A mediational model linking perceptions of security,alexithymia and behavior problems of sexually abused children

BackgroundPerceptions of security toward parents are related with internalized and externalized problems among victims of child sexual abuse (CSA). Alexithymia, which is difficulty in identifying and expressing feelings, is associated with the quality of parent-child relationships (Oskis et al., 2013) and behavior problems in children (Di Trani et al., 2013).ObjectiveThe current study tested the mediational role of alexithymia in the relationship between perceptions of security toward parents and behavior problems among CSA victims.Participants and methodUsing a short-term multi-informant prospective design, 263 victims of CSA aged 6–12 years completed the Kerns Security Scale (Kerns, Klepac, & Cole, 1996), which evaluates perceived attachment security to mothers and fathers. Parents completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at Time 1 to provide baseline scores of behavior problems and again four months later. At Time 2, parents also assessed the children’s alexithymia using the Children’s Alexithymia Measure (Way et al., 2010).ResultsPerceptions of security were both associated with alexithymia, as well as with internalizing and externalizing problems (p < .05). A mediational model showed that perception of security toward fathers outweighed the mother-child relationship in predicting children’s alexithymia. Path analysis revealed that the father-child relationship predicted decreased behavioral problems at Time 2 through a lower level of alexithymia. The model explained 46.9% of internalizing problems and 56.1% of externalizing problems (p < .05).ConclusionsThe findings support the relevance of alexithymia as an intervention target for CSA victims and underscore the importance of the father-child relationship.     

From childhood emotional maltreatment to depressive symptoms in adulthood: The roles of self-compassion and shame

BackgroundEmotional abuse is a form of maltreatment that most strongly predicts adult depressive symptoms in community samples. Introject theories suggest that some depressive symptoms stem from survivors having learned to treat themselves the way they were treated by their perpetrators.ObjectiveMalevolent introjects may undermine self-compassion, which may subsequently maintain feelings of shame. Thus, we hypothesized that self-compassion and shame would mediate the path from retrospective reports of maltreatment to concurrent depressive symptoms in adulthood.Participants and SettingParticipants were 244 adult community members and college students living in a Southwestern American metroplex.MethodWe ran a multiple mediator path model with emotional abuse as the independent variable. We specified four covariates: physical abuse, sexual abuse, physical neglect, and emotional neglect, and held constant the variance they explained in self-compassion, shame, and depression.ResultsOur final model accounted for 53.1% of the variance in adult depressive symptoms. A significant indirect effect from emotional abuse passed through both mediators and ended in adult depressive symptoms. We also found an indirect path from emotional neglect to depression passing through both mediators.ConclusionsIt appears emotional abuse and emotional neglect can undermine the formation of self-compassion. Low self-compassion predicts greater shame and depressive symptoms. Our model suggests self-compassion may be a particularly effective intervention point for survivors of emotional maltreatment.     

Health care utilization pattern prior to maltreatment among children under five years of age in Taiwan

BackgroundSeveral studies have hypothesized that the pattern of health care utilization among maltreated children differ from others without the experience. However, the conclusions have not been consistent.ObjectiveThe study aims to examine whether the pattern of health care utilization among children 0–5 years old with maltreatment different from their counterparts without maltreatment in Taiwan.Subjects and SettingAll children born in 2007 in Taiwan.MethodThis is a population-based and case-controlled study. Cases are children under five years of ago with maltreatment-related diagnosis in the claims data of the National Health Insurance in Taiwan during the 2007–2013 period. For each case, there were 10 birth date-matched controls. Exposure variables include the number of injury or non-injury-related outpatients, emergency department (ED) visits, and hospitalization. Multivariate models were employed, with adjustment for sex, urbanization level, and comorbidities of children.ResultsOf children born in 2007, 382 had maltreatment-related diagnosis during the age of 0–5. The adjusted odds ratio (aOR) for having two or more ED visits with or without injury-related diagnosis is 3.52 (95% CI 1.75–7.07) and 2.0-0 (95% CI 1.47–2.72), respectively. Children with maltreatment also had significantly higher number of hospitalization without injury-related diagnosis and aOR for those having two more hospitalizations stands at 2.47 (95% CI 1.59–3.83).ConclusionsChildren with maltreatment when 0–5 years old had higher number of ED visits with injury-related diagnosis, as well as hospitalization without injury-related diagnosis. Recognition of the health care utilization is conducive to early identification of children with risk for maltreatment.     

Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006–2014

ObjectiveTo determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses.MethodsNationally estimated rates of definitive and suggestive physical abuse and neglect injuries for children <10 years were generated using the Nationwide Emergency Department Sample, the National Inpatient Sample, and census estimates. Trends over time were evaluated, including the trend in the proportion of definitive diagnoses to all diagnoses (definitive plus suggestive). Logistic regression was used to evaluate whether patient characteristics and hospital patient volumes were associated with definitive versus suggestive diagnoses.ResultsThe population rates of child physical maltreatment medically treated injuries were unchanged from 2006 to 2014; the trends were not statistically significant for ED or hospitalized patients. Over time, physician definitive diagnoses as a proportion of all physical maltreatment diagnoses (definitive plus suggestive) increased in admitted children from 17.6% in 2006 to 22.0% in 2014 (p = 0.02). Older age, white race, lower income by zip code, and public insurance as well as larger patient volumes increased the odds of definitive rather than suggestive diagnoses of physical abuse and neglect injuries.ConclusionsDefinitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias. The use of electronic medical records may have influenced the coding of definitive diagnoses.     

