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.

Validade da fotogrametria computadorizada na detecção de escoliose idiopática adolescente / Validity of computed photogrammetry for detecting idiopathic scoliosis in adolescents

INTRODUÇÃO: A escoliose idiopática adolescente (EIA) é uma alteração tridimensional da coluna vertebral. Sua etiologia é desconhecida e seu início ocorre no início da puberdade, tendo sua progressão associada ao estirão de crescimento. A análise angular de movimento e postura corporal através da imagem estática, conhecida como fotogrametria, permite ao fisioterapeuta quantificar e qualificar sua avaliação da postura/movimento corporal. OBJETIVO: Este estudo foi realizado para avaliar a sensibilidade deste instrumento na detecção da EIA no exame escolar. MÉTODOS: Estudo transversal de base escolar sobre alunos de 5ª a 8ª série do ensino fundamental das redes pública e particular de Pelotas. Foram realizados coleta de imagem digital e exame radiográfico em postura antero-posterior e perfil. A sensibilidade e especificidade da fotogrametria foram verificadas utilizando três e dois graus de margem para desnivelamento da superfície corporal. RESULTADOS: Duzentos e vinte e quatro alunos realizaram o exame de fotogrametria na escola e o exame radiológico padrão. A prevalência de EIA foi de 4,5 por cento (n=10), sendo oito meninas e dois meninos, com média de 13,3º Cobb; média de 1,1 para rotação vertebral (Nash-Moe); 29,5º Cobb para cifose dorsal; 3,6º para ângulo íleo-lombar; e sinal de Risser em 1,6. Para trêsº, a sensibilidade foi de 21,4 por cento e a especificidade de 90,7 por cento. Utilizando dois graus, a sensibilidade foi de 50 por cento e a especificidade de 61,2 por cento. CONCLUSÕES: Com base nestes resultados, verificou-se que a fotogrametria computadorizada não pode ser realizada como screening para detecção de escoliose de grau leve nas escolas.

INTRODUCTION: Adolescent idiopathic scoliosis (AIS) is a three-dimensional abnormality of the spine, of unknown etiology. It starts at the beginning of puberty and its progression is associated with the growth spurt. Analysis of angular movement and body posture through the static imaging method known as photogrammetry could allow physical therapists to quantify and qualify their body posture/movement assessments. OBJECTIVE: This study was carried out to evaluate the sensitivity of this instrument for detecting AIS in examinations in schools. METHODS: This was a school-based cross-sectional study among fifth to eighth-grade elementary school students in public and private schools in Pelotas. Digital images were collected and radiographic examinations were performed in the anteroposterior and lateral planes. The sensitivity and specificity of the photogrammetry were investigated using three and two degrees of margin for the body surface asymmetry. RESULTS: Two hundred twenty four students underwent the photogrammetry and standard radiological examinations at the schools. The prevalence of AIS was 4.5 percent (n=10), in eight girls and two boys with mean Cobb of 13.3º; mean vertebral rotation of 1.1 (Nash-Moe); dorsal kyphosis of 29.5º Cobb; iliolumbar angle of 3.6°; and Risser sign of 1.6. With three degrees margin, the sensitivity was 21.4 percent and the specificity was 90.7 percent. With two degrees margin, the sensitivity was 50 percent and the specificity was 61.2 percent. CONCLUSIONS: Based on these results, it was found that computerized photogrammetry could not be used as a screening method for detecting mild scoliosis in schools.