Patterns of childhood adversity and their associations with internalizing and externalizing problems among at-risk boys and girls.

BACKGROUND: Different types of childhood adversity often cluster and overlap, underlining the importance of studying likely patterns of adversity co-occurrences and their impact on child functioning. Further sex-specific investigations of adversity co-occurrences and their associations with child mental health are warranted. OBJECTIVE: To investigate if different sex-specific patterns of childhood adversity exist among at risk-children living in Denmark and to explore if divergent constellations of adversity are differentially associated with externalizing and internalizing problems. PARTICIPANTS AND SETTING: Participants (N = 2198) were a sample of children ages 1-17 who have been in contact with the Danish child protection system due to suspected child abuse. The study included existing data collected as a part of child case procedures. METHOD: Latent class analysis was used to identify patterns of adversity co-occurrences among girls and boys, respectively. Inter-class differences on age and child mental health were assessed using ANOVAs. RESULTS: Greater variation and complexity in adversity exposure was found among girls (5 classes) compared to boys (3 classes). The female classes differed on age (p < .001, η2 = 0.06), internalizing (p < .001, η2 = 0.05), and externalizing problems (p = .002, η2 = 0.02). The male classes differed on internalizing (p < .001, η2 = 0.02) and externalizing problems (p < .001, η2 = 0.04). Overall, classes characterized by multiple adversities displayed higher scores of mental health problems compared to less exposed classes. CONCLUSIONS: Exposure to multiple adversities is common among at-risk children. Information on different sex-specific patterns of adversity co-occurrences can guide intervention planning for affected children.

Polyvictimization and psychopathology among children and adolescents: A systematic review of studies using the Juvenile Victimization Questionnaire.

BACKGROUND: Exposure to child abuse can lead to lasting mental health problems. Extant research has found that different types of child abuse tend to co-occur and overlap, which merits the investigation of the effects of exposure to multiple types of childhood mistreatment. OBJECTIVE: The aim of this study was to systematically review the evidence on the associations between multiple different types of interpersonal victimization or polyvictimization, and indicators of psychopathology among children ages 0-17. METHODS: The review included studies across all economic strata and research on nationally representative, community, and at-risk samples, using the same standardized assessment tool (i.e. the Juvenile Victimization Questionnaire or JVQ). The review was conducted using peer-reviewed evidence published up until August 2019 from Scopus, EMBASE, PsycINFO, Medline, CINAHL, and ERIC. Out of 4998 relevant references screened, 255 met the inclusion criteria, 22 of which aimed to address childhood polyvictimization and psychopathology. RESULTS: A total of 21 of the 22 included studies identified a significant positive association between polyvictimization and various indicators of psychopathology comprising both externalizing (e.g. anger), internalizing problems (e.g. depression) and total psychological distress. A range of studies demonstrated that polyvictimization was a stronger risk factor for psychopathology than individual (sub)types of victimization. Based on the study findings, we provide a set of recommendations for future research on polyvictimization and psychopathology. CONCLUSION: The present systematic review was the first to review the evidence on the associations between polyvictimization (as measured by the JVQ) and child and adolescent psychopathology in the global research literature. As a novel approach, the present review included both normative and high-risk samples. The results showed that polyvictimization is a substantial risk factor for mental health problems spanning both inner-directed and outer-directed mental health difficulties. However, the inconsistency in methods of defining and measuring polyvictimization severely undermines the scientific impact of this body of work. Additional well-designed, longitudinal studies that take account of the context-specific nature of polyvictimization are required to better establish the causal relationships between childhood polyvictimization and psychopathology so as to improve prevention and intervention efforts.

Females have more complex patterns of childhood adversity: implications for mental, social, and emotional outcomes in adulthood.

