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1.
Nurs Clin North Am ; 54(4): 569-584, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703782

RESUMO

Human trafficking is the intentional exploitation of vulnerable individuals for the personal gain of the exploiter and is now recognized as an emerging public health care priority. Health care providers are well positioned to identify and assist trafficked individuals as well as those who may be at risk for exploitation. Trauma informed care is essential to identify victims and evaluate the impact of traumatic stress while highlighting survivors' strengths and supporting their resiliency. Human trafficking demographics, including mental and physical health problems, health considerations, risk factors, screening, implications for practice, and national resources, are reviewed.


Assuntos
Assistência à Saúde , Medicina Baseada em Evidências , Tráfico de Pessoas/estatística & dados numéricos , Sobreviventes/psicologia , Adulto , Criança , Pessoal de Saúde , Tráfico de Pessoas/psicologia , Humanos , Serviços de Saúde Mental , Saúde Pública
2.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501237

RESUMO

The following is the winning submission from the third annual Section on Pediatric Trainees essay competition. This year's competition was informed by the 2018-2019 Section on Pediatric Trainees Advocacy Campaign: Advocacy Adventure, which empowered trainees to find their areas of passion, acquire and polish new skills, and organize advocacy efforts collaboratively. We asked writers to share experiences as physician advocates and were impressed with the broad variety of important topics submitted by trainees from around the country. This essay by Drs Panda and Garg highlights a critical issue facing children, human trafficking, and shares their innovative and sustainable survivor-informed training for pediatric trainees. Along with the runner-up submission by Dr Ju, which also appears in this issue, this piece is a wonderfully inspiring reminder that we are all well positioned to advocate for children in our roles as trainees and pediatricians.


Assuntos
Abuso Sexual na Infância/diagnóstico , Assistência à Saúde , Escravização/prevenção & controle , Tráfico de Pessoas/prevenção & controle , Pediatras/educação , Adolescente , Criança , Defesa da Criança e do Adolescente/educação , Escravização/psicologia , Feminino , Tráfico de Pessoas/psicologia , Humanos , Internet , Papel do Médico , Desenvolvimento de Programas , Comportamento Sexual/psicologia , Ideação Suicida , Gravação em Vídeo
4.
Int J Public Health ; 64(7): 1015-1024, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31243470

RESUMO

OBJECTIVES: To assess the association of living and working conditions experienced during trafficking with mental health of female and male survivors. METHODS: We analyzed a cross-sectional study of 1015 survivors who received post-trafficking services in Cambodia, Thailand, and Vietnam. Modified Poisson regression models were conducted by gender to estimate prevalence ratios. RESULTS: For females, the elevated prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms was associated with adverse living conditions, while for males the prevalence of anxiety (PR = 2.21; 95% CI 1.24-3.96) and depression (PR = 2.63; 95% CI 1.62-4.26) more than doubled and almost tripled for PTSD (PR = 2.93; 95% CI 1.65-5.19) after adjustment. For males in particular, excessive and extreme working hours per day were associated with more than a four- and threefold greater prevalence of PTSD. Being in a detention center or jail was associated with all three mental health outcomes in males. CONCLUSIONS: Providers and stakeholders need to consider the complex mental health trauma of the differential effects of living and working conditions for female and male survivors during trafficking to support treatment and recovery.


Assuntos
Habitação/normas , Tráfico de Pessoas/psicologia , Saúde Mental , Sobreviventes/psicologia , Local de Trabalho/normas , Ansiedade/epidemiologia , Camboja/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Tailândia/epidemiologia , Vietnã/epidemiologia
5.
Obstet Gynecol ; 133(4): 803-809, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30870277

