conception of personality traits to one of collective aspects of community systems. They also identify cultural values of solidarity within the community that provide cultural capital for the social functioning of young people dealing with polyvictimization in high-risk environments. The findings provide pathways for professionals to promote resilience and develop resilience-oriented primary preventive measures for adolescents living in high-risk environments in Africa.


Subject(s)
Resilience, Psychological , Social Structure , Adolescent , Adult , Child , Family , Ghana , Humans , Poverty , Social Environment , Young Adult
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