Even though South Africa is a signatory to international declarations that aim to eliminate violence against women, intimate partner violence (IPV) remains a significant problem. While many women eventually leave IPV relationships after enduring violence for a long period, the matter of why women leave IPV relationships is not adequately researched in South Africa. This study explored the turning points that trigger the decision to leave IPV relationships and examined the process of leaving in a sample of women who left their abusive partners. In-depth interviews with 11 women living in shelters of safety for women in Gauteng Province, South Africa, were analyzed using Giorgi's phenomenological analysis method. Leaving IPV relationships was a complex process that involved multiple decisions and actions over time; thus, most women endured many years of abuse. Leaving was triggered by various turning points, resulting in the leaving process being either planned or unplanned. For some of the women, the turning point was a specific violent event, while, for others, it was a culmination of violent events. Severe or escalating violence and the desire to protect their children from the impact of violence were key turning points for most of the women, such that they feared for their lives and that of their children. Overall, turning points played a crucial role in the decisions to leave abusive partners, and the leaving process for women was characterized to a great extent by fear. Understanding the complexities of the process of leaving and the relevance of turning points is essential to informing the development of appropriate interventions to respond more appropriately to women experiencing IPV.
This article presents findings from a case file review of post-separation parenting cases in England and Wales. It first outlines that jurisdiction's legal framework relevant to these cases, before providing an overview of the findings relating to the profile of the cases and their outcomes. It then describes the types of abuse most frequently encountered in these cases, and examines the attitude of the courts to post-separation abuse by looking at both interim and final court orders. The study finds that key legal provisions governing these cases are not being followed, with little understanding shown for the nature of post-separation abuse.
Hypersexuality and impulsivity are regarded as risk factors for sexual offending against children. Studies exploring these factors in undetected men who offended or are at risk of offending are rare. This study aims to investigate hypersexuality and impulsivity in treatment-seeking men with and without a diagnosis of (exclusive) pedophilia who committed child sexual abuse (CSA), consumed child sexual abuse images (CSAI), or feel at risk of offending sexually. Data were obtained from three child abuse prevention projects in Bamberg, Germany. We employed self-report (BIS-11, HBI), objective measures (TSO), and risk assessment tools (STABLE-2007). We computed Bayesian ordinal logit and binomial generalized linear models to explore differences between groups and to predict lifetime CSA and CSAI. Hypersexuality scores were particularly pronounced in patients with exclusive and non-exclusive pedophilia. Patients without pedophilia scored similarly to nonclinical samples. Impulsivity measures did not consistently differ between groups. We could not predict lifetime CSA and CSAI using impulsivity and hypersexuality measures. Sexual rather than general impulsivity seems to be an issue in men with pedophilia. The motivation to offend in patients without pedophilia is discussed.
Ralf Bergner-Koether, Lasse Peschka, Alexander Pastukhov et al.
Longitudinal studies of the effects of adversity on human brain development are complicated by the association of stressful events with confounding variables. To counter this bias, we apply a propensity-weighted analysis of the first two years of The Adolescent Brain Cognitive DevelopmentSM (ABCD) Study® data, employing a machine learning analysis weighted by individuals' propensity to experience adversity. Data included 338 resting-state functional connections from 7190 youth (46% female), divided into a training group (80%) and an independent testing group (20%). Propensity scores were computed using 390 variables to balance across two-year adverse life event exposures. Using elastic net regularization with and without inverse propensity weighting, we developed linear models in which changes in functional connectivity of brain connections during the two-year period served as predictors of the number of adverse events experienced during that same period. Haufe's method was applied to forward-transform the backward prediction models. We also tested whether brain changes associated with adverse events correlated with concomitant changes in internalizing or externalizing behaviors or to academic achievement. In the propensity-weighted analysis, brain development significantly predicted the number of adverse events experienced during that period in both the training group (ρ = 0.14, p < 0.001) and the independent testing group (ρ = 0.10, p < 0.001). The predictor indicated a general pattern of decreased functional connectivity between large-scale networks and subcortical brain regions, particularly for cingulo-opercular and sensorimotor networks. These network-to-subcortical functional connectivity decreases inversely associated with the development of internalizing symptoms, suggesting adverse events promoted adaptive brain changes that may buffer against stress-related psychopathology. However, these same functional connections were also associated with poorer grades at the two-year follow-up. Although cortical-subcortical brain developmental responses to adversity potentially shield against stress-induced mood and anxiety disorders, they may be detrimental to other domains such as academic success.
