Childhood abuse and risk of migraine: A systematic review and meta-analysis.

BACKGROUND: Childhood abuse is associated with an increased risk of migraines. However, the literature on this association is limited. OBJECTIVE: To determine the pooled effect size of the association between childhood abuse and migraines. PARTICIPANTS AND SETTING: System review and meta-analysis. METHODS: A systematic literature search for studies published until September 20, 2023, was performed using the Embase, PubMed, and Web of Science databases. Specifically, original articles reporting the statistical effect size (odds ratio) of the association between childhood abuse and migraines were selected. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using random- or fixed-effects models. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. RESULTS: Twelve studies involving 110,776 participants were included. Individuals with childhood abuse (OR = 1.60, 95 % CI: 1.49, 1.71) were at increased risk of migraine when compared with individuals with no childhood abuse. Of the different types of childhood abuse examined, sexual abuse (OR = 1.71, 95 % CI: 1.43, 2.04), physical abuse (OR = 1.47, 95 % CI: 1.38, 1.56), and emotional abuse (OR = 1.71, 95 % CI: 1.52, 1.93) were associated with an increased risk of migraine. CONCLUSIONS: Childhood abuse increases migraine risk. Multifaceted interventions to curb abuse and related behaviors can effectively reduce migraine risk. However, considering that multiple factors, such as obesity and anxiety, are causatively associated with both childhood abuse and migraines, our findings should be interpreted with caution.

Adaptation of the Adverse Childhood Experience Questionnaire for Adults Into Turkish: A Validity and Reliability Study.

Background and Purpose: Questioning the adverse childhood experiences of adults may facilitate their search for help for their physical, social, and psychological well-being. The aim of this study is to determine the validity and reliability of the Adverse Childhood Experience Questionnaire for Adults in Turkish. Methods: This methodological study was conducted with 290 participants. The data collection tools consisted of a personal information form, the Adverse Childhood Experience Questionnaire for Adults, and the Childhood Trauma Experiences Questionnaire Short Form. Results: The number of items in the original questionnaire was 29 and became 24 in the Turkish adaption, which showed content validity, construct validity, and internal consistency reliability (Cronbach's alpha (α) = 0.928). Conclusions: The Adverse Childhood Experience Questionnaire for Adults was found to be valid and reliable for the Turkish population.

Adverse Childhood Experiences and Police Contact in Canada.

A growing body of research has demonstrated that adverse childhood experiences (ACEs) are a risk factor for criminal justice system contact. However, much of this research is limited by (1) being conducted in the United States and (2) a lack of details on specific types of harmful experiences of criminal justice system contact, such as police contact characterized by intrusion or harassment. Using survey data from 940 individuals aged 16 to 30 in Canada from the Canadian Study of Adolescent Health Behaviors, this study investigates the relationship between ACEs and police contact, focusing on encounters involving intrusion or harassment. Results from logistic and multinomial logistic regression analyses reveal that individuals with high ACE exposure, particularly those with four or more ACEs, are more likely to have police contact, including experiences of intrusion and harassment. The results are significant in understanding the interplay between childhood trauma and later encounters with the criminal justice system, emphasizing the need for trauma-informed approaches in policing and healthcare. The study highlights the importance of early interventions to mitigate the effects of ACEs and prevent adverse outcomes in police interactions.

Maternal, prenatal and postnatal risk factors for early child physical abuse: a French nationwide cohort study.

