Gender differences in the effects of childhood maltreatment on adult depression and anxiety: A systematic review and meta-analysis

Child maltreatment has well-documented long-term, adverse effects on mental health, but it is not clear whether there are gender differences in these effects. We conducted a systematic review to investigate whether there are gender differences in the effects of maltreatment on adult depression and anxiety. Medline, PsycINFO, Web of Science, and Lilacs were searched for relevant studies published up to May 2016. Eligible studies included population-based studies (with a cohort, case-control or cross-sectional design) which assessed maltreatment during childhood or adolescence (≤18 years) and its association with major depression or generalized anxiety disorder (DSM/ICD diagnostic criteria) in adulthood (>18 years) separately for females and males. Meta-analysis was performed to estimate the association between each exposure and outcome using fixed and random effects models. Pooled odds ratios (OR) were estimated separately for women and men and compared. Five studies of physical and sexual abuse were included in the meta-analyses. These provided twenty-two effects sizes estimates (11 for men, 11 for women) for associations between physical/sexual abuse and depression/anxiety. Exposure to each kind of abuse increased the odds of depression/anxiety. Associations were larger for women than for men, however, these gender differences were not statistically significant. Physical and sexual abuse in childhood/adolescence are risk factors for depression/anxiety in adulthood and the effect could be larger for women; however, currently there is insufficient evidence to definitively identify gender differences in the effects of maltreatment.     

Abuse in the investigation and treatment of intrafamilial child sexual abuse

This paper examines the effects of current practice in the investigation and treatment of documented incest abusers on the offenders and families involved. Fifteen offenders attending the Utah Parents United group completed a questionnaire on the sequence of events in the investigation and prosecution of their cases and the concomitant results of the investigation on their job status, living and financial situations, family and social relationships, and media reporting of the abuse. Results indicate that there is great variability in the investigation and prosecution of incest cases and the public announcement of abuse convictions. The consequences of the abuse investigation are devastating for offender and his family in terms of job loss; need for public assistance; family disbandonment through removal of the offender, victim, or both from the family, marital separation, and foster care for nonabused siblings; changes of residence, and the public announcement of the abuse in the media. Results also show that offenders receive little, if any, social support from family or friends. Changes in the current approach to the investigation and prosecution of incest offenders are proposed and include the following: (1) banning the publication of convictions for child abuse; (2) streamlining the legal process so that it is consistent from case to case; and (3) developing diversion programs as alternatives to prison for offenders. Suggested are self-help, court-ordered therapeutic programs, such as Parents United, that are designed for the treatment of families involved in child sexual abuse and incest. The desired outcomes of such a diversion program are low offender recidivism, avoidance of the offender's family being placed on welfare, less reliance on foster care placement for the offender's children, involvement of the offender's family in moving toward reunion when feasible, and the use of existing half-way houses in lieu of incarceration when necessary.     

Physical and sexual abuse in orphaned compared to non-orphaned children in sub-Saharan Africa: A systematic review and meta-analysis

This systematic review assessed the quantitative literature to determine whether orphans are more likely to experience physical and/or sexual abuse compared to non-orphans in sub-Saharan Africa (SSA). It also evaluated the quality of evidence and identified research gaps. Our search identified 10 studies, all published after 2005, from Zimbabwe, South Africa, Kenya and Uganda. The studies consisted of a total 17,336 participants (51% female and 58% non-orphans). Of those classified as orphans (n = 7,315), 73% were single orphans, and 27% were double orphans. The majority of single orphans were paternal orphans (74%). Quality assessment revealed significant variability in the quality of the studies, although most scored higher for general design than dimensions specific to the domain of orphans and abuse. Combined estimates of data suggested that, compared to non-orphans, orphans are not more likely to experience physical abuse (combined OR = 0.96, 95% CI [0.79, 1.16]) or sexual abuse (combined OR = 1.25, 95% CI [0.88, 1.78]). These data suggest that orphans are not systematically at higher risk of experiencing physical or sexual abuse compared to non-orphans in sub-Saharan Africa. However, because of inconsistent quality of data and reporting, these findings should be interpreted with caution. Several recommendations are made for improving data quality and reporting consistency on this important issue.     