RESUMO

This article describes the Engage, Motivate, Protect, Organize, self-Worth, Educate, Respect (EMPOWER) Clinic for Survivors of Sex Trafficking and Sexual Violence located at Gouverneur Health in New York, New York, as a model for integrated gynecologic and psychiatric care of survivors of sexual and gender-based violence. Although patients with a history of sexual trauma often have critical health needs that persist long after the traumatic event, most existing services for survivors of sexual violence focus solely on the provision of acute care immediately after the violence has occurred. There are very few clinics in the United States dedicated to managing the significant long-term medical consequences and sequelae of sexual violence in a trauma-informed setting. We report on best practices for the provision of trauma-sensitive medical care to this patient population based on those employed at the EMPOWER Clinic. In particular, we outline some of the unique considerations for treating survivors relating to taking a patient history, conducting the physical and gynecologic examinations, ensuring confidentiality, and managing legal issues. Finally, we reflect on the challenges faced in sustaining the EMPOWER Clinic and the importance of the existence of a clinic dedicated to this specific population.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , Participação do Paciente , Guias de Prática Clínica como Assunto , Delitos Sexuais/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/terapia , Sobreviventes/estatística & dados numéricos , Adulto , Assistência à Saúde/organização & administração , Feminino , Tráfico de Pessoas/psicologia , Tráfico de Pessoas/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Organizacionais , Cidade de Nova Iorque , Educação de Pacientes como Assunto/organização & administração , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Sobreviventes/psicologia , Populações Vulneráveis/psicologia , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
6.
PLoS One ; 14(3): e0213766, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870468

RESUMO

OBJECTIVE: Healthcare providers have key roles in the prevention of, detection of, and interventions for human trafficking. Yet caring for trafficked persons is particularly challenging: patients whose identities are unknown, unreliable, or false could receive subpar care from providers delivering care in a vacuum of relevant information. The application of precision medicine principles and integration of biometric data (including genetic information) could facilitate patient identification, enable longitudinal medical records, and improve continuity and quality of care for this vulnerable patient population. Scant empirical data exist regarding healthcare system preparedness and care for the needs of this vulnerable population nor data on perspectives on the use and risks of biometrics or genetic information for trafficked patients. METHODS: To address this gap, we conducted mixed-methods research involving semi-structured interviews with key informants, which informed a subsequent broad survey of physicians and registered nurses. RESULTS: Our findings support the perception that trafficked persons obtain care yet remain unnoticed or undocumented in the electronic health record. Our survey findings further reveal that healthcare providers remain largely unaware of human trafficking issues and are inadequately prepared to provide patient-centered care for trafficked and unidentified patients. CONCLUSION: Meaningful efforts to design and implement precision medicine initiatives in an inclusive way that optimizes impacts are unlikely to succeed without concurrent efforts to increase general awareness of and preparedness to care for trafficked persons. Additional research is needed to examine properly the potential utility for biometrics to improve the delivery of care for trafficked patients.


Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Assistência à Saúde/organização & administração , Registros Eletrônicos de Saúde , Empatia/ética , Pessoal de Saúde/normas , Tráfico de Pessoas/psicologia , Assistência Centrada no Paciente/normas , Adolescente , Adulto , Idoso , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Feminino , Pessoal de Saúde/psicologia , Necessidades e Demandas de Serviços de Saúde , Tráfico de Pessoas/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Nurs Womens Health ; 23(2): 98-104, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30853510

RESUMO

Human trafficking is a significant women's health issue in the United States. Clinicians who provide care to women are often unaware of the signs and symptoms of human trafficking and are unprepared to provide appropriate care. Nurses represent one of the few agents of change who women may encounter while they are in captivity; this places nurses at the forefront of their care. To provide safe and effective care, nurses can use the ABCD treatment model, which stands for assessment, buy-in, case management, and diversion programming. Any gaps between recognition of women's health care needs and the provision of appropriate care must be closed. Integrating evidence-based human trafficking education and skill building into nursing curricula, standard nursing orientation, and continuing education is an essential step to help nurses transform care and advocate on behalf of those who have been trafficked.


Assuntos
Enfermagem Baseada em Evidências/métodos , Tráfico de Pessoas/psicologia , Adulto , Comportamento Criminoso , Enfermagem Baseada em Evidências/tendências , Feminino , Tráfico de Pessoas/tendências , Humanos , Estados Unidos , Saúde da Mulher/tendências
8.
PLoS One ; 14(1): e0210241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682056