Background: Identifying risk factors for early child physical abuse (CPA) is crucial for understanding its mechanisms and defining effective preventive interventions. We aimed to identify maternal, prenatal and postnatal factors associated with early CPA. Methods: This cohort study was based on comprehensive data from the Mother-Child EPI-MERES nationwide register and included all infants born alive in France between 2010 and 2019. Factors associated with early CPA (before age 1) were identified with a multilevel Cox regression model with random intercepts at the regional level. Findings: Among the 6,897,384 included infants, 2994 (40/100,000) had a diagnosis of early CPA, at a median age of 4 months. Independent factors most strongly associated with early CPA were maternal low financial resources (adjusted hazard ratio [aHR] 1.91; 95% confidence interval [95% CI] 1.67-2.18), maternal age <20 years versus 35-40 years (aHR 7.06; 95% CI 6.00-8.31), maternal alcohol use disorder (aHR 1.85; 95% CI 1.48-2.31), opioid use disorder (aHR 1.90; 95% CI 1.41-2.56), intimate partner violence (aHR 3.33; 95% CI 2.76-4.01), diagnosis of a chronic mental disorder (aHR 1.50; 95% CI 1.14-1.97) or somatic disorder (aHR 1.55; 95% CI 1.32-1.83), hospitalisation for a mental disorder (aHR 1.88; 95% CI 1.49-2.36), very preterm birth (aHR 2.15; 95% CI 1.68-2.75), and diagnosis of a chronic severe neurocognitive disorder in the infant (aHR 14.37; 95% CI 11.85-17.44). Interpretation: Independent risk factors of early CPA identified at the national level in France may help in understanding CPA mechanisms and developing effective prevention programs including risk-stratification tools to optimise the allocation of parenting interventions to parents who could most benefit from them. Funding: Ile-de-France regional council, L'Oréal-UNESCO For Women In Science France Young Talent Award, French National Observatory for Child Protection [ONPE], French Association of Ambulatory Paediatrics [AFPA], HUGO university hospitals network, Mustela Foundation and Sauver la Vie prizes.

Posttraumatic stress disorder following childhood sexual and physical abuse: a study protocol for an 11-week randomised controlled trial comparing imaginal exposure and imagery rescripting.

Background: There is a vast amount of evidence supporting the effectiveness of trauma-focused cognitive-behavioral therapy in treating posttraumatic stress disorder (PTSD). However, it remains unclear which specific treatment is most effective for patients with PTSD following childhood sexual and physical abuse (CSPA). Although Imaginal Exposure (IE) has proven highly effective in treating PTSD and is widely acknowledged as a standard method, Imagery Rescripting (IR) may be more suitable for CSPA-related PTSD. IR not only addresses fear but also targets other emotions and cognitions associated with childhood maladaptive schemas. Preliminary findings suggest lower drop-out rates for IR compared to IE, but no Randomized Controlled Trial (RCT) currently assesses the effectiveness of IR for CSPA-related PTSD.Objective: This article presents a study protocol designed to investigate the optimal treatment (IE or IR) for individuals with CSPA-related PTSD and explore predictors of treatment success.Method: In our study protocol, we suggest the inclusion of 173 patients (N = 64 in IR, N = 64 in IE, and N = 45 in the waitlist condition). The therapy procedures for both IE and IR will consist of 16 sessions lasting 90 min each, with treatment durations of 11 weeks. Measurements take place at baseline, at start of treatment, 11 weeks after the start of treatment (after 16 sessions) and at follow-up at 26 weeks after the last session. A mixed regression will be used to compare the three active conditions before and after measurement.Results: This article serves as a study protocol. The results are not yet available but they will be presented in a subsequent article.Conclusion: This study protocol outlines a RCT which will be the first to provide information on the effectiveness of IR versus IE versus a control group in CSPA-related PTSD.Trial registration: Netherlands Trial Register NTR 4817. Registered 26 September 2014.

This study protocol is designed to enhance the clinical treatment for individuals (aged 18 and above) experiencing posttraumatic stress disorder (PTSD) resulting from childhood sexual and physical abuse (CSPA) occurring before the age of 16.Within this protocol, the efficacy of two PTSD interventions ­ Imagery Rescripting (IR) and Imaginal Exposure (IE) ­ will be systematically compared, both against each other and a control group.The secondary objective of this study protocol is to investigate potential predictors of treatment success, including factors such as tonic immobility, dissociation, heart rate variability, measures of autonomic arousal, personality disorders, and the quality of therapeutic alliance.

Acute presentation of abusive head trauma.

Child abuse is a major cause of morbidity and mortality in the United States. The leading cause of child physical abuse related deaths is abusive head trauma, formerly known as shaken baby syndrome, making the rapid identification and assessment of these children critical. The clinical presentation of cases of abusive head trauma ranges from neurological complaints, such as seizures, to vague or subtle symptoms, such as vomiting. This results in frequent missed diagnoses of abusive head trauma. The identification of abusive head trauma relies on a thorough medical history and physical examination, followed by lab evaluation and imaging. The goal of the evaluation is to discover further injury and identify possible underlying non-traumatic etiologies of the patient's symptoms. In this article we present a framework for the assessment of abusive head trauma and provide information on common presentations and injuries, as well as differential diagnoses. A strong foundational knowledge of abusive head trauma will lead to greater recognition and improved safety planning for victims of this unfortunate diagnosis.

