For a long time,legal entities have developed and used crime prediction methodologies.The techniques are frequently updated based on crime evaluations and responses from scientific communities.There is a need to devel...For a long time,legal entities have developed and used crime prediction methodologies.The techniques are frequently updated based on crime evaluations and responses from scientific communities.There is a need to develop type-based crime prediction methodologies that can be used to address issues at the subgroup level.Child maltreatment is not adequately addressed because children are voiceless.As a result,the possibility of developing a model for predicting child abuse was investigated in this study.Various exploratory analysis methods were used to examine the city of Chicago’s child abuse events.The data set was balanced using the Borderline-SMOTE technique,and then a stacking classifier was employed to ensemble multiple algorithms to predict various types of child abuse.The proposed approach successfully predicted crime types with 93%of accuracy,precision,recall,and F1-Score.The AUC value of the same was 0.989.However,when compared to the Extra Trees model(17.55),which is the second best,the proposed model’s execution time was significantly longer(476.63).We discovered that Machine Learning methods effectively evaluate the demographic and spatial-temporal characteristics of the crimes and predict the occurrences of various subtypes of child abuse.The results indicated that the proposed Borderline-SMOTE enabled Stacking Classifier model(BS-SC Model)would be effective in the real-time child abuse prediction and prevention process.展开更多
Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less...Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.展开更多
When a child abuse situation arises, the responsible agencies and entities in charge of response should be capable of providing a fast and personalized solution for the good of the child. This need leads the authors t...When a child abuse situation arises, the responsible agencies and entities in charge of response should be capable of providing a fast and personalized solution for the good of the child. This need leads the authors to consider the formation of dynamic virtual organizations tailored to each particular abuse case. In the authors' approach the partner selection of these collaborative networks is done through a software tool that combines two technologies from the field of artificial intelligence, specifically multi-agent systems and expert systems. In addition, these partners come from the breeding environment constituted by all the agencies or individuals, either in a region or locality, which have the potential of response.展开更多
Child abuse is an important source of mental and physical adverse consequences for victims,their family,and their community.The impact of violence during childhood on the development of the victim is a very sensitive ...Child abuse is an important source of mental and physical adverse consequences for victims,their family,and their community.The impact of violence during childhood on the development of the victim is a very sensitive theme.Other than internalizing symptoms,it is interesting to analyze the possibility that a victim may assume the role of persecutor.With this aim,we evaluate Literature and examine the interplay among different types of child abuse(emotional neglect,emotional abuse,physical neglect,physical abuse and sexual abuse)and the development of psychopathy.We consider the role of post-traumatic stress disorder and that of personal environment as potential mediators between abuse and psychopathy.Furthermore,an in-depth analysis on possible differences due to the victim's gender is performed.Finally,analysis focused on genetic variants,such as the polymorphism of 5HTT and MAO-A,or a biological alteration,like the difference in daily cortisol levels that could be related to the development of psychopathy after a trauma.展开更多
<strong>Background: </strong>There are many reports in the mass media and scientific literature about child abuse caused by parents. Medical practitioners also are concerned about child abuse and need to g...<strong>Background: </strong>There are many reports in the mass media and scientific literature about child abuse caused by parents. Medical practitioners also are concerned about child abuse and need to grapple with the prevention and early detection of child abuse when working in medical facilities. <strong>Aim:</strong> The aim of this descriptive study was to explore the relationship between maternal and child factors contributing to child abuse. <strong>Methods:</strong> A sample of 50 multiparas (mothers with more than 1 child) in a 48-bed postpartum hospital unit in Okinawa prefecture were asked to fill out an anonymous questionnaire regarding the relationship between mothers and their first child in September, 2007. The questionnaire contained 30 items of physical punishment that are quoted from “The Handbook of