RESUMO

Sustainability standards for seafood mainly address environmental performance criteria and are less concerned with the welfare of fisheries workers who produce the seafood. Yet human rights violations such as slavery and human trafficking are widespread in fisheries around the world, and underscore the need for certification bodies and other seafood supply chain actors to improve social performance, in addition to addressing environmental challenges. Calls for socially responsible seafood have referenced human rights law and policy frameworks to shape the guiding principles of socially responsible seafood and to provide the legal machinery to implement these aspirations, but practical guidance on how to achieve this is lacking. To provide clarity on this challenge, we reviewed the literature concerning human rights in the seafood supply chain, and prepared an analysis of opportunities and challenges to implement socially responsible seafood through relevant human rights, legal and policy instruments. We observe that human rights laws are generally framed in favour of addressing violations of civil and political rights, but there remains considerable scope for applying economic, social and cultural (ESC) rights in this context. Other challenges include weakly defined ESC rights infringements, a lack of straightforward mechanisms to enforce human rights entitlements, and practical difficulties such as resources to support and secure rights. On the positive side, governments can draw on international instruments to inspire national policies and legislation to eliminate illegalities from the seafood supply chain. However, for socially responsible seafood principles to translate into tangible actions, these objectives must be rooted in clear legal obligations and be supported by sufficient national capacity and political will.


Assuntos
Pesqueiros/legislação & jurisprudência , Direitos Humanos/legislação & jurisprudência , Tráfico de Pessoas/psicologia , Aplicação da Lei , Cultura , Tráfico de Pessoas/legislação & jurisprudência , Humanos , Alimentos Marinhos
9.
Artigo em Inglês | MEDLINE | ID: mdl-30696049

RESUMO

Human trafficking is a significant and growing public health concern. Subgroups of adolescents and young adults are particularly vulnerable to human trafficking, especially youth who are unstably housed or homeless. While youth experiencing trafficking come into contact with the healthcare system, they are often not identified during routine assessment due to lack of specific inquiry and low disclosure. Therefore, we utilized a mixed-methods study design to assess the differences in the identification of human trafficking among youth experiencing homelessness (n = 129) between a standard psychosocial assessment tool and a human trafficking specific assessment tool. Findings indicate that the tool developed to specifically assess for human trafficking was more likely to identify youth experiencing sexual and labor exploitation, as well as the risk factors for human trafficking. Secondly, youth reported that mistrust of the system, fear of involving the police if reported, not wanting to interact with the mental healthcare system, and stigma are barriers to disclosing human trafficking. In conclusion, healthcare providers caring for youth experiencing homelessness should adopt improved screening tools for human trafficking to reduce the risk of missed opportunities for prevention and treatment among this high-risk population of youth.


Assuntos
Pessoas Escravizadas/psicologia , Pessoal de Saúde/psicologia , Jovens em Situação de Rua/psicologia , Jovens em Situação de Rua/estatística & dados numéricos , Tráfico de Pessoas/psicologia , Programas de Rastreamento/métodos , Estigma Social , Adolescente , Adulto , Pessoas Escravizadas/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Tráfico de Pessoas/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Texas , Adulto Jovem
10.
BMC Int Health Hum Rights ; 19(1): 3, 2019 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-30669999

RESUMO

BACKGROUND: In 2010, a shelter programme was established in the Netherlands to provide social and health services for trafficked people. This article describes how service users in this programme conceptualized and experienced their own process of recovery. METHODS: In 2012, 14 people of non-Dutch nationality who had been trafficked for the purpose of sexual exploitation were interviewed at all three shelters of the programme. Data analysis followed a grounded theory approach. RESULTS: Participants felt a strong need to turn over a new leaf in life, leaving negative experiences of the past behind and moving towards a life with a job, a family and friends. In contrast with their willingness to work towards realizing that future, they experienced a lack of autonomy and a thwarted sense of agency in redressing their present situation. Together with the ostracized nature of their place in Dutch society this left them 'in limbo': a feeling of standing still, while wanting to move forward. This led participants to find it more difficult to deal with problems related to their pasts and futures. They particularly appreciated Dutch language training, vocational skills training and opportunities for volunteer work. CONCLUSIONS: Participants exhibited a strong desire to fulfil the basic psychological needs of competence, relatedness and autonomy, but were thwarted in pursuing these goals. Seemingly against all odds, while faced with several external regulators that limited their agency to change their situation, participants found ways to pursue these goals, through their enthusiasm for activities that helped them get closer to their envisioned futures (language and skills training and volunteer work). Identifying pathways toward attaining their goals allowed them to hope for a better future. That hope and pursuing their goals helped them to cope with the problems of their past and their worries about the future. Therefore, to facilitate service users' recovery in a post-trafficking setting, there is a need to provide them with opportunities to hope for, pursue and attain their personal goals within the structural boundaries of their situation. A future-orientated, strengths-based approach towards service provision and responsive and supportive environments help to do this.