A retrospective study with ICAST-R (ispcan child abuse screening tools-retrospective) questionnaire for determination of child abuse in first year medical students in Turkish population

Child Abuse and Neglect (CAN) is an important problem both in Turkey and worldwide. Unfortunately, we still don’t have enough and reliable data on this important subject. In this study, we aimed to investigate the prevalence of childhood maltreatment in a population of first year medical students in a Turkish university using the retrospective version of the ISPCAN Child Abuse Screening Tool (ICAST-R). One hundred seventy three first year medical students, aged between 18 and 24 years, who agreed to complete the ICAST-R questionnaire, were recruited in our study. Of 173 students who completed the survey, 51.4% are found to be subjected to at least one type of child abuse (physical, emotional or sexual). The prevalence is higher in male gender and the difference is statistically significant. Physical, emotional and sexual abuse exposure rates are found to be 23.1%, 40.5% and 11% respectively. Physical and emotional abuse rates are higher in male gender and the difference is statistically significant. We did not find any statistically significant association between gender and sexual abuse. Efforts to prevent child abuse and neglect are growing in our country, as they are worldwide. However, child abuse is still common and a problematic issue. It is important to determine the prevalence of child abuse in order to raise awareness. We need further studies investigating not only prevalence but also risk factors to have reliable data for our country.     

A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families

Child abuse is a global problem, and parents with histories of childhood abuse are at increased risk of abusing their offspring. The objective of this systematic review is to provide a clear overview of the existing literature of randomized controlled trials evaluating the effectiveness of interventions to prevent child abuse. PubMed, PsychINFO, Web of Science, Sociological Abstracts, and CINAHL were systematically searched and expanded by hand search. This review includes all randomized controlled trials (RCTs) of interventions designed to prevent abuse among mothers identified as high-risk. Of the eight studies identified, only three found statistically significant reductions in abuse by any measure, and only two found reductions in incidents reported to child protective services. While much has been written about child abuse in high-risk families, few RCTs have been performed. Only home visitation has a significant evidence base for reducing child abuse, and the findings vary considerably. Also, data from low- and middle-income countries are limited.     

AD/HD: The role of teachers in the assessment of children suspected of having AD/HD

In the light of recent guidance published by The National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of attention deficit disorders in children, young persons and adults, Gill Salmon, a consultant Child and Adolescent Psychiatrist based in Swansea, South Wales, and Amanda Kirby, Professor of Developmental Disorders in Education based at the University of Wales, Newport, give an overview of the rationale for involving teachers in the assessment of children with AD/HD and the development and implementation of subsequent educational interventions. They also review the resulting training implications; explore some of the obstacles to multi‐agency, multi‐disciplinary working; and examine how current special educational needs policy goes hand‐in‐hand with the tiered approach to provision of child and adolescent mental health services in offering a graduated response to these children.     

The association between five forms of child maltreatment and depressive and anxiety disorders: A systematic review and meta-analysis

BackgroundChild maltreatment is a global public health issue that encompasses physical abuse, sexual abuse, emotional abuse, neglect, and exposure to intimate partner violence (IPV). This systematic review and meta-analysis summarises the association between these five forms of child maltreatment and depressive and anxiety disorders.MethodsPublished cohort and case-control studies were included if they reported associations between any form of child maltreatment (and/or a combination of), and depressive and anxiety disorders. A total of 604 studies were assessed for eligibility, 106 met inclusion criteria, and 96 were included in meta-analyses. The data were pooled in random effects meta-analyses, giving odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for each form of child maltreatment.ResultsAll forms of child maltreatment were associated with depressive disorders (any child maltreatment [OR = 2.48, 2.14–2.87]; sexual abuse [OR = 2.11, 1.83–2.44]; physical abuse [OR = 1.78, 1.57–2.01]; emotional abuse [OR = 2.35, 1.74–3.18]; neglect [OR = 1.65, 1.35–2.02]; and exposure to IPV [OR = 1.68, 1.34–2.10]). Several forms of child maltreatment were significantly associated with anxiety disorders (‘any child maltreatment’ [OR = 1.68, 1.33–2.4]; sexual abuse [OR = 1.90, 1.6–2.25]; physical abuse [OR = 1.56, 1.39–1.76]; and neglect [OR = 1.34, 1.09–1.65]). Significant associations were also found between several forms of child maltreatment and post-traumatic stress disorder (PTSD).ConclusionsThere is a robust association between five forms of child maltreatment and the development of mental disorders. The Global Burden of Disease Study (GBD) includes only sexual abuse as a risk factor for depressive and anxiety disorders. These findings support the inclusion of additional forms of child maltreatment as risk factors in GBD.     

