Backgroundthis study analyses psychopathological symptomatology and post-traumatic stress disorder (PTSD) in victims of intimate partner violence against women (IPVAW) and examines the presence of school, behavioural and emotional problems in their children.ObjectivesThe aim of the study was to (1) analyse psychopathological symptomatology and PTSD in women survivors of IPVAW, in comparison to women unexposed; (2) analyse the connection between the experience of this type of violence and the presence of psychopathological symptomatology and PTSD; (3) examine the presence of school, behavioural and emotional problems in the children of women survivors of IPVAW compared to the children of unexposed women; and to (4) examine the relationship between psychopathological symptomatology in women survivors of IPVAW and the presence of school, behavioural and emotional problems in their children.DesignA cross-sectional comparative study. Participants were recruited through Women's Care Institutions (experimental group) and schools (control group).MethodThe sample included 29 women survivors of IPVAW and 30 non-exposed women, along with their respective children (n = 60). Maternal psychopathology was assessed with the SCL-90-R and ITQ; violence exposure with the CAS-R-SF; and children's behavioural, emotional and school outcomes with the BASC-3.ResultsWomen survivors of IPVAW and their children present significantly more psychopathological symptoms compared to women and children unexposed to this violence. Furthermore, a relationship was found between the symptomatology in mothers and school, behavioural and emotional problems of their children.ConclusionIPVAW has a broad psychopathological impact on both survivors and their children. This study shows the importance of specifically working on psychological intervention with both.
Bueso-Izquierdo N, Ferrera-Silva M, Barbosa-Torres C et al.
Problem/condition In 2023, approximately 23,000 persons died of homicide and 49,000 persons died of suicide in the United States, according to the National Vital Statistics System. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths and suicides that occurred in the 50 states, the District of Columbia, and Puerto Rico in 2023. Period covered 2023. Description of system NVDRS collects data from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected from all 50 states, the District of Columbia, and Puerto Rico. Forty-seven states had statewide data, three additional states had data from counties representing a subset of their population (31 California counties, representing 74.1% of its population; 38 Florida counties, representing 59.3% of its population; and 13 Texas counties, representing 62.9% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. Results For 2023, NVDRS collected information on 70,133 fatal incidents involving 72,093 deaths. The deaths recorded in NVDRS accounted for 91.6% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2023. In addition, information was collected for 671 fatal incidents involving 730 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately.Of the 72,093 deaths that occurred in the 50 states and the District of Columbia, the majority (62.4%) were suicides, followed by homicides (28.5%), deaths of undetermined intent that might be due to violence (6.9%), legal intervention deaths (1.5%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (<1.0%). Of the 730 deaths reported for Puerto Rico, 66.4% were homicides and 32.9% were suicides.Demographic patterns and circumstances varied by manner of death. In the 50 states and the District of Columbia, the suicide rate was higher for males than for females (23.5 versus 6.1 per 100,000 population). The suicide rate for males was highest for those aged ≥85 years (53.0), whereas for females, the suicide rate was highest for those aged 45-54 years (8.8). In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups (22.7). Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide decedents for whom circumstances were known, suicide was most often preceded by an intimate partner, mental health, or physical health problem or by a recent or impending crisis.The homicide rate was also higher for males (10.8 per 100,000 population) than for females (2.7). Among all homicide victims, the homicide rate was highest among adults aged 20-24 years (14.1) compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group (50.6). Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. When circumstances were known, homicide was most often precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male (95.6%) and the legal intervention death rate was highest among men aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in most legal intervention deaths. When circumstances were known, the most frequently reported circumstances for legal intervention deaths were the victim's reported use of a weapon, the victim being previously known to authorities, or that the victim reportedly had mental health or substance use problems.Other manners of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths occurred most frequently among males, non-Hispanic White (White) persons, and persons aged 15-19 years. When circumstances were known, these deaths most frequently occurred while the shooter was playing with a firearm and most often were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 35-44 years. Poisoning was the most common method of injury in deaths of undetermined intent, often involving opioids (67% positive among decedents tested).In Puerto Rico, the homicide rate was twice as high as the suicide rate and was 10.7 times higher for males than for females. Firearms were the most common method of injury in homicides. When the relationship between the homicide victim and suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Among male homicide victims in Puerto Rico when circumstances were known, the most common precipitating circumstances were drug involvement and the victim previously being known to authorities, whereas among female victims, the most common homicide circumstance was intimate partner violence. The suicide rate in Puerto Rico was also higher for males than for females. The most common suicide method was hanging, strangulation, or suffocation. Depressed mood or currently diagnosed mental health problem were frequent circumstances reported for both male and female suicide decedents. Interpretation This report summarizes NVDRS data on violent deaths and suicides that occurred in 2023. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black males. Intimate partner violence precipitated a large proportion of homicides of females. Mental health and substance use problems, previous awareness of the victim by authorities, intimate partner problems, interpersonal conflicts, and acute life stressors were the primary precipitating circumstances for multiple types of deaths examined. Public health action The injury-related deaths described in this report are preventable, and data can guide public health action. NVDRS data are used to monitor the occurrence of these fatal injuries and assist public health agencies in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent deaths. Violent death reporting system data are helping states identify disproportionately affected groups and implement targeted prevention strategies, including youth suicide-focused analyses in Maryland and veteran suicide-focused initiatives in Michigan and Connecticut that guided statewide partnerships, crisis line outreach, and mental health service expansion.
Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable to trauma; however, patterns of trauma exposure and psychological responses in East Asian contexts remain underexplored.Objective: To examine associations among ADHD, trauma exposure, and psychological outcomes, and to differentiate trauma-specific reactions from broader internalising symptoms.Methods: This cross-sectional study included 295 adolescents aged 12-18 years (149 with ADHD and 146 controls). Adolescents and their caregivers completed validated measures of trauma exposure (Trauma Exposure Experience Questionnaire), trauma reactions (Revised Child's Reaction to Traumatic Events Scale), anxiety (Multidimensional Anxiety Scale for Children), depression (Centre for Epidemiological Studies Depression Scale), and self-esteem (Rosenberg Self-Esteem Scale). All measures demonstrated excellent internal consistency (Cronbach's α = .92-.95). Intergroup differences were examined using chi-square tests and t-tests. Hierarchical regression models incorporating ADHD × trauma exposure interaction terms, along with sex-stratified analyses, were used to evaluate associations.Results: Adolescents with ADHD reported stronger trauma reactions (p = .039), greater depressive symptoms (p = .032), and lower self-esteem (p = .002) than controls. Logistic regression analyses indicated that physical assault (odds ratio = 3.11) and threats of violence (odds ratio = 3.77) were significantly associated with ADHD. Trauma reactions were strongly predicted by anxiety, depression, and trauma exposure across the sample. The interaction between ADHD and trauma exposure was not significant in the total sample (p = .600) or in stratified analyses.Conclusion: Adolescents with ADHD in Taiwan are highly vulnerable to interpersonal trauma. Although ADHD does not moderate the association between trauma exposure and subsequent reactions, trauma responses are closely associated with comorbid anxiety and depression. These findings highlight the need for trauma-informed ADHD care that addresses internalising symptoms within relevant familial and cultural contexts.
