Childhood adversity increases the risk of onward transmission from perinatal HIV-infected adolescents and youth in South Africa

Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13–24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09–1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth.     

Childhood adversity and cognitive functioning in patients with major depression

ObjectiveMajor depression is often accompanied by deficits in cognitive functioning and lowered executive functions. However, not all depressed patients show impairments in these domains. The aim of this study was to examine whether different kinds of childhood adversity might account for cognitive deficits in patients with major depression.MethodsNinety-one patients with major depression (DSM-IV) and 40 healthy controls completed a neuropsychological test battery assessing memory, processing speed and executive functions. The Childhood Trauma Questionnaire (CTQ) was used to measure the severity and number of incidences of sexual, physical and emotional abuse and physical and emotional neglect.ResultsPatients with major depression had a significantly higher number of traumas and reported more severe emotional abuse, emotional neglect and physical neglect than healthy controls. Patients performed less well in memory tasks, general knowledge and processing speed than healthy controls. Hierarchical regression analyses indicated that the overall number of traumas was significantly associated with poorer general knowledge, lower processing speed and impaired executive functions in patients with major depression. A second model including all CTQ-subscales simultaneously demonstrated an association between physical neglect and poorer verbal learning, and physical abuse and diminished executive functions.ConclusionA higher number of childhood adversities may influence general knowledge, processing speed and executive functions in patients with major depression. In addition, physical abuse and neglect seemed to be associated with verbal learning deficits and poorer executive functions.     

Childhood adversity and adult depression among the incarcerated: Differential exposure and vulnerability by race/ethnicity and gender

The relationship between childhood adversity and adult depression is well-established but less is known about the association between childhood adversity and adult depression among the incarcerated. In this paper, we examine differential exposure and vulnerability to childhood adversity by race/ethnicity and gender on adult depression among the incarcerated in the United States. We address three research questions: does exposure to childhood adverse experiences vary by race/ethnicity and gender? Is there an association between these childhood adverse events and depression and does the strength of the association vary by the specific adverse experiences? And does vulnerability to childhood adversity vary by gender and race/ethnicity? Using the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), we measure four key childhood adverse events – parental/caretaker substance abuse, physical assault, having been placed in foster care, and sexual assault. We use ordinary least squares regression and a series of interaction effect analyses to examine differential exposure and vulnerability to the four childhood adverse experiences by race/ethnicity and gender. Incarcerated women are more likely to report parental substance abuse, but all inmates/prisoners are similarly vulnerable to this experience. For the other three adverse experiences measured, we find that there are important racial/ethnic and gender differences in both exposure and vulnerability. African American men and women are more vulnerable to the effects of physical and sexual victimization than White and Hispanic men and women. Women are much more likely to be exposed to sexual victimization, but men who report this experience are significantly more depressed. Hispanic women and White men and women are more likely to report foster care, but all inmates/prisoners who report foster care experiences are significantly more depressed than other inmates/prisoners, with the exception of white men. The findings indicate that there are significant differences in exposure and vulnerability to childhood adversity by race/ethnicity and gender. We conclude that in order to effectively design and implement programs to decrease the probability that childhood adversity is a risk factor for adult depression interventions must be targeted toward specific, vulnerable groups according to race/ethnicity and gender.     

Examining the role of attachment in the relationship between childhood adversity,psychological distress and subjective well-being

Childhood adversity is associated with a wide range of detrimental psychological consequences. This study examined the mediating role of relationship-specific attachment (avoidance and anxiety) in the associations between childhood adversity and both psychological distress and subjective well-being. University students (N = 190) across the Republic of Ireland completed self-report measures including the Adverse Childhood Experiences scale, Experiences in Close Relationships − Relationship Structures scale, Depression Anxiety and Stress scales and measures of subjective well-being. One hundred and twenty-eight participants (67.4%) reported experiencing at least one adverse childhood experience. Childhood adversity was associated with symptoms of psychological distress and subjective well-being. All such associations were mediated by certain relationship-specific attachment dimensions. Of these, attachment anxiety in general relationships was the most prominent mediator for both psychological distress and subjective well-being. Attachment to one’s father and to one’s romantic partner did not mediate any association. These findings indicate that attachment, in particular relationships, is an important factor in the associations between childhood adversity and both psychological distress and subjective well-being as an adult. One’s attachment anxiety in general relationships is particularly important in these associations. Therapeutic interventions addressing these attachment domains may offset the detrimental effects of childhood adversity. Future research is required using a longitudinal design.     