Correspondence to Child Abuse” (Ministry of Health, Labor and welfare in Japan), 24 items relating to maternal factors and 22 items to child factors, plus items related to mothers’ satisfaction with the health guidance given in the hospital. Data were analyzed using JMP (ver. 14.2;SAS Institute Inc., Cary, NC, U.S.). The significance level was set at 0.05. <strong>Results:</strong> Forty-one (82%) questionnaires were analyzed. Of the 41 valid responses, 19 mothers reported abusing their children. Child factors contributing to the abuse included the first child’s regression to infantile behavior, bullying younger brothers or sisters and being rough and violent to their friends. The significant maternal factor leading to abuse was the belief that mothers were irritated by their child. <strong>Conclusion:</strong> A first child’s developmental difficulties had a significant relationship with the harsh punishment by their mothers. The mothers need to understand their child’s developmental behavior and provide a favorable environment for nurturing young children.展开更多
Objective To determine the status of adverse childhood experiences (ACEs) and the association of multiple ACEs with both parental alcoholism and later personal alcohol abuse among Chinese medical students with a vie...Objective To determine the status of adverse childhood experiences (ACEs) and the association of multiple ACEs with both parental alcoholism and later personal alcohol abuse among Chinese medical students with a view of improving adolescent health and reducing alcohol abuse among them. Methods In this cross-sectional study, 2073 Chinese medical students completed a survey on ten categories of ACEs in Anhui province of China. The association of parental alcoholism with ACEs and personal alcohol abuse was assessed by logistic regression analyses. Results The adjusted odds ratio (OR) for each category of ACEs in the subjects whose parents (either fathers or mothers or both) had alcohol abuse was 2 to 14 times higher than that in those with parental alcoholism (P〈0.05). Subjects with bi-parental alcoholism had the highest likelihood of ACEs. Compared with the subjects without ACEs, therisk of personal alcohol abuse was increased by 2-4-folds in the subjects with ACEs, irrespective of parental alcoholism (P〈0.05). The total number of ACEs (ACE score) had a graded relationship to 4 categories of personal alcohol abuse with or without parental alcoholism. The prevalence of personal alcohol abuse among the subjects with parental alcoholism was higher, which was independent of ACE scores. Conclusion The prevalence of ACEs is generally serious in China. Efforts should be made to prevent and treat children with ACEs and subsequently to reduce alcohol abuse and later problems.展开更多
This study aims to identify the support to provide to fathers who have abused children as reported by public health nurses (PHNs). In this study, a qualitative descriptive design was applied to the data analysis. Inte...This study aims to identify the support to provide to fathers who have abused children as reported by public health nurses (PHNs). In this study, a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs) in charge of child abuse services for at least 5 years at public health centers. The study analyzed 13 cases reported in the interviews. Measures to support fathers who abuse their children as suggested by PHNs were classified into direct support to the father, support to other family members, and support to be provided by others involved including related organizations. The direct support to the father includes “gaining an in-depth understanding of the abusive situation and psychological states of those involved”, “refraining from involvement in areas where it is difficult to understand the personality of the father”, and others. Support of other family members includes “understanding the marital relationship and assessing the qualities of the relationship”, “refraining from matters that will involve divorce”, and others. Support to be provided by others including related organizations includes “understanding the value of social exchange and assessment of the ability to create and maintain interpersonal relationships”, “establishing support arrangements to enable intervention when necessary”, and others. The interviews report that PHNs arrange support measures that enable intervention as it becomes required, and that this enables learning about child-abuse preventing activities.展开更多