In India, an estimated 41% of women report experiencing domestic violence in their lifetime and up to 28% report violence during pregnancy. Our study aims to understand local perceptions/attitudes towards GBV and lived experiences of GBVvictimisation and perpetration in marital relationships in rural Rajasthan. We conducted a focus group discussion with community health workers (n = 7) and interviews with young married men (n = 17) and women (n = 21), and local government officials (n = 2). The data was analysed using thematic analysis with triangulation conducted across methods and researchers. Our findings reveal that women experience multiform violence, including physical, sexual, and economic violence. In the continuum of GBV, violence stems from everyday conditions of disempowerment produced through early marriage and reproduction, norms of hegemonic masculinity, and community norms that normalise violence against women. These conditions of disempowerment lead to women's isolation through control of mobility and surveillance through technology, setting the stage for further violence to occur. Violence prevention efforts in the region must follow a multi-level approach to reduce child marriage through community education and improved enforcement of legislation, enhance reporting and identification alongside help-seeking behaviours through formal or informal channels, transform rigid gender norms, and leverage key actors in the family system such as the in-laws or matchmakers as potential agents of change.
Background Maternal incarceration has great potential to disrupt children's lives. Yet, children whose mothers become involved with the criminal justice system (CJS) may also experience myriad other adversities, regardless of whether their mother is subsequently incarcerated. A failure to account for concurrent adversities is likely to mischaracterize the impact of maternal incarceration itself and obfuscate the needs of children whose mothers are CJS involved but not incarcerated. Prior research has been unable to characterize these environments due to small samples of incarcerated women, lack of data on criminal offending and noncustodial CJS involvement, and other methodological barriers. Objectives (1) To characterize adverse childhood experiences, including child maltreatment, domestic violence exposure, victimization risk, parental substance use, and parental mental illness, by the level of mothers' CJS involvement; and (2) To assess whether adversity precedes, follows, or surrounds maternal CJS involvement, including incarceration. Participants and setting This study uses linked administrative data from Wisconsin on a cohort of children born to low-income mothers in 2009-2011 (N = 108,396), of whom 16.4% (N = 17,748) experienced maternal CJS involvement by age 10 years. Method Measures of adverse childhood experiences are generated using CJS, child welfare, and medical claims records. Descriptive statistics are used to characterize variation in ACE types and timing by maternal CJS involvement. Results Childhood adversities are identified for a vast majority of children with maternal CJS involvement. The prevalence of adversity was highest among children whose mothers experienced prison incarceration, with nearly 99% experiencing at least one ACE. Yet, their exposure to adversity typically began in infancy and persisted throughout early childhood, rather than being precipitated by maternal incarceration. Conclusion Children of CJS-involved mothers, regardless of maternal incarceration, may face substantial risks to healthy development due to their high rates of exposure to multiple forms of adversity.
Background Violence experienced by women has serious consequences for maternal and child health, generating short- and long-term damage. Objective The aim of this study was to evaluate the relation between violence experienced by women and the mother-child bond in the first 6 months after childbirth and on the child's mental health at preschool age, mediated by stress, postpartum depression (PPD), breastfeeding and infant sleep. Participants were recruited from three public hospitals in the city of Porto Alegre (Southern Brazil). Methods This study is part of a larger research project with the objective to assess the reflex of different intrauterine environments on the child's health. Five mother-child pair assessment interviews were carried out in order to identify the interrelation between violence and mother-child bond and the influence of this bond on preschool children's mental health, mediated by stress, PPD, breastfeeding and infant sleep, tested using a path analysis model. Results From the 295 mother-child pairs analysed, 48.8% of the women experienced violence in their lives and 15.9% during their pregnancy. There was a statistically significant association among violence, stress, PPD, mother-child bond and externalization problems for preschoolers. Violence is correlated with the mother's stress, which is directly linked to the PPD, and thus, indirectly, to the mother-child bond. Conclusions This study found that the violence experienced by women before and during pregnancy interferes negatively both in the mother's health and in the mother-child bond, and the weakened mother-child bond can positively explain the externalization problems for preschoolers. Early prevention and identification of the occurrence of violence against women could avoid negative outcomes for the mother-child bond and behavioural problems for preschool-aged children, as well as in their future life.