幼儿主题活动的有效开发实施策略--以班本化“清明节”主题课程资源为例

《幼儿园指导纲要》中明确指出,幼儿教育活动要能够充分注重综合性、生活性和趣味性,而主题活动打破了学科之间的界限,围绕幼儿的学习经验组织教育教学,对幼儿五大领域的全面发展有积极推动作用,恰好契合幼儿教育活动这一要求。本文笔者基于班本化“清明节”主题课程资源,从五个方面探究幼儿主题活动的有效实施策略。     

当代大学生的性现状研究

面对当前大学生呈现的各种性问题,可从生理、心理和社会等多个角度进行研究,从中揭示性的伦理学意义。对于发生在大学生身上的性问题,我们的态度应该是教育和引导,而不是逃避和漠视。     

Determination of peak cardiorespiratory fitness parameters in children: which averaging method should we use?

The purpose of this study was to identify which averaging methods most accurately measures peak cardiorespiratory fitness (CRF) parameters [peak O₂ uptake (VO₂), peak O₂pulse and peak respiratory exchange ratio (RER)] in a sample of healthy children and adolescents. In this cross-sectional multicenter study, we recruited 278 healthy children aged 12–17 years. We compared the mean peak value of three CRF parameters using the recommended averaging methods (30-second block average) with alternative averaging methods such as moving averages or shorter smoothing periods. We also assessed averaging methods for accuracy by individually reviewing breath-by-breath scatter plots. The 30-second block average method resulted in a lower mean peak VO₂ and in an increased proportion of underestimated peak values. Using a 30-second moving average significantly increased mean peak values which increased accuracy. Similar results were found for peak RER and peak O₂pulse. In conclusion, the currently recommended averaging method (30-second block average) increased the risk of misinterpretation of peak CRF values in children. Using a moving average approach decreased misinterpretation and increased accuracy.     

困境与出路：我国性侵运动员犯罪行为的刑事规制探究

近年来,性侵运动员的犯罪行为频发,成为国际社会聚焦的热点。以此审视我国运动员性法益的保护,虽有强奸罪、强制猥亵罪的刑事立法,却缺乏对该犯罪行为特殊性的深入思考,既不能在惩治犯罪人方面达到理想效果,亦不能在预防犯罪方面发挥良好功能。同时,司法中的“以纪代法”、针对性缺乏、未回应被害人需求等诸多问题,亦使该犯罪行为的刑事规制效果大打折扣。所以,在该犯罪立法上应有针对性采用附属刑法进行修正,完善犯罪的特别预防与一般预防制度;司法上,积极回应被害人的诉求,努力克服刑事规制过程中的各种困境,让运动员的性法益得到全面而充分的保护。     

反性骚扰立法研究——以劳动法为新视野

性骚扰已经成为一个严重的社会问题,美国、英国和我国台湾对反性骚扰的立法都有各自不同的特色,值得借鉴。美国将性骚扰定性为性别歧视,规制性骚扰以工作场所为主,范围不断扩大,并确立了雇主责任原则。我国台湾的反性骚扰立法明确界定了性骚扰的概念,特别是直接将性骚扰纳入了劳动法的调整范畴,认为工作场所性骚扰侵犯的是劳动者的工作环境权,开创了劳动立法的新篇章,并建立了完整的反性骚扰法律体系。我国应当在劳动法特别是《劳动合同法》中用工作环境权构建反性骚扰制度,以规制工作场所的性骚扰,在民法(民法典)中建立反性骚扰民事侵权制度,以之为反性骚扰的一般法。     

Educational program on evaluation of alleged sexual abuse victims

Increased awareness of the problem of child sexual abuse has resulted in increasing numbers of children presenting to professionals for the evaluation of possible sexual victimization. A multidisciplinary project to develop professionals' knowledge and skills in the identification and evaluation of possible victims is described. The program focused on the child as a victim and emphasized developmental perspectives with regard to identification, interviewing children, the medical examination, and children in the legal system. Fifty-one medical and social work professionals from ten Indiana counties attended the program and responded to questionnaires about their experience and knowledge. Of 40 (78%) respondents, 63% had had no previous training in the medical evaluation for child sexual abuse. Child protective workers referred alleged victims primarily to the child's regular physician (37%) or emergency room (31%) for medical examination. Knowledge about child sexual abuse improved significantly at two weeks postsymposium (p = .001) and remained improved at six months postsymposium (p less than .02). These original participants have subsequently organized similar multidisciplinary programs in their local communities for medical, social, law enforcement, and legal professionals; thus, they have been "seeds" for further educational and cooperative efforts throughout the state.