Child sexual abuse (CSA) is a stressful associated with alterations in the hypothalamic-hypophyseal-adrenal (HPA) axis and behavioral problems. Children and adolescents with history of CSA could have higher cortisol l...Child sexual abuse (CSA) is a stressful associated with alterations in the hypothalamic-hypophyseal-adrenal (HPA) axis and behavioral problems. Children and adolescents with history of CSA could have higher cortisol levels, as these have been associated with deleterious changes in brain regions involved in controlling social behavior and self-control. The aim of the present study was to determine the relationship among basal cortisol levels, social skills and behavioral problems in adolescents with CSA by evaluating two groups: one consisting of 12 - 15-year-old girls with CSA (n = 23), the other healthy comparison adolescents with no history of child abuse (n = 23). Social skills and behavioral problems were assessed using the Social Skills Improvement System. Three saliva samples were collected from each participant. The girls with CSA had lower social skills and more behavioral problems, as well as, higher cortisol concentrations. Besides, these participants showed significant negative correlations among cortisol levels and social skills, as well as, positive correlations with behavioral problems scales. It is feasible to suggest that the social deficiencies observed in these participants with CSA are related to alterations of the HPA.展开更多
Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma ar...Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma are disruptions of sleep.Sleep problems,such as shorter sleep duration,difficulty falling asleep,frequent awakenings,nightmares,sleepless nights,and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events.This review will illustrate the role of sleep problems in traumatized children and adolescents,and emphasize the need to consider a wide range of etiological mechanisms for these symptoms.However,the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research.Moreover,in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma,the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.展开更多
Survivors of Child Sexual Abuse (CSA) can develop Post-Traumatic Stress Disorder (PTSD), alterations in the prefrontal cortex, changes in electroencephalographic (EEG) activity, and lower performance on working memory...Survivors of Child Sexual Abuse (CSA) can develop Post-Traumatic Stress Disorder (PTSD), alterations in the prefrontal cortex, changes in electroencephalographic (EEG) activity, and lower performance on working memory tasks. The aim of this study was to characterize brain electrical correlations in girls with PTSD secondary to CSA during a working memory task based on recognizing emotional facial stimuli. Girls aged 8 - 16 years old were evaluated: 12 with PTSD secondary to CSA, and 12 healthy girls with no history of abuse. EEG activity during a working memory task with emotional stimuli was recorded, and the inter- and intra-hemispheric correlations that assessed the functional connectivity among different cortical regions were analyzed. The PTSD group showed lower performance than controls on the working memory task while watching happy faces, while the EEG of this group showed greater intrahemispheric correlation among frontal areas and between frontal and posterior cortical regions. Also, the PTSD group had lower interhemispheric correlations between posterior temporal areas. The higher intrahemispheric correlation in the PTSD group could indicate that those girls used more brain areas when performing the task, likely because it required greater effort. The lower inter-posterior temporal correlation could be attributed to a reduction of the corpus callosum.展开更多
The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental stat...The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.展开更多
The past 50 years has seen a heightened awareness of abusive injury patterns and increased concern for the plight of children victimized by their caregivers.Murder of the young,however,has been embedded in society sin...The past 50 years has seen a heightened awareness of abusive injury patterns and increased concern for the plight of children victimized by their caregivers.Murder of the young,however,has been embedded in society since the beginning of recorded time.Indeed,nature provides abundant examples of infanticide in lower animals,raising the question of whether exploitation,apathy,and violence toward children are on some level evolutionarily conserved.In human antiquity,selective killing of females,the illegitimate,and the malformed,killing by ritualistic sacrifice or to conserve resources was carried out with impunity.The middle ages and later saw a decline in these practices albeit limited.One hundred years into the industrial revolution,with harsh child labor in public view,legal remedies were sought to protect children but with little effect.The domestic abuse of children was not addressed until a pivotal 19^(th)-century case,in which the rights of animals were invoked to intervene on behalf of a child.In the 20th century,physicians began to look closely at anatomical findings;patterns due to trauma,especially inflicted trauma,began to emerge.“Battered child syndrome”was followed by“shaken baby syndrome”,the latter prompted by the recurrent findings of subdural hematoma,retinal hemorrhages,and brain injury with the absence of impact injuries and no plausible accidental or natural disease explanation.In the 21st century,high-quality studies and an emphasis on evidenced-based medicine substantiated the existence ofiiijury patterns resulting from homicidal violence.However,progress has been uneven.A case of child abuse that reached the US Supreme Court resulted in an ill-cited dissent that seems to have amplified an already toxic medicolegal environment,perhaps unjustifiably.The difficulties in balancing the welfare of society with that of caregivers in the aftermath of homicidal abuse will no doubt continue.展开更多