Childhood trauma,PTSD, and psychosis: Findings from a highly traumatized,minority sample

Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public, urban hospital (N = 328, >90% African American). Psychotic disorders were measured using the MINI International Neuropsychiatric Interview, PTSD was measured using the Clinician Administered PTSD Scale, child abuse was measured with the Childhood Trauma Questionnaire, and lifetime trauma exposure was measured with the Traumatic Events Inventory. Logistic regression analyses showed that both child abuse and current PTSD were statistically significant predictors of psychotic disorder beyond the effects of lifetime trauma load. When PTSD symptom clusters were examined, avoidance and numbing symptoms showed unique association with psychotic disorder independent of demographic variables and trauma exposure. Using bootstrapping techniques, we found a full indirect effect of PTSD on the association between child abuse and, suggesting a particularly important role of PTSD symptoms in relation to psychotic disorder in the presence of early life trauma. Because this is a cross-sectional study, continued research is needed to determine causality of such models. Identifying co-occurring psychosis and PTSD, particularly in populations with high levels of trauma exposure, is critical and will likely aid in more successful treatment interventions.     

Enhancing Transition from Early Childhood Phase to Primary Education: Evidence from the research literature

There are many levels in the educational continuum, and each time a child moves from one level to the other transition occurs. Transition from the early childhood phase to primary school is one of the major steps that each child has to take in the education continuum, and has been known to be traumatic for most children. There is also research evidence which contends that this transition to the first year of primary school is very important for the child's future physical, emotional and intellectual development. This article examines the literature on transition to school, and discusses its importance and the need to minimise its adverse effects by providing a smooth transition for the child. The article presents the factors which impact on successful transition from the early childhood phase to primary school.     

Growing up with adversity: From juvenile justice involvement to criminal persistence and psychosocial problems in young adulthood

Several studies have been carried out to investigate the effect of child maltreatment on juvenile justice involvement and future criminal life. However, little is known about the impact of other forms of adversity, beyond abuse and neglect, on juvenile delinquency and criminal persistence. The effect of early adversity on psychosocial problems is underexplored, particularly in juvenile delinquents. This study, using the Childhood Adverse Experiences (ACE) questionnaire, a tool accessing the exposure to different types of abuse, neglect and serious household dysfunction, explored the role of each adverse experience on juvenile justice involvement, persistence in crime and psychosocial problems during young adulthood. A Portuguese sample of 75 young adults with official records of juvenile delinquency in 2010/2011, and 240 young adults from a community sample completed ACE questionnaire and measures of psychosocial adjustment. Seven out of ten adverse experiences were significantly more prevalent in young adults with juvenile justice involvement than in the community sample, after matching the main demographic variables. The strongest predictor of juvenile justice involvement and criminal persistence during early adulthood was sexual abuse. Dimensions of child/adolescent emotional maltreatment and a mental illness in the household predicted a set of psychosocial problems in young adulthood. This study indicates that early adversity is significantly related to juvenile justice involvement, criminal persistence and psychosocial problems. This study also suggests that each experience has a different role in this process. There is an urgent need to screen, prevent and stop serious adversity. Future scientific directions and recommendations for policies are provided.     

Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale

This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women (M = 29.10 years, SD = 6.56, range = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity.     

Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States

Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders.     

Comparing cultural differences in two quality measures in Chinese kindergartens: the Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

This study examined the degrees of congruence between two early childhood evaluation systems on various quality concepts: the Early Childhood Environment Rating Scale-Revised (ECERS-R) and Zhejiang’s Kindergarten Quality Rating System (KQRS). Analysis of variance and post hoc least significant difference tests were employed to show the extent to which the ECERS-R ratings predict a kindergarten’s placement on the KQRS. Results found two quality dimensions (Language-reasoning and Interaction) that did not distinguish the quality between any levels of kindergartens, whereas one dimension (Space and furnishing) successfully distinguished the quality between all levels of kindergartens. Activities and Programme structure only distinguished the quality differences between Level-2 and Level-3 kindergartens, whereas Personal care and Routines only distinguished the quality differences between Level-1 and Level-3 kindergartens. Findings based on item-level analysis provided further insights into underlying cultural and contextual reasons for differences found in the concepts of quality in the two evaluation systems.     