Assuntos
Emigrantes e Imigrantes/psicologia , Metas , Tráfico de Pessoas/psicologia , Recuperação da Saúde Mental , Populações Vulneráveis/psicologia , Adulto , Feminino , Teoria Fundamentada , Humanos , Masculino , Países Baixos , Pesquisa Qualitativa , Apoio Social
12.
Crisis ; 40(4): 240-248, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30375247

RESUMO

Background: Youth experiencing homelessness are at risk for sex trafficking and mental health concerns. Aims: More information is needed to elucidate the prevalence and characteristics of suicidal ideation and behavior among youth experiencing sex trafficking. Method: The present study examined suicidal ideation and behavior in a convenience sample of 128 youths experiencing homelessness aged 12-25 years in metropolitan Louisville, Kentucky, and southern Indiana. Participants were asked seven questions regarding suicidal ideation and attempts as part of an enhanced version of the 60-item Youth Experiences Survey (YES). Results: Approximately 53% of the sample reported experiencing suicidal ideation at some point in their lifetime and the odds of a youth experiencing homelessness who had experienced sex trafficking reporting suicidal ideation was 3.87 times higher than the odds of a youth experiencing homelessness who had not experienced sex trafficking. Additionally, of those who reported experiencing suicidal ideation, the majority (84.4%) reported they had attempted suicide in their lifetime. Limitations: This study relied on a convenience sample of youth receiving services in the Kentuckiana region and brief, self-report measures yielding categorical data. Conclusion: Programs servicing youth experiencing homelessness should require additional training and resources regarding the identification, screening, and assessment of youth who are at risk of or who have experienced sex trafficking in order to more quickly connect youth with much-needed, trauma-informed services.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Tráfico de Pessoas/estatística & dados numéricos , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Criança , Vítimas de Crime/psicologia , Revelação , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Pessoas em Situação de Rua/psicologia , Pessoas em Situação de Rua/estatística & dados numéricos , Tráfico de Pessoas/psicologia , Humanos , Indiana/epidemiologia , Kentucky/epidemiologia , Masculino , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Adulto Jovem
13.
Trauma Violence Abuse ; 20(2): 183-196, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29333961

RESUMO

BACKGROUND: Human trafficking is a global problem and results in deleterious psychological, social, and physical effects on the lives of those who are trafficked; however, it is not clear how to best intervene with survivors. The purpose of this review was to synthesize the evidence of exit and postexit intervention programs for survivors of human trafficking to inform practice and research. METHOD: Systematic review methods were used to search, select, and extract data from published and unpublished experimental, quasi-experimental, and preexperimental studies that assessed the effects of any exit or postexit interventions for victims of human trafficking. The authors searched eight databases, reviewed bibliographies, and conducted forward citation searches from relevant reports and prior reviews to find studies authored between 2005 and 2015. RESULTS: The search yielded six eligible studies that included 155 female and 6 male survivors from four countries. Interventions were diverse, with three using a trauma-informed approach. Authors measured a myriad of outcomes, including mental health, social network, community reintegration, and employment; however, the quality of most studies was poor. DISCUSSION: Evidence of effects of exit and postexit interventions is sparse, and much of the research is poorly designed and executed; however, the needs of trafficking survivors are complex and effective interventions are desperately needed. Implications for practice and research are discussed.