Rape and sexual violence occur in all social classes and societies.In most cases,the sexual offenders are known to the victim and the majority of rapes happen in intimate relationships.Children are particularly vulner...Rape and sexual violence occur in all social classes and societies.In most cases,the sexual offenders are known to the victim and the majority of rapes happen in intimate relationships.Children are particularly vulnerable to sexual abuse,in particular,the female sex.The sexual abuse of minors is defined as“any sexual activities that an adult carries on or with a person under the age of consent.”Literature evidence that the prevalence of any type of violence among women with disabilities varies between 26.0%and 90.0%,compared to nondisabled women,showing that people with disabilities have an increased risk of suffering physical and sexual violence.Children with intellectual disabilities(ID)show a high risk of sexual victimization.The World Health Organization presently defines mental retardation as“a significantly reduced ability to understand new or complex information and to learn and apply new skills(impaired intelligence).This results in a reduced ability to cope independently(impaired social functioning),and begins before adulthood,with a lasting effect on development.”The aim of this study is to investigate the correct identification of sexual abuse and severe mental retardation through the collaboration of a team of experts(forensic pathologist,psychiatrist,psychologist,gynecologist,pediatrician,and social worker).We present a case of a 12-year-old female child,who suffers from severe mental retardation and was the victim of rape by a 79-year-old man.The study shows the difficulties in discovering episodes of sexual abuse among children affected by ID by evidencing the importance of adequate analysis through a multidisciplinary approach.The work focuses on the need to improve knowledge about medical and forensic investigations through proper protocols,for early recognition and appropriate management of these complicated cases.展开更多
This study evaluates variables concerning demographic characteristics for all adult male offenders convicted of Child Sexual Abuse(CSA)aged 0–17 in Malmö,Sweden between 2013 and 2018.All convictions(n=18)based o...This study evaluates variables concerning demographic characteristics for all adult male offenders convicted of Child Sexual Abuse(CSA)aged 0–17 in Malmö,Sweden between 2013 and 2018.All convictions(n=18)based on court documents from the District Court,the Court of Appeals and information from the Swedish Tax Agency were reviewed.A total of 30 victims were identified.Frequency analyses show that the most common features were that of a single offender,averaging 25 years old,with a non-Swedish background and a high school degree.The predominately extrafamilial CSA(i.e.committed by an acquaintance to the family)occurred in a private setting and consisted of penetrative acts.Girls averaging 13years old were abused multiple times,under fear and pressure.Although assumptions based on these results are preliminary,they provide a clearer image of the typical circumstances under which CSA occurred within this time frame and geographical location.This study is a first attempt to construct an overview of demographic characteristics of CSA.As more data are gathered from this region,more sophisticated analyses can be conducted,providing stronger generalizations.Information of this kind may be important for research,classification of offender profiling and in case linking.展开更多
Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment,leading to changes in the regulation of multiple ...Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment,leading to changes in the regulation of multiple organ systems.This study was established to review the epigenetic mechanisms associated with childhood abuse as well as the long-term deter-minants that these epigenetic changes may have on future illness.We retrospectively ana-lysed the effect of exposure to adverse childhood experiences(ACEs,specifically those relating to childhood maltreatment)between the ages of 0 and 16years on the human epi-genome,as well as possible clinical associations.After meeting inclusion and exclusion crite-ria,36 articles were included in this systematic review.Eight of these studies did not find a relationship between childhood maltreatment and DNA methylation.Of the remaining 28 studies,nine were genome-wide association studies,whereas the rest were candidate gene studies,mainly studying effects on neuroendocrine,serotoninergic and immunoregulatory systems.Meta-analysis of correlation coefficients from candidate gene studies estimated an association of childhood adversity and DNA methylation variation at r=0.291(P<0.0001),and meta-analysis of two epigenome-wide association studies(EWASs)identified 44 differen-tially methylated CpG sites.In conclusion,childhood maltreatment may mediate epigenetic mechanisms through DNA methylation,thereby affecting physiological responses and con-ferring a predisposition to an increased risk for psychopathology and forensic repercussions.Similar evidence for somatic illnesses is not yet available.展开更多