BACKGROUND: Atypical reward processing is implicated in a range of psychiatric disorders associated with childhood maltreatment and may represent a latent vulnerability mechanism. In this longitudinal study, we investigated the impact of maltreatment on behavioural and neural indices of reward learning in volatile environments and examined associations with future psychopathology assessed 18 months later. METHODS: Thirty-seven children and adolescents with documented histories of maltreatment (MT group) and a carefully matched group of 32 non-maltreated individuals (NMT group) aged 10-16 were presented with a probabilistic reinforcement learning task featuring a phase of stable and a phase of volatile reward contingencies. Brain activation and connectivity were assessed simultaneously using functional magnetic resonance imaging (fMRI). Computational models were used to extract individual estimates of learning rates and temperature, and neural signals in prespecified regions of interest were analysed during volatile and stable environments. In regression analyses, behavioural measures and neural signals at baseline were used to predict psychological symptoms at follow-up. RESULTS: The MT group showed lower behavioural exploration, which predicted decreased internalising symptoms at follow-up. The MT group had lower activation in the orbitofrontal cortex (OFC) during outcome delivery in volatile relative to stable contexts. OFC connectivity with an area in the mid-cingulate cortex was also lower during outcome processing, which predicted higher general psychopathology at follow-up. CONCLUSIONS: These findings are consistent with the notion that low exploratory behaviour following childhood maltreatment is potentially a protective adaptation against internalising symptoms, while disrupted neural processing of reward learning in volatile environments may index latent vulnerability to mental illness.
Diana J N Armbruster-Genç, Louise Neil, Vincent Valton et al.
OBJECTIVE: This study aimed to identify distinct profiles of investigators based on their exposure to child sexual abuse material (CSAM) and associated mental health symptomatology. Specifically, the study seeks to differentiate resilient profiles from those exhibiting psychopathologies. Additionally, this research explores resilience as a transdiagnostic and distal factor, examining individual- and agency-level coping and resiliency factors. METHOD: An analytic sample of 500 police investigators and forensic examiners exposed to CSAM comprised the current sample. Latent profile analysis identified five profiles based on CSAM exposure and psychopathology. Profiles were compared across various individual- and agency-level factors. RESULTS: Distinct profiles emerged, including low exposure and psychopathology, average exposure and low psychopathology, low exposure and high psychopathology, high exposure and low psychopathology (representing resilience), and high exposure and high psychopathology. Resilient profiles demonstrated higher scores in general resiliency, future orientations, and purpose in life. Noteworthy differences were found in individual- and agency-level factors, emphasizing the role of appreciation, support, and a positive work climate. CONCLUSIONS: The study underscores the diversity of experiences among law enforcement professionals conducting CSAM investigations. Resilient profiles highlight the importance of factors like mattering, appreciation, support, and a positive work climate. These findings have implications for wellness training and agency practices to enhance the well-being of investigators dedicated to protecting children. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Kimberly J Mitchell, Ateret Gewirtz-Meydan, Jennifer E O'Brien et al.
BACKGROUND: Women who engage in sexual acts against their will are at high risk for sexual and reproductive health complications including sexually transmitted infections (STIs), menstruation disturbance, infertility, abnormal uterine bleeding, reproductive cancers, dyspareunia, vaginismus, and chronic pelvic pain. However, the occurrence of these gynecological sequelae in women who experienced sexual violence during their youth has not been scoped in the literature. To map the breadth of gynecological sequelae, corresponding interventions, and associated symptomatology in childhood and adolescence, the researchers conducted a scoping review. OBJECTIVES: To identify the most common gynecological disease manifestations and symptomatology for patients who have experienced sexual violence in childhood and/or adolescence; to identify existing healthcare interventions indicating promising strategies to mitigate the impact of sexual violence for adolescents; and to provide future recommendations for clinicians and researchers to reduce gaps in care. SEARCH STRATEGY: A scoping review methodology was chosen and completed in accordance with the PRISMA-ScR. Embase, CINAHL Complete, Web of Science, and MEDLINE PubMed were searched on October 4, 2023. A medical librarian developed, ran, and recorded the search in accordance with PRISMA extension for searching. The search retrieved 11 253 records. After deduplication 7656 articles were screened at the title and abstract levels, of which 212 underwent full text review for eligibility. Ultimately, 92 articles were included. SELECTION CRITERIA: The following inclusion criteria was used to lead the search and for full-text review: (1) the study focuses on persons with a history of sexual violence prior to adulthood; (2) the study focuses on gynecological interventions from healthcare practitioners; (3) the study is based in the US; (4) the study is published in a peer-reviewed journal; (5) the study was published between 1990 and 2022; and (6) because the patient population resides in the US, the literature is limited to English language. The exclusion criteria that have been identified are: (1) the study focuses on intimate partner violence and/or spousal abuse; (2) the study was published prior to 1990. DATA COLLECTION AND ANALYSIS: Researchers utilized Research Electronic Data Capture (REDCap) for data collection and analysis. Norming, title-abstract review, and full-text review were conducted in that order among reviewers. The data that were extracted include: (a) author, year of publication, and other background information; (b) research approach (quantitative, qualitative, mixed methods, etc.); (c) type of sexual violence reported in the study; (d) type of gynecological symptoms and/or diagnoses reported in the study. Additional qualitative data points might have been added by the researchers throughout the process of data extraction and charting. The primary researcher then used REDCap to analyze the provided charts and statistics. MAIN RESULTS: A total of 7656 articles were screened at the title and abstract levels, of which 212 underwent full text review for eligibility. A total of 120 articles were excluded, and 92 articles were included in this review, highlighting the types of sexual violence reported, gynecological intervention, and any gynecological symptoms or diagnoses, with the most prominent being rape, antibiotic therapy, and STIs, respectively. CONCLUSIONS: Further research to determine the benefit of earlier cervical cancer screening in a subset of women who experienced early lifetime sexual abuse may prevent invasive cervical cancer as an adult and would provide insight for improved management of child sex abuse victims. Consideration of early psychiatry involvement, or pelvic floor therapy referral prior to the onset of psychiatric-related gynecological symptoms secondary to sexual trauma may improve quality of life in adulthood. Finally, a protocol for pharmacologic management following sexual abuse could be considered in the acute setting of sexual trauma, including an algorithm to at least offer HIV prophylaxis, human papillomavirus vaccination, hepatitis B vaccination (HBV) and/or immunoglobulin if the perpetrator is a known intravenous drug user or HBV carrier, tetanus vaccination, antibacterial therapy, and pregnancy prophylaxis in the emergency department setting.