Coerced and forced sexual initiation and its association with negative health outcomes among youth: Results from the Nigeria,Uganda, and Zambia Violence Against Children Surveys

IntroductionCoerced and forced sexual initiation (FSI) can have detrimental effects on children and youth. Understanding health outcomes that are associated with experiences of FSI is important for developing appropriate strategies for prevention and treatment of FSI and its consequences.MethodsThe Violence Against Children Surveys were conducted in Nigeria, Uganda, and Zambia in 2014 and 2015. We examined the prevalence of FSI and its consequences (sexual high-risk behaviors, violence experiences, mental health outcomes, and sexually transmitted infections (STI)) associated with FSI among youth aged 13–24 years in three countries in sub-Saharan Africa.ResultsOver one in ten youth aged 13–24 years who had ever had sex experienced FSI in Nigeria, Uganda, and Zambia. In multivariable logistic regression, FSI was significantly associated with infrequent condom use (OR = 1.4, 95%CI = 1.1–2.1), recent experiences of sexual violence (OR = 1.6, 95%CI: 1.1–2.3), physical violence (OR = 2.2, 95%CI: 1.6–3.0), and emotional violence (OR = 2.0, 95%CI: 1.3–2.9), moderate/serious mental distress (OR = 1.5, 95%CI: 1.1–2.0), hurting oneself (OR = 2.0, 95%CI: 1.3–3.1), and thoughts of suicide (OR = 1.5, 95%CI: 1.1–2.3), after controlling for demographic characteristics. FSI was not statistically associated with engaging in transactional sex, having multiple sex partners, or having a STI.ConclusionFSI is associated with infrequent condom use, recent experiences of violence and mental health outcomes among youth in sub-Saharan Africa, which may increase the risk for HIV and other consequences. Developing strategies for prevention is important for reducing the prevalence of FSI and its effects on children and youth.     

Adverse childhood experiences among youth reported to child welfare: Results from the national survey of child & adolescent wellbeing

The negative influence of adverse childhood experiences (ACEs) on social, emotional, and behavioral (SEB) outcomes are well documented. However, no research to date has examined the effect of ACEs on SEB outcomes in youth who received mental health services after reporting to the child welfare system. This study's analyses of data from the National Survey of Child and Adolescent Well-Being II revealed that the most prevalent ACEs included hospitalization for a medical condition, neglect, and exposures to domestic and community violence. Logistic regression of this data showed that the odds of being diagnosed with internalizing problems increased with age and when sexual abuse was reported. The results also showed that compared to Caucasian youth, Latinos were less likely to be diagnosed with externalizing behaviors, even when sexual abuse had been reported. Contrary to one of this study's hypotheses, mental health service use within the past 18 months increased the odds of being diagnosed with SEB problems. These findings highlight the persistence of SEB problems despite receipt of mental health services. Future research should assess the impact of interventions that aim to mitigate poor SEB outcomes due to ACEs, especially sexual abuse.     

Anxiety, depression, and peer relationships during adolescence: Results from the Portuguese national health behaviour in school-aged children survey

Use data from the Portuguese HBSC (Health Behaviour in School-Aged Children) survey, which was conducted by one of the authors who is the national representative of the European Study HBSC, a World Health Organisation collaborative study (Currie, Hurrelmann, Setterbulte, Smith, & Todd, 2000; Matos, Simões, Carvalhosa, Reis & Canha 2000), to examine correlates of depression and anxiety in a large, representative sample of adolescents. The study had four aims: (1) to examine the relationship between feelings of anxiety and depression; (2) to examine the association of positive peer relationships, and anxiety and depression in school-age adolescents; (3) to examine the relationship between health, peer relationships, depression and anxiety; and finally, (4) to assess age and gender differences with regard to the above issues. Measures were constructed of depression, anxiety, peer relationships, and health. Consistent with previous studies, anxiety and depression were found to be significantly correlated. A MANOVA revealed that females and adolescents in grades 8 and 10 were more likely to report high anxiety and/or depressive symptoms. High anxiety and depression in adolescence was associated with poor peer relationships and poorer health. Implications of these results and directions for further research are discussed.     