Spontaneous subdural hemorrhage(SDH)is an uncommon nontraumatic bleed of the brain,involving the dura and arachnoid mater.SDH commonly occurs due to tearing of bridging veins;however,SDH from the rupture of arterioven...Spontaneous subdural hemorrhage(SDH)is an uncommon nontraumatic bleed of the brain,involving the dura and arachnoid mater.SDH commonly occurs due to tearing of bridging veins;however,SDH from the rupture of arteriovenous malformation(AVM)is an uncommon phenomenon,particularly in children.We report a case of atypical SDH in a 1-year-old child with AVM and a history of alleged abuse.Autopsy revealed SDH in the right parietal and middle cranial fossa without any external or internal injuries to the head,brain,or other parts of the body.Histopathological examination and immunohistochemical staining of the brain tissue revealed an abnormal distribution of arteries and veins of various sizes and architecture.From a detailed histopathological examination of the brain and meticulous investigation of vascular abnormalities,we conclude the cause of acute SDH to be due to a ruptured AVM.展开更多
文摘For a long time,legal entities have developed and used crime prediction methodologies.The techniques are frequently updated based on crime evaluations and responses from scientific communities.There is a need to develop type-based crime prediction methodologies that can be used to address issues at the subgroup level.Child maltreatment is not adequately addressed because children are voiceless.As a result,the possibility of developing a model for predicting child abuse was investigated in this study.Various exploratory analysis methods were used to examine the city of Chicago’s child abuse events.The data set was balanced using the Borderline-SMOTE technique,and then a stacking classifier was employed to ensemble multiple algorithms to predict various types of child abuse.The proposed approach successfully predicted crime types with 93%of accuracy,precision,recall,and F1-Score.The AUC value of the same was 0.989.However,when compared to the Extra Trees model(17.55),which is the second best,the proposed model’s execution time was significantly longer(476.63).We discovered that Machine Learning methods effectively evaluate the demographic and spatial-temporal characteristics of the crimes and predict the occurrences of various subtypes of child abuse.The results indicated that the proposed Borderline-SMOTE enabled Stacking Classifier model(BS-SC Model)would be effective in the real-time child abuse prediction and prevention process.
文摘Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.
文摘When a child abuse situation arises, the responsible agencies and entities in charge of response should be capable of providing a fast and personalized solution for the good of the child. This need leads the authors to consider the formation of dynamic virtual organizations tailored to each particular abuse case. In the authors' approach the partner selection of these collaborative networks is done through a software tool that combines two technologies from the field of artificial intelligence, specifically multi-agent systems and expert systems. In addition, these partners come from the breeding environment constituted by all the agencies or individuals, either in a region or locality, which have the potential of response.
文摘Child abuse is an important source of mental and physical adverse consequences for victims,their family,and their community.The impact of violence during childhood on the development of the victim is a very sensitive theme.Other than internalizing symptoms,it is interesting to analyze the possibility that a victim may assume the role of persecutor.With this aim,we evaluate Literature and examine the interplay among different types of child abuse(emotional neglect,emotional abuse,physical neglect,physical abuse and sexual abuse)and the development of psychopathy.We consider the role of post-traumatic stress disorder and that of personal environment as potential mediators between abuse and psychopathy.Furthermore,an in-depth analysis on possible differences due to the victim's gender is performed.Finally,analysis focused on genetic variants,such as the polymorphism of 5HTT and MAO-A,or a biological alteration,like the difference in daily cortisol levels that could be related to the development of psychopathy after a trauma.