Background: Adverse childhood experiences (ACEs) have been identified as an important public health problem with serious implications. Less well understood is how distinct configurations of childhood adversities carry differential risks for mental health, emotional, and social outcomes later in life. Objective: To determine if distinct profiles of childhood adversities exist for males and females and to examine if unique associations exist between the resultant latent profiles of childhood adversities and multiple indicators of mental health and social and emotional wellbeing in adulthood. Method: Participants (N = 1,839) were a nationally representative household sample of adults currently residing in the USA and the data were collected via online self-report questionnaires. Latent class analysis was used to identify the optimal number of classes to explain ACE co-occurrence among males and females, separately. ANOVAs, chi-square tests, and t-tests were used to compare male and female classes across multiple mental health, emotional, and social wellbeing variables in adulthood. Results: Females were significantly more likely than males to report a range of ACEs and mental health, social, and emotional difficulties in adulthood. Two- and four-class models were identified as the best fit for males and females, respectively, indicating more complexity and variation in ACE exposures among females. For males and female, ACEs were strongly associated with poorer mental health, emotional, and social outcomes in adulthood. Among females, growing up in a dysfunctional home environment was a significant risk factor for adverse social outcomes in adulthood. Conclusions: Males and females have distinct patterns of childhood adversities, with females experiencing more complex and varied patterns of childhood adversity. These patterns of ACEs were associated with numerous negative mental, emotional, and social outcomes among both sexes.

Antecedentes: Las experiencias adversas infantiles (ACEs en su sigla en inglés) se han identificado como un problema de salud pública importante, con serias implicaciones. Menos comprendido es el cómo distintas configuraciones de adversidades infantiles acarrean riesgos diferenciales para los resultados de salud mental, emocional y social.Objetivo: Determinar si existen distintos perfiles de adversidades infantiles para hombres y para mujeres y examinar si existen asociaciones únicas entre los perfiles latentes resultantes de adversidad infantil y múltiples indicadores de salud mental y bienestar social y emocional en la adultez.Método: Los participantes (N = 1,839) fueron una muestra representativa de hogares de adultos actualmente residiendo en los Estados Unidos y los datos se recolectaron en cuestionarios de auto-reporte vía online. El análisis de clases latentes se utilizó para identificar el número óptimo de clases que explican la co-ocurrencia de ACEs entre hombres y mujeres, separadamente. Se empleó pruebas de ANOVA, chi-cuadrado y t para comparar clases de hombres y mujeres a través de múltiples variables de salud mental y bienestar social y emocional en la adultez.Resultados: Las mujeres fueron significativamente más propensas que los hombres a reportar un rango de ACEs y dificultades de salud mental y dificultades sociales y emocionales en la adultez. Modelos de dos y cuatro clases se identificaron como los de mejor ajuste para hombres y mujeres, respectivamente, indicando mayor complejidad y variación de exposición a ACEs en las mujeres. Para hombres y mujeres, las ACEs se asociaron fuertemente a resultados más pobres en salud mental, emocionales y sociales en la adultez. En las mujeres, crecer en un ambiente de hogar disfuncional fue un factor de riesgo significativo para resultados sociales adversos en la adultez.Conclusiones: Los hombres y mujeres tienen distintos patrones de adversidad infantil, en tanto las mujeres experimentan más complejos y variados patrones de adversidad infantil. Estos patrones de ACEs se asociaron con numerosos resultados negativos mentales, emocionales y sociales entre ambos sexos.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT).

In this paper we present a description of the Horizon2020, Marie Sklodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

En este artículo presentamos una descripción de un nuevo programa de investigación y formación, Horizon2020, con fondos de Marie Sklodowska-Curie Action, llamado CONTEXT o 'Red coordinadora para la formación y la excelencia en psicotraumatología'. Se presentan los tres objetivos del programa y cada uno de los cuales hace referencia a un componente clave del programa CONTEXT. Primero, resumimos los doce proyectos individuales de investigación que se llevarán a cabo en tres poblaciones prioritarias: (i) refugiados y solicitantes de asilo, (ii) personal de respuesta en emergencias y (iii) perpetradores y sobrevivientes de violencia infantil y de género. En segundo lugar, detallamos el programa de tutoría y formación, eje central de CONTEXT. Finalmente, describimos cómo la investigación, junto con la formación, contribuirá a una mejor política, directrices y práctica en el campo de la psicoterapia.