Facility dogs during police investigative interviews: Does it decrease children's reluctance?

BACKGROUND: Using facility dogs during police investigative interviews is a recent practice in Canada. While the common use of this intervention is decidedly an indicator of sympathy capital, its utility in this context is relatively unknown and no study has specifically evaluated the effect of using facility dogs on children's collaboration during investigative interviews. OBJECTIVE: This study compares police investigative interviews conducted in the presence of a service dog (n = 46) to those without (n = 45) to examine the effects of the presence of and interactions with a dog on children's reluctance. PARTICIPANTS, SETTING AND METHODS: The interviews were done with children aged 3 to 15 years and were coded for children's reluctance, their physical interactions with and comments about the dog, as well as for investigator's verbal support. RESULTS: No significant group differences were found in terms of children's overall reluctance (p = 0.700), though the children accompanied by a dog showed significantly more digression (p = 0.008). Among the children who were accompanied by a dog, those who interacted with the dog more frequently (p = 0.035) and who made more comments about the dog (p < 0.001) showed more signs of reluctance, even after accounting for child age and investigator support. No association was observed between children's reluctance and the total duration of dog-child physical interactions (p = 0.097). CONCLUSIONS: This study contributes to an enhanced understanding of the usefulness of facility dogs and the factors that influence children's reluctance during investigative interviews.

Polygenic risk, childhood abuse and gene x environment interactions with depression development from middle to late adulthood: A U.S. national life-course study.

OBJECTIVE: Utilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood. METHOD: Data from 7512 participants (4323 females and 3189 males) of European ancestry aged 51-90, retrieved from the U.S. Health and Retirement Study (1992-2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis. RESULTS: Increasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years. CONCLUSIONS: The interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse.

Childhood Parental Neglect, Abuse and Rejection Among Transgender Women: A Cross-Sectional Study in Rio de Janeiro, Brazil.

We aimed to estimate the proportions of childhood parental neglect, abuse, and rejection and to evaluate the co-occurrence of these experiences among transgender women in Rio de Janeiro, Brazil. This was a cross-sectional study with a convenience sample enrolled between July 2019 and March 2020, using an adapted version of the Childhood Trauma Questionnaire. Proportions and corresponding confidence intervals (CI) were calculated. Kendall correlation with Tau-b estimator was used in the bivariate analyses. We gathered data from 139 participants. The most prevalent types of childhood traumas were emotional abuse (60.43%, 95% CI [51.79, 68.62]), physical abuse (57.55%, 95% CI [48.90, 65.89]) and sexual abuse (44.60%, 95% CI [36.18, 53.27]). Severe to extreme physical and emotional abuse occurred among 40.29% (95% CI [32.06, 48.93]) and 5.75% (95% CI [2.51, 11.02]) of participants, respectively. The proportion of parental rejection (eviction) was 32.37% (95% CI [25.04, 40.69]) and occurred with the other forms of abuse, except sexual abuse. Multiple types of childhood abuse, neglect, and parental rejection were observed among transgender women in our sample. The harmful effects of childhood abuse on the mental and physical health of people in the transgender population are of concern, particularly considering the cumulative effect produced by the co-occurrence of such events and their harmful lifetime effects. It is urgently necessary to debate and formulate public policies to ensure the right to gender expression from childhood.

Pediatric skeletal injuries in emergency department; an alarm of child maltreatment in Egypt: A cross-sectional study.

BACKGROUND: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children. OBJECTIVE: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children. METHODS: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians. RESULTS: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries. CONCLUSION: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs.

Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review.

BACKGROUND: Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. OBJECTIVE: The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. METHODS: Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. RESULTS: Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. CONCLUSIONS: This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.

Childhood maltreatment and alcohol and tobacco use trajectories in rural Chinese adolescents.