文摘<strong>Background: </strong>There are many reports in the mass media and scientific literature about child abuse caused by parents. Medical practitioners also are concerned about child abuse and need to grapple with the prevention and early detection of child abuse when working in medical facilities. <strong>Aim:</strong> The aim of this descriptive study was to explore the relationship between maternal and child factors contributing to child abuse. <strong>Methods:</strong> A sample of 50 multiparas (mothers with more than 1 child) in a 48-bed postpartum hospital unit in Okinawa prefecture were asked to fill out an anonymous questionnaire regarding the relationship between mothers and their first child in September, 2007. The questionnaire contained 30 items of physical punishment that are quoted from “The Handbook of Correspondence to Child Abuse” (Ministry of Health, Labor and welfare in Japan), 24 items relating to maternal factors and 22 items to child factors, plus items related to mothers’ satisfaction with the health guidance given in the hospital. Data were analyzed using JMP (ver. 14.2;SAS Institute Inc., Cary, NC, U.S.). The significance level was set at 0.05. <strong>Results:</strong> Forty-one (82%) questionnaires were analyzed. Of the 41 valid responses, 19 mothers reported abusing their children. Child factors contributing to the abuse included the first child’s regression to infantile behavior, bullying younger brothers or sisters and being rough and violent to their friends. The significant maternal factor leading to abuse was the belief that mothers were irritated by their child. <strong>Conclusion:</strong> A first child’s developmental difficulties had a significant relationship with the harsh punishment by their mothers. The mothers need to understand their child’s developmental behavior and provide a favorable environment for nurturing young children.
基金grant from the National Natural Science Foundation of China (No. 30671815)Anhui Provincial Natural Science Foundation (No. 070413106)
文摘Objective To determine the status of adverse childhood experiences (ACEs) and the association of multiple ACEs with both parental alcoholism and later personal alcohol abuse among Chinese medical students with a view of improving adolescent health and reducing alcohol abuse among them. Methods In this cross-sectional study, 2073 Chinese medical students completed a survey on ten categories of ACEs in Anhui province of China. The association of parental alcoholism with ACEs and personal alcohol abuse was assessed by logistic regression analyses. Results The adjusted odds ratio (OR) for each category of ACEs in the subjects whose parents (either fathers or mothers or both) had alcohol abuse was 2 to 14 times higher than that in those with parental alcoholism (P〈0.05). Subjects with bi-parental alcoholism had the highest likelihood of ACEs. Compared with the subjects without ACEs, therisk of personal alcohol abuse was increased by 2-4-folds in the subjects with ACEs, irrespective of parental alcoholism (P〈0.05). The total number of ACEs (ACE score) had a graded relationship to 4 categories of personal alcohol abuse with or without parental alcoholism. The prevalence of personal alcohol abuse among the subjects with parental alcoholism was higher, which was independent of ACE scores. Conclusion The prevalence of ACEs is generally serious in China. Efforts should be made to prevent and treat children with ACEs and subsequently to reduce alcohol abuse and later problems.
文摘This study aims to identify the support to provide to fathers who have abused children as reported by public health nurses (PHNs). In this study, a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs) in charge of child abuse services for at least 5 years at public health centers. The study analyzed 13 cases reported in the interviews. Measures to support fathers who abuse their children as suggested by PHNs were classified into direct support to the father, support to other family members, and support to be provided by others involved including related organizations. The direct support to the father includes “gaining an in-depth understanding of the abusive situation and psychological states of those involved”, “refraining from involvement in areas where it is difficult to understand the personality of the father”, and others. Support of other family members includes “understanding the marital relationship and assessing the qualities of the relationship”, “refraining from matters that will involve divorce”, and others. Support to be provided by others including related organizations includes “understanding the value of social exchange and assessment of the ability to create and maintain interpersonal relationships”, “establishing support arrangements to enable intervention when necessary”, and others. The interviews report that PHNs arrange support measures that enable intervention as it becomes required, and that this enables learning about child-abuse preventing activities.
文摘Child sexual abuse (CSA) is a stressful associated with alterations in the hypothalamic-hypophyseal-adrenal (HPA) axis and behavioral problems. Children and adolescents with history of CSA could have higher cortisol levels, as these have been associated with deleterious changes in brain regions involved in controlling social behavior and self-control. The aim of the present study was to determine the relationship among basal cortisol levels, social skills and behavioral problems in adolescents with CSA by evaluating two groups: one consisting of 12 - 15-year-old girls with CSA (n = 23), the other healthy comparison adolescents with no history of child abuse (n = 23). Social skills and behavioral problems were assessed using the Social Skills Improvement System. Three saliva samples were collected from each participant. The girls with CSA had lower social skills and more behavioral problems, as well as, higher cortisol concentrations. Besides, these participants showed significant negative correlations among cortisol levels and social skills, as well as, positive correlations with behavioral problems scales. It is feasible to suggest that the social deficiencies observed in these participants with CSA are related to alterations of the HPA.