Assuntos
Tráfico de Pessoas/psicologia , Sobreviventes/psicologia , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto , Projetos de Pesquisa/normas
14.
BMC Psychol ; 6(1): 56, 2018 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541612

RESUMO

BACKGROUND: Human trafficking is a pervasive global crime with important public health implications that entail fundamental human rights violations in the form of severe exploitation, violence and coercion. Sex-specific associations between types of violence or coercion and mental illness in survivors of trafficking have not been established. METHODS: We conducted a cross-sectional study with 1015 female and male survivors of trafficking (adults, adolescents and children) who received post-trafficking assistance services in Cambodia, Thailand or Vietnam and had been exploited in various labor sectors. We assessed anxiety and depression with the Hopkins Symptoms Checklist (HSCL-25) and post-traumatic stress disorder (PTSD) symptoms with the Harvard Trauma Questionnaire (HTQ), and used validated questions from the World Health Organization International Study on Women's Health and Domestic Violence to measure physical and sexual violence. Sex-specific modified Poisson regression models were estimated to obtain prevalence ratios (PRs) and their 95% confidence intervals (CI) for the association between violence (sexual, physical or both), coercion, and mental health conditions (anxiety, depression and PTSD). RESULTS: Adjusted models indicated that for females, experiencing both physical and sexual violence, compared to not being exposed to violence, was a strong predictor of symptoms of anxiety (PR = 2.08; 95% CI: 1.64-2.64), PTSD (PR = 1.55; 95% CI: 1.37-1.74), and depression (PR = 1.57; 95% CI: 1.33-1.85). Among males, experiencing physical violence with additional threats made with weapons, compared to not being exposed to violence, was associated with PTSD (PR = 1.59; 95% CI: 1.05-2.42) after adjustment. Coercion during the trafficking experience was strongly associated with anxiety, depression, and PTSD in both females and males. For females in particular, exposure to both personal and family threats was associated with a 96% elevated prevalence of PTSD (PR = 1.96; 95% CI: 1.32-2.91) and more than doubling of the prevalence of anxiety (PR = 2.11; 95% CI: 1.57-2.83). CONCLUSIONS: The experiences of violence and coercion in female and male trafficking survivors differed and were associated with an elevated prevalence of anxiety, depression, and PTSD in both females and males. Mental health services must be an integral part of service provision, recovery and re-integration for trafficked females and males.


Assuntos
Coerção , Tráfico de Pessoas/psicologia , Saúde Mental/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Criança , Estudos Transversais , Depressão/psicologia , Feminino , Tráfico de Pessoas/estatística & dados numéricos , Humanos , Masculino , Prevalência , Delitos Sexuais/psicologia , Sobreviventes/estatística & dados numéricos , Adulto Jovem
15.
AMA J Ethics ; 20(12): E1212-1216, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30585586

RESUMO

This first-person narrative describes some of the barriers to caring well for patients at the intersection of human trafficking and substance use disorder. I canvass some of the ethical considerations regarding these patients' autonomy and call for establishing and using evidence-based practice to manage these complex scenarios.


Assuntos
Enfermagem Baseada em Evidências/ética , Tráfico de Pessoas/ética , Tráfico de Pessoas/psicologia , Autonomia Pessoal , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sobreviventes/psicologia , Adulto , Feminino , Humanos , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/psicologia , Estados Unidos , Adulto Jovem
16.
J Am Acad Child Adolesc Psychiatry ; 57(11): 809-812, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30392617

RESUMO

Commercial sexual exploitation of children (CSEC) is a pervasive public health crisis that affects children across the United States. After receiving public attention in recent years, several approaches have been developed to aid in identifying and intervening with trafficked youth to prevent further exploitation. Despite these developments, intervention efforts are plagued by client dropout, treatment nonadherence, and failures in placement, partially due to the failure of service systems to recognize the child's voice and preferences in decision-making conversations. We propose a new approach to addressing CSEC by applying shared decision making, a model developed in other areas of medicine, to working with high-risk and trafficked juveniles to increase youth voice and participation in care and to prevent revictimization.