BACKGROUND: There is a high prevalence of childhood maltreatment among Chinese children and adolescents, but little is known about its impact on alcohol and tobacco use trajectories and how positive school and neighborhood environments moderate the associations. The objective of this study was to assess the association between multiple forms of childhood maltreatment and longitudinal alcohol and tobacco use trajectories, and to assess the possibility that perceived connections to school and neighborhood moderate these associations. METHODS: This longitudinal cohort study included 2594 adolescents (9 to 13 years) from a low-income rural area in China. Childhood exposure to abuse and neglect was assessed using the Childhood Trauma Questionnaire. Participants reported past-month alcohol and tobacco use at three time points over 1 year. RESULTS: Growth curve models revealed that childhood sexual abuse was associated with a higher risk of past-month drinking (OR = 1.53, 95% CI 1.19-2.03, p < 0.001) and smoking (OR = 1.82, 95% CI 1.30-2.55, p < 0.001). Neglect was associated with a higher risk of past-month drinking (OR = 1.52, 95% CI 1.06-1.90, p < 0.05) and smoking (OR = 2.02, 95% CI 1.34-3.02, p < 0.001). None of the maltreatment forms predicted a faster increase in either drinking or smoking. These associations were found independent of personal, family, and contextual characteristics. School and neighborhood connection moderated the association between physical abuse and past-month drinking, such that physical abuse was associated with a greater risk of drinking only for youth who perceived low school or neighborhood connections. CONCLUSIONS: Findings demonstrate the importance of early experiences of childhood maltreatment for adolescent alcohol and tobacco use. Enhancing school and neighborhood connectedness for physically abused youth may help protect them from alcohol use.

Examining the Relation Between Early Violence Exposure and Firearm-Related Experiences in Emerging Adulthood: A Longitudinal Cohort Study.

Firearms are a leading cause of death among adolescents and young adults in the United States. Early exposure to violence, as a victim or witness, is associated with increased risk of firearm-related experiences, including carrying and threatening others with a gun. These experiences, in turn, increase the risk of both fatal and non-fatal firearm injuries. Using an ethnically diverse sample of emerging adults, we build on prior research by examining the link between early violence exposure at multiple contexts of the social-ecological model and multiple firearm-related experiences (i.e., firearm-threatening victimization, firearm-threatening perpetration, and firearm carriage). We analyzed data from a 10-year longitudinal study of 1042 youth in the Southern United States. Experiencing childhood physical abuse was associated with both firearm-threatening victimization and perpetration in emerging adulthood. Additionally, exposure to neighborhood and interparental violence were linked to threatening others with firearms and carrying firearms, respectively. Counter to expectations, bullying victimization did not emerge as a predictor of any firearm-related experiences. Findings highlight the importance of cross-cutting violence prevention efforts to prevent high-risk firearm-related behaviors among emerging adults. Programs for children and adolescents that address these types of violence exposure should highlight coping skills and sources of positive social support to bolster protective factors against firearm-related outcomes.

Does parental use of harsh discipline and punishment in response to ambiguous child situations vary by child physical abuse risk?

BACKGROUND/OBJECTIVES: The present study investigated the extent to which fathers and mothers at high-risk and low-risk for child physical abuse (CPA) differed in their use of harsh discipline and punishment when presented ambiguous child situations (situations where differences in positive and negative valences are close to zero). PARTICIPANTS/METHODS: High-risk for CPA parents (N = 74: fathers, n = 41; mothers, n = 33) and low-risk parents (N = 178: fathers, n = 91; mothers, n = 87) were asked to indicate their likelihood of using harsh verbal discipline (HVD), harsh physical discipline (HPD), and punishment (i.e., retributive harm separate from HVD and HPD) after viewing each of eighteen ambiguous child situations. RESULTS: As expected, high-risk, compared to low-risk, for CPA parents were significantly (ps < 0.001) more likely to use HVD (d = 0.546), HPD (d = 0.595), and punishment (d = 0.564). Overall, fathers, relative to mothers, were significantly more likely to use HVD (d = 0.261) and HPD (d = 0.238). For punishment, however, there was no significant parental role (father, mother) difference (d = 0.136). CONCLUSIONS: Since in everyday living situations many child behaviors are ambiguous, the findings that parents, especially high-risk for CPA parents, use harsh discipline and punishment when encountering ambiguous child situations suggest that non-contingent harsh child-related parental behaviors may be frequent in the lives of some children. The findings that parents may use non-contingent discipline and punishment suggest the need to explore whether, when these parenting behaviors occur, they increase the likelihood of negative child outcomes.

Fracture prevalence in children diagnosed with Ehlers-Danlos Syndrome and Generalized Joint Hypermobility.