文摘Rates of childhood trauma exposure are extremely high,with approximately 70%of children and adolescents experiencing at least one traumatic event.Among the most common non-specific consequences of stress and trauma are disruptions of sleep.Sleep problems,such as shorter sleep duration,difficulty falling asleep,frequent awakenings,nightmares,sleepless nights,and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events.This review will illustrate the role of sleep problems in traumatized children and adolescents,and emphasize the need to consider a wide range of etiological mechanisms for these symptoms.However,the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research.Moreover,in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma,the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.
文摘Survivors of Child Sexual Abuse (CSA) can develop Post-Traumatic Stress Disorder (PTSD), alterations in the prefrontal cortex, changes in electroencephalographic (EEG) activity, and lower performance on working memory tasks. The aim of this study was to characterize brain electrical correlations in girls with PTSD secondary to CSA during a working memory task based on recognizing emotional facial stimuli. Girls aged 8 - 16 years old were evaluated: 12 with PTSD secondary to CSA, and 12 healthy girls with no history of abuse. EEG activity during a working memory task with emotional stimuli was recorded, and the inter- and intra-hemispheric correlations that assessed the functional connectivity among different cortical regions were analyzed. The PTSD group showed lower performance than controls on the working memory task while watching happy faces, while the EEG of this group showed greater intrahemispheric correlation among frontal areas and between frontal and posterior cortical regions. Also, the PTSD group had lower interhemispheric correlations between posterior temporal areas. The higher intrahemispheric correlation in the PTSD group could indicate that those girls used more brain areas when performing the task, likely because it required greater effort. The lower inter-posterior temporal correlation could be attributed to a reduction of the corpus callosum.
文摘The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.
文摘The past 50 years has seen a heightened awareness of abusive injury patterns and increased concern for the plight of children victimized by their caregivers.Murder of the young,however,has been embedded in society since the beginning of recorded time.Indeed,nature provides abundant examples of infanticide in lower animals,raising the question of whether exploitation,apathy,and violence toward children are on some level evolutionarily conserved.In human antiquity,selective killing of females,the illegitimate,and the malformed,killing by ritualistic sacrifice or to conserve resources was carried out with impunity.The middle ages and later saw a decline in these practices albeit limited.One hundred years into the industrial revolution,with harsh child labor in public view,legal remedies were sought to protect children but with little effect.The domestic abuse of children was not addressed until a pivotal 19^(th)-century case,in which the rights of animals were invoked to intervene on behalf of a child.In the 20th century,physicians began to look closely at anatomical findings;patterns due to trauma,especially inflicted trauma,began to emerge.“Battered child syndrome”was followed by“shaken baby syndrome”,the latter prompted by the recurrent findings of subdural hematoma,retinal hemorrhages,and brain injury with the absence of impact injuries and no plausible accidental or natural disease explanation.In the 21st century,high-quality studies and an emphasis on evidenced-based medicine substantiated the existence ofiiijury patterns resulting from homicidal violence.However,progress has been uneven.A case of child abuse that reached the US Supreme Court resulted in an ill-cited dissent that seems to have amplified an already toxic medicolegal environment,perhaps unjustifiably.The difficulties in balancing the welfare of society with that of caregivers in the aftermath of homicidal abuse will no doubt continue.