A longitudinal study of the effects of chronic maltreatment on children's behavioral and emotional problems

OBJECTIVE: The aim of the present longitudinal study was to examine the links between chronicity of maltreatment and child behavioral and emotional problems. METHOD: Forty-nine maltreated children (32 victims of continuous, or chronic, maltreatment; 17 victims of transitory maltreatment) and their mothers were evaluated in their homes three times over a period of 6 years: at the time of recruitment (T1), 3 years following the initial evaluation (T2) and 6 years following the initial evaluation (T3). The home visits were designed to obtain longitudinal assessments of different types of behavioral and emotional problems in the children, and of the mothers' self-reported potential for abuse to help determine the chronic/transitory aspect of the maltreatment situation. Child Protection Services (CPS) files were also consulted at each assessment time in order to obtain more accurate information regarding the chronic/transitory aspect of the maltreatment situation. RESULTS: The results show that over time the victims of chronic maltreatment (Chronic group; CH) had significantly more emotional problems (i.e., Anxiety/Depression) than those victims of transitory maltreatment (Transitory group; TR). There was also a tendency for CH children to exhibit more aggressive behavior and social withdrawal problems than the children in the TR group. Furthermore, at T3, the proportion of children in the CH group showing a clinical level of behavior problems in general was significantly higher than in the TR group. CONCLUSIONS: The study confirms that there are differences among maltreated children in levels of behavior and emotional problems and shows that chronicity must be taken into consideration in order to identify more clearly the impact of maltreatment on the child. Chronically maltreated children appear to be at high-risk for developing clinical levels of problems. The results also suggest that intervention efforts resulting in an improvement of the family situation (i.e., reduction or elimination of maltreatment), also lead to an improvement in the behavior of children.     

Assessment for self-blame and trauma symptoms during the medical evaluation of suspected sexual abuse

The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8–17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse.     

Child victims of sexual abuse: Teachers' evaluation of emotion regulation and social adaptation in school

This study assessed the social adaptation of sexually abused children and tested whether children's emotion regulation competencies mediated the association between child sexual abuse (CSA) and two outcomes of the social domain (i.e. withdrawal and social difficulties). A group of 283 child victims of sexual abuse and a comparison group composed of 60 nonabused children was recruited. Teachers completed questionnaires assessing the children's emotion regulation competencies, withdrawal, and social difficulties exhibited in the school context. Results showed that sexually abused children displayed poorer emotion regulation skills and higher levels of both withdrawal and social difficulties relative to nonabused children. CSA was associated with social difficulties and withdrawn behavior through the mediation of emotion regulation competencies. Teachers and school psychologists should be assisted in identifying children at risk of social difficulties and emotional dysregulation and schools be encouraged to adopt a trauma‐informed approach.     

The battered child: A study of the role of services in 25 cases of child abuse in The Netherlands

With the help of a questionnaire and the study of 25 cases of child abuse from 1973 to 1976, the course of assistance given by various services and social workers involved was followed and the extent of the coordination between them was assessed. The starting point was the fact that when child abuse has reached the crisis stage many different bodies give immediate assistance to both the child and his parents. Later on, however, as help continues, it is not clear which of the persons or bodies concerned is really in charge of the case. The following conclusions were drawn: Abused children came from multiproblem families who often already have had contact with care or welfare services though no steps had been taken to intervene before ill-treatment was verified. Many parents confessed to illtreatment of their child and desired help. Abused children were subjected to longer than usual hospital stays due to lack of reception facilities outside the hospital. Most ill-treated children abused enough to be hospitalized, were placed away from home although half of the parents did not agree with that decision. Of those later returned to their parents, over half had to be removed later for renewed ill-treatment and neglect. The need for one body to coordinate and be responsible for execution of plans for treatment was stressed.     