Assuntos
Abuso Sexual na Infância/psicologia , Vítimas de Crime/psicologia , Tomada de Decisões , Tráfico de Pessoas/psicologia , Criança , Tráfico de Pessoas/prevenção & controle , Humanos , Relações Médico-Paciente , Estados Unidos
17.
J Evid Inf Soc Work ; 15(6): 617-648, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30199350

RESUMO

This paper (a) examines the evidence base around rehabilitation of victims of trafficking for commercial sexual exploitation (CSE), (b) identifies the extent that India's proposed 2016 Trafficking of Persons (Prevention, Protection, and Rehabilitation) Bill reflects scientific and experiential evidence, and (c) discusses how gaps in the proposed bill can be informed by evidence. A rapid review of empirical studies on policies and interventions addressing rehabilitation of CSE victims was conducted. Although evidence is lacking, research suggests that cross-sectoral collaboration, training and monitoring law enforcement, psychotherapeutic interventions and care provided by short-term shelters, reintegration, and recognizing victims' rights improve the success of rehabilitative efforts. The proposed legislation does not sufficiently reflect evidence around successful rehabilitation efforts and suggests that implementing the bill as it currently stands would change little of the existing structures to support victims in receiving adequate services or successfully reintegrating into society.


Assuntos
Vítimas de Crime/reabilitação , Tráfico de Pessoas/legislação & jurisprudência , Tráfico de Pessoas/prevenção & controle , Trabalho Sexual/psicologia , Saúde Global , Direitos Humanos , Tráfico de Pessoas/psicologia , Humanos , Índia , Aplicação da Lei/métodos , Políticas , Psicoterapia/métodos
18.
Behav Med ; 44(3): 234-241, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30020865

RESUMO

Trafficked children are frequently exposed to multiple traumatic events, including during their recruitment, transit, and exploitation. It has been hypothesized that such exposures can lead to the development of Complex Posttraumatic Stress Disorder (PTSD). Complex PTSD includes (in addition to the core PTSD symptoms of re-experiencing, avoidance, and hyperarousal) disturbances in affect regulation, dissociation, self-concept, interpersonal relationships, somatization, and systems of meaning. This historical cohort study aimed to investigate Complex PTSD in trafficked children with a diagnosis of PTSD and compare these with nontrafficked controls exposed to single or multiple trauma. Trafficked children were identified by keyword searches of the electronic health records of more than 250,000 mental health service users; a matched cohort of nontrafficked children was randomly selected. Regression models compared the number of Complex PTSD symptoms in trafficked children and non-trafficked children who had experienced multiple or single trauma. Fifty-one trafficked children were identified: eleven with a diagnosis of PTSD (22%). A high proportion of trafficked children with PTSD had Complex PTSD symptoms. Trafficked and non-trafficked children with PTSD who had been exposed to multiple trauma showed a greater number of Complex PTSD symptoms compared to nontrafficked children with PTSD exposed to single-event traumas. Somatic symptoms were noted for almost two-thirds of the trafficked children but only 10%-11% of the nontrafficked children. Child trafficking and multiple trauma exposure are associated with more complex posttraumatic presentations. A thorough clinical assessment at intake is crucial to ensure additional symptoms can be meaningfully incorporated into treatment plans.


Assuntos
Maus-Tratos Infantis/psicologia , Tráfico de Pessoas/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Estudos de Casos e Controles , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Masculino
19.
Behav Med ; 44(3): 250-258, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30020869

RESUMO

This article presents seven challenges of collecting primary (i.e., firsthand) data from commercially sexually exploited children (CSEC). We drew on our research team's experience collecting longitudinal data from 28 CSEC survivors with a 12-month follow-up period. We used both face-to-face and electronic group brainstorming methods to nominate a list of research-related challenges. The two main themes that were identified were challenges that can limit data quality and concerns about the impact of research on participants, researchers, and others. The three challenges related to data quality are (1) the age of the research participants; (2) questions about obtaining informed consent from parents or guardians; and (3) the over-interrogation of CSEC youth. The four challenges related to concerns about the impact of research were (4) concerns that research participation may further exploit youth; (5) staying in the role of researcher and refraining from providing advocacy; (6) secondary trauma and burnout experienced by research staff; and (7) the additional burden that research and data collection may place on the advocates and direct service providers. Because the process of collecting data from CSEC youth can be complicated, and rife with ethical and practical challenges, we have relayed our experiences with seven specific research-related challenges in order to stimulate discourse and further progress in the field.


Assuntos
Coleta de Dados/ética , Tráfico de Pessoas/ética , Tráfico de Pessoas/psicologia , Trabalho Sexual/psicologia , Adolescente , Criança , Confiabilidade dos Dados , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino
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