BACKGROUND: There is limited understanding of the hypothesized association between the Ehlers-Danlos Syndromes (EDS), hypermobility and fractures in children. Despite this, EDS and hypermobility continue to be raised in the legal setting as possible causes of unexplained fractures in infants where there is a concern for physical abuse. Further understanding is needed regarding fractures in children with EDS and hypermobility. OBJECTIVE: This study assessed fracture prevalence and characteristics in children diagnosed with EDS and Generalized Joint Hypermobility (GJH). The secondary outcome was fracture prevalence in infants <1 year of age. PARTICIPANTS AND SETTING: Children aged <18 years with EDS or GJH seen in a single-center EDS clinic from April 2017 to December 2021 were included. Diagnoses were based on the 2017 international classification. Exclusion criteria were concurrent medical conditions associated with bone fragility. METHODS: This retrospective descriptive study examined variables including fracture history, fracture location, fracture type, age of sustaining fracture, and injury mechanism. Descriptive statistics were used for analysis. RESULTS: Fracture prevalence was 34.6 % (9/26, 95 % CI [16.3, 52.9]) in the EDS population and 25.4 % (15/59, 95 % CI [14.3, 36.5]) in the GJH population. No fractures occurred in infancy. Most fractures occurred in the limbs. There were no rib or skull fractures. Most fractures were the result of an identifiable injury event. CONCLUSION: In a cohort of children with formally diagnosed EDS or GJH, fractures occurred commonly in ambulatory children and generally in the limbs from identifiable events. This study does not support EDS or GJH as a cause of fractures in infancy.

Development of a standardized peer review and oversight process in cases of suspected child physical abuse.

Peer review of medical opinions provided in cases of suspected child physical abuse is generally considered to be best practice for pediatricians engaged in this field. However, there are no published standardized guidelines on how pediatricians should undertake physical abuse peer review including case selection and process. Due to the high-stakes nature in the field of child abuse pediatrics, rigorous quality assurance practices and oversight mechanisms are essential to safeguard children, families, health care providers, and intersecting systems. The Suspected Child Abuse and Neglect program at The Hospital for Sick Children, Toronto, Canada developed a structured peer review process for cases of suspected physical abuse. Included in the process is an approach for the evaluation of institutional complaints received related to a child abuse pediatrician's medical opinion. This quality assurance process is presented so that other child abuse pediatricians and programs may replicate or adapt the protocol for their own local context.

Association between maternal dissatisfaction with oneself at birth and shaking and smothering toward the offspring up to 18 months old.

BACKGROUND: A mother who feels dissatisfaction with herself may resort to abusive behavior such as shaking or smothering toward their offspring. Understanding this association can inform effective prevention strategies. OBJECTIVE: This study aimed to investigate the associations between maternal feelings of dissatisfaction with oneself and infant physical abuse. PARTICIPANTS AND SETTING: The study included 434 mothers who had recently given birth in two obstetric wards in a relatively wealthy area in Tokyo, Japan. METHODS: Adopting a longitudinal design, the study used questionnaires post-childbirth to measure mothers' dissatisfaction with themselves. This involved evaluating perceptions of failing to meet personal standards or self-image. Physical abuse (specifically shaking or smothering) in infants was tracked at 3, 6, 12, and 18 months. Data analysis comprised multilevel analysis, group-based trajectory modeling, and multivariable logistic regression to explore the association between maternal dissatisfaction and child physical abuse. RESULTS: Multilevel analysis showed that mothers with middle or high dissatisfaction with themselves were more likely to abuse their infant compared to mothers with low dissatisfaction with themselves (adjusted odds ratios [aOR] 5.71, 95 % confidence interval [CI], 1.06-30.78 and aOR 12.47, 95 % CI: 2.11-73.69, respectively). Trajectory analyses indicated that mothers with middle or high dissatisfaction with themselves were consistently more likely to abuse their infants up to 18 months (aOR 8.08, 95 % CI 1.61-40.53 and aOR 6.42, 95 % CI 1.27-32.43, respectively). CONCLUSIONS: Our findings highlight a robust association between mother's dissatisfaction with themselves and a higher risk of infant physical abuse. These insights call for a comprehensive review of preventive measures for childhood physical abuse.

Childhood Violence, High School Academic Environment, and Adult Alcohol Use Among Latinas and Black Women: A Structural Equation Modeling Study.