Inclusion of students with emotional and behavioural disorders in general education settings: a scoping review of research in the US

ABSTRACT

Inclusion of students with disabilities in general education settings has been an international focus for over two decades. In the US, federal laws [e.g. Individuals with Disabilities Education Improvement Act (IDEIA). 2004. H.R. 1350, 108th Congress] mandate access to the general education curriculum for all students, including those with disabilities. These mandates codify a philosophical orientation of least restrictive environment, within a free appropriate public education, while explicitly requiring evidence-based practices. The policies support and protect inclusive practices for individuals with emotional and behavioural disabilities, yet the state of the empirical literature is unknown. A review is needed to provide an overview of the research and reveal the breadth of the literature. To this end, scoping review methodology was used to map the state of the literature. This particular approach is recommended for topics with myriad and complex definitions and issues, as is the case with inclusive education. Results map six themes (professional and student experience, strategy effectiveness, policy and programmes, perception of influencing factors, teacher training, teacher knowledge) and reveal several gaps in the literature. Recommendations are made for systematic review, meta-analyses, and individual studies to address the gaps in the literature.     

网格信任声誉评估模型研究进展

信任、声誉等基于社群的自适应性测度已成为网格环境下支撑服务质量需求的砖石.借鉴社会学、心理学和诸如P2P计算、普适计算等计算机科学中的相关研究,网格环境下的信任声誉研究主要应用在资源管理和调度中.对网格环境信任声誉评估的典型模型进行评述与比较,包括基本模型、离散模型、Bayesian模型、信念模型和模糊逻辑模型.在设计评估模型时应该考虑计算收敛能力,动态性和健壮性等多方面因素.考虑评估模型对负载的影响,设计针对网格环境特性的信任声誉评估模型是一个发展方向.     

A review and evaluation of the internal structure and consistency of the Approaches to Teaching Inventory

ABSTRACT

This study presents a review from 39 studies that provide evidence for the structural validity and internal consistency of the Approaches to Teaching Inventory (ATI). In addition to this review, we evaluate many alternative factor structures on a sample of 267 first- and second-year chemistry faculty members participating in a professional development, a sample of instructors for which the ATI was originally designed. A total of 26 unique factor structures were evaluated. Through robust checking of assumptions, compilations of existing evidence, and new exploratory and confirmatory analyses, we found that there is greater evidence for the structural validity and internal consistency for the 22-item ATI than the 16-item ATI. Additionally, evidence supporting the original two-factor and four-factor structures proposed by the ATI authors (focusing on information transmission and conceptual change) were not reproducible and while alternative models were empirically viable, more theoretical justification is warranted. Recommendations for ATI use and general comments regarding best practices of reporting psychometrics in educational research contexts are discussed.     

A meta-analysis of the prevalence of child sexual abuse disclosure in forensic settings

BackgroundIdentification, substantiation, prosecution, and treatment of child sexual abuse often rely heavily on a disclosure from the victim in the absence of corroborating evidence. For some, disclosure can be impeded by developmental or motivational barriers, thus compromising child safety and wellbeing. The literature on disclosure prevalence and mitigating influences does not yield a coherent picture. A more accurate estimate will help to inform investigation strategies to facilitate disclosure.ObjectiveThis study provides a meta-analysis of available research examining the prevalence of sexual abuse disclosure in forensic interviews with children under 18 years, and examines a range of factors that may influence the likelihood of disclosure.MethodDatabases were searched for published and unpublished studies up to May 2017. In total, 2393 abstracts were assessed for eligibility, 216 full-text articles were reviewed, and 45 samples (with 31,225 participants) provided estimates of effect sizes.ResultsThe mean prevalence of child sexual abuse disclosure in forensic settings was 64.1% (95% CI: 60.0–68.1). Between-study variability was explained by: (1) child age and gender, with higher prevalence in older children and females; (2) prior disclosure, with higher prevalence when present; and (3) study year, with higher prevalence in more recent studies.ConclusionsThis meta-analysis confirms an upward trend in child sexual abuse disclosure prevalence. However, more than a third of children do not disclose when interviewed, with those who are younger, male, and without a prior disclosure at greatest risk. Important implications for forensic interviewing protocols and future research are discussed.     

Formative and summative evaluation in the faculty peer review of teaching

If the process of the faculty peer review of teaching is to overcome institutional marginalization, then its formative and summative components must employ rules, criteria, and standards for the identification of effective teaching that have been agreed to within a peer conversation among the faculty members of a scholarly unit. This conversation serves to collectively clarify the unit's expectations for its curriculum, teaching, and student learning. Only such a process can produce the credibility necessary to regularly effect the faculty development and personnel decisions of a unit.Dr. Ronald R. Cavanagh holds a doctorate from the Graduate Theological Union in Berkeley, California, a Master of Divinity from Moravian College and the Moravian Theological Seminary in Bethlehem, Pennsylvania, and a B.A. in English. Since coming to Syracuse University in 1967, Dr. Cavanagh has served as a faculty member in and chairperson of the Department of Religion, Associate Dean, and Dean of the College of Arts and Sciences, and he is presently the University's Vice President for Undergraduate Studies. In 1995, he was a participant in the Institute for Educational Management at Harvard Univesity, Boston, Massachusetts.     