文摘Rape and sexual violence occur in all social classes and societies.In most cases,the sexual offenders are known to the victim and the majority of rapes happen in intimate relationships.Children are particularly vulnerable to sexual abuse,in particular,the female sex.The sexual abuse of minors is defined as“any sexual activities that an adult carries on or with a person under the age of consent.”Literature evidence that the prevalence of any type of violence among women with disabilities varies between 26.0%and 90.0%,compared to nondisabled women,showing that people with disabilities have an increased risk of suffering physical and sexual violence.Children with intellectual disabilities(ID)show a high risk of sexual victimization.The World Health Organization presently defines mental retardation as“a significantly reduced ability to understand new or complex information and to learn and apply new skills(impaired intelligence).This results in a reduced ability to cope independently(impaired social functioning),and begins before adulthood,with a lasting effect on development.”The aim of this study is to investigate the correct identification of sexual abuse and severe mental retardation through the collaboration of a team of experts(forensic pathologist,psychiatrist,psychologist,gynecologist,pediatrician,and social worker).We present a case of a 12-year-old female child,who suffers from severe mental retardation and was the victim of rape by a 79-year-old man.The study shows the difficulties in discovering episodes of sexual abuse among children affected by ID by evidencing the importance of adequate analysis through a multidisciplinary approach.The work focuses on the need to improve knowledge about medical and forensic investigations through proper protocols,for early recognition and appropriate management of these complicated cases.
文摘This study evaluates variables concerning demographic characteristics for all adult male offenders convicted of Child Sexual Abuse(CSA)aged 0–17 in Malmö,Sweden between 2013 and 2018.All convictions(n=18)based on court documents from the District Court,the Court of Appeals and information from the Swedish Tax Agency were reviewed.A total of 30 victims were identified.Frequency analyses show that the most common features were that of a single offender,averaging 25 years old,with a non-Swedish background and a high school degree.The predominately extrafamilial CSA(i.e.committed by an acquaintance to the family)occurred in a private setting and consisted of penetrative acts.Girls averaging 13years old were abused multiple times,under fear and pressure.Although assumptions based on these results are preliminary,they provide a clearer image of the typical circumstances under which CSA occurred within this time frame and geographical location.This study is a first attempt to construct an overview of demographic characteristics of CSA.As more data are gathered from this region,more sophisticated analyses can be conducted,providing stronger generalizations.Information of this kind may be important for research,classification of offender profiling and in case linking.
文摘Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment,leading to changes in the regulation of multiple organ systems.This study was established to review the epigenetic mechanisms associated with childhood abuse as well as the long-term deter-minants that these epigenetic changes may have on future illness.We retrospectively ana-lysed the effect of exposure to adverse childhood experiences(ACEs,specifically those relating to childhood maltreatment)between the ages of 0 and 16years on the human epi-genome,as well as possible clinical associations.After meeting inclusion and exclusion crite-ria,36 articles were included in this systematic review.Eight of these studies did not find a relationship between childhood maltreatment and DNA methylation.Of the remaining 28 studies,nine were genome-wide association studies,whereas the rest were candidate gene studies,mainly studying effects on neuroendocrine,serotoninergic and immunoregulatory systems.Meta-analysis of correlation coefficients from candidate gene studies estimated an association of childhood adversity and DNA methylation variation at r=0.291(P<0.0001),and meta-analysis of two epigenome-wide association studies(EWASs)identified 44 differen-tially methylated CpG sites.In conclusion,childhood maltreatment may mediate epigenetic mechanisms through DNA methylation,thereby affecting physiological responses and con-ferring a predisposition to an increased risk for psychopathology and forensic repercussions.Similar evidence for somatic illnesses is not yet available.
文摘Spontaneous subdural hemorrhage(SDH)is an uncommon nontraumatic bleed of the brain,involving the dura and arachnoid mater.SDH commonly occurs due to tearing of bridging veins;however,SDH from the rupture of arteriovenous malformation(AVM)is an uncommon phenomenon,particularly in children.We report a case of atypical SDH in a 1-year-old child with AVM and a history of alleged abuse.Autopsy revealed SDH in the right parietal and middle cranial fossa without any external or internal injuries to the head,brain,or other parts of the body.Histopathological examination and immunohistochemical staining of the brain tissue revealed an abnormal distribution of arteries and veins of various sizes and architecture.From a detailed histopathological examination of the brain and meticulous investigation of vascular abnormalities,we conclude the cause of acute SDH to be due to a ruptured AVM.