Trends in the payoff to academic and occupation-specific skills: the short and medium run returns to academic and vocational high school courses for non-college-bound students

Using data from three longitudinal surveys of American high school students, I show that vocational courses helped non-college-bound students to start their work life more successfully. A comparison of the returns to academic and vocational course work for non-college-bound students who graduated in 1972, 1980 and 1992 finds that the short and medium term payoffs to vocational courses rose substantially between 1972 and 1980 and remained high in 1992. Holding a host of variables constant, academic course work had much smaller labour market payoffs than vocational course work. These findings contradict the often repeated claim that employers now seek workers with a good general education and are happy to teach the occupation specific skills necessary to do the job. High school students who do not plan to attend college full-time would be well advised to start studying a well paying occupation before they complete high school. [JEL: I20, J23, J24]     

日本"幼小衔接"热潮剖析

本文在对近几年日本出现的"幼小衔接"热潮的发展历程和主要特点进行研究的基础上,对其原因进行了分析,认为地方分权化的推动、"小一问题"的驱使和终身教育思潮的影响是当今日本出现"幼小衔接"热潮的主要原因.     

Child Observation and Accountability in Early Childhood Education: Perspectives from Australia and the United States

The changing ways child observation is being used by preschool teachers in the United States and Australia are described in relation to the accountability movement pressuring young children and their teachers in both countries. The costs of the accountability movement in early childhood education are explored, and a call for genuine accountability based on assessment strategies such as traditional child observation is made.     

民众的腐败容忍度: 实证研究及启示——基于世界价值观调查数据的分析

要从根本上消除腐败,不仅需要纪检监察机关加强对政府及公职人员的监督,也需要社会公众的积极参与。降低腐败容忍度是提高公众反腐败参与意愿和实际行动的关键。基于全国314个地级行政区的数据分析发现,政府治理、经济发展和社会文化等三个维度对公众的腐败容忍度有显著影响。地区的政府科教事业支出越高,城乡收入差距越大,离首都的距离越远,则公众的腐败容忍度越高;地区的社会信任度越高,对中央政府的政治信任度、索贿指数越高,则公众的腐败容忍度越低;中西部地区的经济发展与腐败容忍度呈倒U型曲线关系。当前需要持续提高经济发展水平,缩小城乡收入差距,增强公众的政治信任和社会信任度,进一步加大反腐败力度,清除群众身边的腐败现象,从而切实降低公众的腐败容忍度,形成政府与社会共同反腐的合力,巩固发展反腐败斗争压倒性胜利。     

Childhood social status in society and school: implications for the transition to higher levels of education

While research into educational inequalities emphasises childhood socio‐economic status, this study adds another dimension of status into the analysis; namely, the child’s own social position among its peers. The aim was to examine whether socio‐economic status and peer status can both be linked to educational transitions and, if so, whether they constitute overlapping paths. In a second step of analyses, the relationship between peer status and adult unemployment was investigated. Data were derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden. Our results suggest that children with higher socio‐economic status and children with higher peer status are consistently more likely than their lower status peers to proceed to the next level of education, and that the effects of socio‐economic status and peer status hardly overlapped at all. Furthermore, educational differences by peer status seem to involve consequences for the studied subjects’ contemporary labour market opportunities.     

Transition from high school to higher education and work in Korea, from the competency-based education perspective

We examined how much Korean high school education helps students to build up the competencies needed for their college education and the world of work. We surveyed 227 high school graduates. They particularly emphasized communication skills, a cooperative attitude, computer skills, making friends and maintaining friendships, adaptability, self-directed learning and creative problem solving skills for their future life. However, they think high school education generally does not help students to build up the needed skills. In fact, they want more extracurricular activities, laboratory classes, practical training, career guidance, and diverse pedagogies than are currently given.     

我国城乡子女高等教育入学机会差距变化研究(1982-2010)——基于四川省的实证调查

本文对1982至2010年间我国城乡子女高等教育入学机会差距的变化情况进行了实证分析。结果显示,城乡子女间总体的入学机会差距在逐渐缩小;在机会的质量方面,城乡子女在部属重点高校和普通本科院校中的入学机会差距呈现出先扩大而后开始缩小的趋势,但在专科院校中的机会差距自1982年以来一直在缩小。此外,这一期间基本上是院校层次越高,城乡子女间的入学机会差距就越大。为此,今后应通过提高农村基础教育质量、中考和高考适当向农村倾斜以及大力发展职业教育等措施,进一步提高城乡子女高等教育入学机会均等化的程度。