A narrative review of Greek myths as interpretative metaphors in educational research and evaluation

This paper reviews a series of Greek myths put forward as cultural narratives that could be used as metaphors or interpretative similes for explanatory and evaluative purposes in educational research and evaluation. These myths have been used in educational research literature, and most of them were found by carrying out an exhaustive search of that literature. In particular, the paper discusses Procrustes, referring to the use of arbitrary evaluative standards; the myth of Mentor, the embodiment of the researcher as facilitator/improver for new, inexperienced researchers; Prometheus, or the archetype of the self-sacrificing researcher; Periphetes, representing the evaluator who is cruel through incompetence; Sisyphus, symbolising the researcher’s anxiousness to achieve his goals; and Ulysses, an archetype for qualitative research.These myths are still absolutely relevant today, after more than 20 centuries, and can be used as powerful explicative frameworks of phenomena in the field of educational research and evaluation. By using myths to interpret educational phenomena, one reconnects contemporary qualitative educational enquiry with its ancient predecessor forms of meaning making.     

The place of colleague evaluation in the appraisal of college teaching: A review of the literature

The present review considers the nature of the problem of evaluating college teaching as well as the means by which this evaluation has been attempted. This review shows that there is little agreement as to what the criteria for evaluating college teaching should be. It is stated that student and administrator evaluation of faculty are, by themselves or combined, limited in scope. A list of 10 activities and faculty behaviors that can be more reliably and validly evaluated by fellow colleagues than by anyone else is presented, as well as 22 different criteria or approaches that could be used for this evaluation. Recommendations for upgrading colleague evaluation of teaching are made in the hope that the present state of affairs can begin to reach high levels of adequacy and objectivity.This research was supported by the Measurement and Research Division of the Office of Instructional Resources, University of Illinois at Urbana-Champaign.     

Maltreatment experiences and associated factors prior to admission to residential care: A sample of institutionalized children and youth in western Kenya

Objectives

This study aims to determine the prevalence of maltreatment experienced by institutionalized children prior to their admission to Charitable Children's Institutions (orphanages) in western Kenya, and to describe their socio-demographic characteristics, reasons for admission, and the factors associated with prior experiences of maltreatment.

Methods

A systematic file review was undertaken in five CCIs. Demographic, prior caregiving settings and maltreatment data were extracted. Forms of maltreatment were recorded according to WHO and ISPCAN guidelines. Logistic regression was used in bivariate and multivariable analyses of factors associated with reasons for placement and forms of maltreatment.

Results

A total of 462 files were reviewed. The median (interquartile range) age of children was 6.8 (5.08) years at admission, 56% were male, and 71% had lost one or both parents. The reasons for admission were destitution (36%), abandonment (22%), neglect (21%), physical/sexual abuse (8%), and lack of caregiver (8%). The majority of child and youth residents had experienced at least one form of maltreatment (66%): physical abuse (8%), sexual abuse (2%), psychological abuse (28%), neglect (26%), medical neglect (18%), school deprivation (38%), abandonment (30%), and child labor (23%). The most common reason for non-orphans to be admitted was maltreatment (90%), whereas the most common reason for orphans to be admitted was destitution (49%). Girls (adjusted odds ratio, AOR: .61, 95% CI: .39–.95) and orphans (AOR: .04, 95% CI: .01–.17) were both independently less likely to have a history of maltreatment irrespective of whether it was the reason for admission. Children whose primary caregiver had not been a parent (AOR: .36, 95% CI: .15–.86) and orphans (AOR: .17, 95% CI: .06–.44) were less likely to have been admitted for maltreatment, while children who were separated from siblings were more likely to have been admitted for maltreatment (AOR: 1.62, 95% CI: 1.01–2.60).

Conclusions

The high prevalence of maltreatment prior to admission, particularly among nonorphans, suggests the need for better child abuse and neglect prevention programs in communities, and psychosocial support services in institutions. The significant proportion of children admitted for poverty, predominantly among orphans, indicates that community-based poverty-reduction programs might reduce the need for institutionalization.