Research on the social networks of children with posttraumatic stress disorder (PTSD) remains limited. Although a link between PTSD symptoms and the child's social environment is often assumed, this can be impacted in cases of interpersonal trauma. This is important, because social support can play a beneficial role in recovery after experiencing trauma. However, little is known about how children with interpersonal trauma perceive their social network and the support they gain from this network. This qualitative study used semi-structured interviews to explore these perceptions in greater depth. Ten children who experienced interpersonal trauma between the ages of 8 to 12 were interviewed about their social network. The content of the interviews was analyzed using reflexive thematic analysis. Descriptive statistics showed that children had varied networks with 40% of relationships experienced as ambivalent or negative. In addition, there was a general tendency to not discuss their traumatic experiences. Thematic analysis identified four key themes. First of all, the parent-child relationship was often strained with both parents, but in different ways. Second, there seemed to be a contrast between the positive definition children gave of friendship and the negative experiences they had within their own reported friendships. Third, children were able to identify supportive actions from different individuals in their network, related to the trauma as well as more general support. Finally, children reported various reasons for their general reluctance to discuss their trauma. The findings emphasize a need for help with strengthening the children's social network to improve recovery from trauma.
Importance Women who inject drugs disproportionately report experiencing violence, yet they are overlooked in interventions and policy responses. Objective To quantify and contextualize experiences of violence among Australian women who inject drugs. Design, setting, and participants This mixed-methods cohort study used data from SuperMIX, a longitudinal cohort of people who inject drugs. Self-reported survey data from January 1, 2008, to December 31, 2019, were linked with administrative health records (hospital, emergency department, ambulance, and mortality). Qualitative interviews with 10 women between October 1 and November 30, 2023, explored experiences of violence and service access. Women were recruited via convenience sampling carried out across Melbourne, Australia, in areas with known drug markets and needle and syringe programs. Statistical analysis was performed between May and August 2025. Main outcomes and measures Experience of assault or violence. Results A total of 431 women were included, with a median age at baseline of 29 years (IQR, 25-34 years). By 2019, combining self-report and administrative data, 353 women (82% [95% CI, 78%-86%]) had experienced at least 1 assault, and 164 (38% [95% CI, 36%-43%]) had experienced at least 1 sexual assault. In administrative data, 82 of the 431 women (19% [95% CI, 15%-23%]) had ever had an assault-related hospital admission, 101 (23% [95% CI, 19%-27%]) had an assault-related emergency department presentation, and 74 (17% [95% CI, 14%-21%]) had an assault-related ambulance attendance. A total of 304 women (71%) completed at least 1 annual follow-up survey (total, 1677 follow-up surveys), of whom 178 (59% [95% CI, 53%-64%]) reported an assault since their last interview. Among 409 follow-up surveys reporting assault, seeking health care was reported in approximately one-third (128 [31%]). Qualitative findings revealed barriers to seeking health care, including stigma, fear of child protection involvement, lack of trust in clinicians, and logistical challenges. Conclusions and relevance In this mixed-methods cohort study of Australian women who inject drugs, violence against women was pervasive and severe, yet rates of seeking health care remained low likely due to intersecting structural and social barriers. Recognition of the burden of violence is a critical first step in ensuring tailored responses to violence that meet the needs of marginalized women.