OBJECTIVE: Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. METHODS: Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. RESULTS: Childhood physical and sexual abuse was positively associated with depressive mood, anxiety disorders, and somatic complaints when participants were in the 20s. Depressive mood mediated childhood abuse and AUD when women were in the 30s. The high school academic environment attenuated the effect of physical, but not sexual abuse, on depressive mood (ß = -0.59, B = -9.38, 95% CI [-14.00, -4.76]), anxiety symptoms (ß = -0.61, B = -14.19, 95% CI [-21.76, -6.61]), appetite loss (ß = -0.41, B = -10.52, 95% CI [-15.61, -5.42]), and sleeplessness (ß = -0.50, B = -9.56, 95% CI [-13.95, -5.17]) in the early 20s. CONCLUSIONS: Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.

Explaining how childhood physical abuse and physical neglect influence adult depression: An analysis with multiple sequential mediators.

BACKGROUND: Substantial evidence indicates that experiencing physical abuse and neglect during childhood significantly elevates the likelihood of developing depression in adulthood. Nevertheless, there remains a dearth of understanding regarding the mechanisms underpinning this correlation. OBJECTIVE: In this study, we aimed to examine the associations of childhood physical abuse and physical neglect with depression using follow-up data from UK Biobank and quantified the contribution of smoking, insomnia, and BMI in these associations. PARTICIPANTS AND SETTINGS: This study included 144,704 participants (64,168 men and 80,536 women) from UK Biobank, most of whom were white (97 %). METHODS: Physical abuse and physical neglect were measured using two items of Childhood Trauma Screener (CTS). Data on the incidence of depression were obtained from primary care, hospital inpatient records, self-reported medical conditions, and death registries. We used a sequential mediation analysis based on the "g-formula" approach to explore the individual and joint effects of potential mediators. RESULTS: The depression incidence rate was 1.85 per 1000 person-years for men and 2.83 per 1000 person-years for women, respectively. Results of Cox proportional risk regression showed that physical abuse (HRs: 1.39-1.53, P < 0.001) and physical neglect (HRs: 1.43-1.60, P < 0.001) are associated with depression. Smoking, insomnia, and BMI together mediated 3 %-26 % of the associations. CONCLUSIONS: These findings contribute to our understanding of how physical abuse and physical neglect influence depression. Furthermore, a more effective reduction in the burden of depression can be achieved by managing modifiable mediators.

Child abuse and pubertal timing: what is the role of child sex and identity of the perpetrator?

BACKGROUND: This study investigated the association between child abuse [child neglect (CN), emotional (CEA) and physical abuse (CPA)] and early puberty with special regard to sex-specific effects concerning child and parental perpetrator. METHODS: Data assessment took place within the framework of the LIFE Child Depression study, a longitudinal study on the development of depressive symptoms and disorders between child- and adulthood in Leipzig, Germany. A sample of 709 children (8-14 years) was recruited from the general population and via psychiatric hospitals. Data on pubertal status were assessed using an instrument for self-assessment of tanner stages (scales of physical pubertal development). Information on menarche was provided by parents. The Parent-Child Conflict Tactics Scales (CTS-PC) served for data on child abuse. RESULTS: Regarding physical puberty markers, significant correlations were found, especially with child neglect (CN) and child emotional abuse (CEA). Regression analyses, controlling for Body-Mass-Index (BMI) and Socioeconomic Status (SES), revealed that children affected by child neglect perpetrated by mother (CNm) and child emotional abuse (CEA) parent-non-specifically enter puberty significantly earlier. Sex-specific analyses identified child neglect perpetrated by mother (CNm) to be associated with early puberty in girls and child emotional abuse perpetrated by father (CEAf) with early puberty in boys. Concerning the onset of menstruation, there was a significant positive correlation between early menarche and parent-specific and non-specific child neglect (CN), as well as between early menarche and child emotional abuse perpetrated by the mother (CEAm). In regression models that controlled for Body-Mass-Index (BMI) and Socioeconomic Status (SES) no significant associations were maintained. Child physical abuse (CPA) was not associated with early puberty. CONCLUSION: Results outlined child neglect (CN) and child emotional abuse (CEA) to be sex- and perpetrator-specific risk factors for early pubertal development. Knowledge of sex- and perpetrator-specific effects could help clinicians to specify their diagnostic process and to define differential prevention and treatment goals for children with experiences of CN and CEA. Further research on the sex-specific impact of parental CN and CEA on girls' and boys' puberty is needed.