Kelcie Hill, Lauren E Robinson, Megan R Yadav et al.
Gender-based violence (GBV) comes in many different forms, including emotional, physical, economic, and cultural. Regardless of its form, it represents an evil that the international community must work hard to eliminate. A crucial step in eradicating men's violent behavior is implementing initiatives aimed at prevention. However, effective prevention requires collaboration among various stakeholders, including policymakers, healthcare providers, psychological and social services, and community organizations. One major obstacle in combating GBV is the fragmentation of efforts. To improve the chances of success, all stakeholders must unite, fostering a dialogue and joint action. It is important that this dialogue includes scientific harmonization between anthropology and social sciences to better understand the origins and nature of male violence. The United Nations have been extremely active in this respect. In 2023, they posted online a document entitled "Ten ways to prevent violence against women and girls." Progress has also been made in enrolling men in programs for the prevention of violence and in preventing partner violence among adolescents. However, despite these success stories, there remain significant gaps in ensuring effective prevention among marginalized groups and young women with disabilities, groups that are at elevated risk of becoming victims of violence. In conclusion, success in combating GBV depends on effective collaboration among all those committed to prevention. Unfortunately, reproductive health specialists have often failed to work alongside psychologists and social scientists. The time has come to encourage full cooperation and overcome these barriers.
S Shantha Kumari, Anne-Beatrice Kihara, Rubina Sohail et al.
The health toll of child maltreatment or violence against children (VAC) has not yet been comprehensively evaluated. Here, in our systematic review and meta-analyses, we focused on the health impacts of physical violence, psychological violence and neglect during childhood. Utilizing the Burden of Proof methodology, which generates conservative measures of association while accounting for heterogeneity between input studies, we evaluated 35 associations between VAC and adverse health outcomes, identifying 27 statistically significant links. The associations between physical violence and major depressive disorder, ischaemic heart disease, alcohol use disorder, eating disorders and drug use disorders were rated as moderately weak, reflecting a small effect size and/or inconsistent evidence. The minimum increased risk ranged from 16% for depression to 2% for drug use disorders. Psychological violence showed similar moderately weak associations with drug use disorders (8% minimum risk increase), migraine (7%) and gynaecological diseases (2%). Neglect was linked to at least a 15% increased risk for anxiety disorders. The other 18 associations were weaker due to smaller effect sizes and/or less consistent evidence. Despite the limitations of the existing evidence, our analysis highlights substantial health impacts for VAC survivors, underscoring the need for health system prioritization and continued efforts to eliminate all forms of VAC.
Luisa S Flor, Caroline Stein, Gabriela F Gil et al.
BACKGROUND: Early childhood experiences, whether positive or adverse, significantly impact health across the lifespan. Children and youth in low-resource settings face unique challenges that increase their vulnerability to poor mental health. OBJECTIVE: To examine the relationship between adverse childhood experiences (ACEs) and suicidal thoughts or behaviors as well as psychological distress, and to explore the moderating role of parent-related positive childhood experiences (PPCEs) on this association. PARTICIPANT AND SETTING: We used data from the 2019 Kenya Violence Against Children and Youth Survey. METHODS: Analyses were restricted to youth ages 18-24. ACEs were dichotomized (into those who have experienced at least one ACEs and those who have not), and logistic regression was used to examine the relationship between ACEs, PPCEs, and suicidal thoughts or behaviors and psychological distress stratified by sex. RESULTS: Significantly more males (75.8 %) than females (57.6 %) experienced at least 1 ACE in their lifetime (p = 0.0003). PPCEs are common; however, significantly more males (59.9 %) than females (41.2 %) had a strong father-child relationship (p = 0.0003). ACEs were positively associated with suicidal thoughts or behaviors and psychological distress, with notable sex-specific differences in the associations. Conversely, PPCEs were negatively associated with those outcomes, but there were also sex-specific differences in the associations. No significant interaction effect was observed between ACEs, PPCEs, and the mental health outcomes. CONCLUSION: Suicidal thoughts or behaviors and psychological distress are pervasive problems that are common among youth in Kenya, and the associations with ACEs vary by sex. A multilevel approach and evidenced-based intervention strategies that consider the context of sociocultural norms are crucial to prevention and response efforts.
Colvette Brown, Ezeigwe Ogochukwu, Stanley Nkemjika et al.