Background In Colombia, internal violence, displacement, COVID-19, suicide, and climate crises threaten the survival of younger adults, many of whom are parents. Such premature mortality increases orphanhood risks. Evidence-based psychosocial support for surviving caregivers has potential to mitigate adverse impacts of orphanhood for bereaved children in crisis settings. Here, we adapted the ‘Hope Group’ program from war-affected Ukraine to post-COVID-19 Colombia ‘Parenting with Hope’, and evaluated the effectiveness of psychosocial and parenting support delivered via home visits on improvements in caregiver mental health, violence against children, parenting practices, and child behavioral issues. Methods Participants (n=220) included surviving caregivers co-residing with children experiencing death of a parent or caregiver in the previous 12-36 months. Next-of-kin caregivers were identified through vital statistics data, death certificate annexes, radio/social media, schools, COVID-19 laboratories, and referrals. We used pre-post and quasi-experimental approaches to evaluate the effectiveness of ‘Parenting with Hope’ . For both analysis types, we constructed Bayesian models to estimate mean change and percent change following completion of the 8-session program. Results Both pre-post and quasi-experimental findings showed significant improvements across all mental health, violence prevention, parenting, and child outcomes. Pre-post results showed caregiver depression/anxiety ratings decreased by 91.2% (95% posterior credible interval (CrI) - 93.7, –87.6), and hopefulness increased by 43.8% (95% CrI 34.5, 54.8) and self-care, by 139.5% (95% CrI 107.5, 178.1). Each component measure of parenting practises (nonviolent discipline, positive parenting, parental monitoring, and parental involvement) improved significantly. By endline, violence against children had decreased by 63.9% (95% CrI -71.1, -54.4), and child externalizing and internalizing behaviors, by 74.4% (95% CrI, -78.0%, -70.3%). Pre-post and quasi-experimental findings showed equivalence. Conclusion This study generalizes evidence for effectiveness of ‘Parenting with Hope’ in crisis settings to surviving Colombian caregivers, on improved mental health, parenting practices, and reduced violence against children and child behavioral issues. Article Summary ‘Parenting with Hope’ for families in crisis settings significantly improved mental health and parenting strategies in post-COVID-19 Colombia, generalizing effectiveness previously measured in war-affected Ukraine. What’s Known on This Subject Caregiver death harms children long-term. Colombia experiences both community violence affecting caregivers and substantial COVID-19-related parental death burden. A Ukrainian program improved caregiver mental health, parenting, and reduced child violence, offering a model for Colombia’s prevention efforts. What This Study Adds We report pre-post evidence of the Parenting with Hope’s effectiveness in Colombian families experiencing bereavement. Adapted from Ukraine ‘Hope Groups’ , the intervention shows consistent benefits and is a promising, transferable and scalable strategy to prevent violence against children in communities globally.
Background Violence against children remains common in South Africa (SA). Children sustaining severe non-accidental injuries (NAIs) may require admission to paediatric intensive care units (PICUs), however, their outcomes have not been well described in SA. Objectives To describe the characteristics and outcomes of patients admitted to the PICU with suspected NAIs at Red Cross War Memorial Children's Hospital (RCWMCH). Methods A retrospective descriptive study of routinely collected data from all children admitted to the PICU at RCWMCH with suspected NAIs from 1 January 2012 to 31 December 2020. Results Of 11 345 children admitted to the PICU, 42 (0.4%) patients with suspected NAI (median (IQR) age 20.3 (7.9 - 62.6) months; 61.9% male) were included in data analysis. Most patients sustained physical injury (n=35; 83.3%) from assaults (n=19; 45.2%), and head injuries were the most common injury site, while 37 (88.1%) received invasive mechanical ventilation for a median (interquartile range) of 2.0 (1.0 - 3.8) days. PICU mortality was 28.6% (n=12), with a risk-adjusted mortality (observed/mean predicted mortality) of 3.6. Of the 30 PICU survivors, 7 (23.3%) were discharged with long-term disability, while the functional outcome of 16 (53.3%) survivors remains unknown. Conclusion Children who have sustained NAI represent a small proportion of PICU admissions, with high mortality and considerable morbidity. Contribution of the study Children with severe non-accidental injury (NAI) represent fewer than 0.5% of paediatric intensive care unit (PICU) admissions at Red Cross War Memorial Children's Hospital over a nine-year period. PICU mortality was 28.6%, more than double the general PICU mortality rate, with a risk adjusted mortality nearly four times the predicted rate. Head injury was the most common and most fatal injury pattern; most incidents occurred in the home, and the perpetrator was most often a family member. Nearly a quarter of survivors were discharged with long-term disability. These findings highlight the need for early clinical recognition of NAI, strict compliance with mandatory reporting obligations, and structured interdisciplinary follow-up of survivors.
