Adults with a history of childhood maltreatment are more likely to experience distrust, feel distant from others, and develop an insecure attachment style which may also affect relationship quality. Furthermore, childhood maltreatment has been linked to several mental health problems; including, depression, anxiety, and alcohol dependance severity, that are also known to relationship quality. The current study was designed to investigate to what extent childhood maltreatment is associated with adult insecure attachment and intimate relationships and whether this association is mediated by psychopathology. In a study comprised of 2035 adults aged 18–65, we investigated whether childhood maltreatment was associated with insecure adult attachment styles and the quality of intimate relationships and whether this was mediated by depression, anxiety, and alcohol dependence severity (based on repeated assessments of the Inventory of Depressive Symptomatology-Self Report, Beck Anxiety Index, and Alcohol Use Disorders Identification Test respectively). The path model showed an acceptable fit, RMSEA = 0.05, and suggested full mediation of the association of childhood maltreatment with quality of intimate relationships by depression severity and a) anxious attachment (β = −4.0 ∗ 10−2; 95% CI = −5.5 ∗ 10−2, −2.7 ∗ 10−2) and b) avoidant attachment (β = −7.2 ∗ 10−2; 95% CI = −9.6 ∗ 10−2, −4.9 ∗ 10−2). Anxiety and alcohol dependence severity were not significant mediators. Conclusions: Childhood maltreatment is associated with a lower quality of intimate relationships, which is fully mediated by depression severity and insecure attachment styles.
Mona K. Shahab, Josja A. de Ridder, Philip Spinhoven et al.
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Abstract Gender‐diverse adolescents have reported excessive experiences of sexual harassment, but studies on this are few and suffer from methodological problems. Our aim was to compare experiences of sexual harassment between adolescents belonging to different gender‐identity groups. A nationally representative cross‐sectional survey of 127,210 adolescents aged 14–20 in Finland in 2017 was used. The respondents were pupils in the eighth and ninth grades of the compulsory nine‐year comprehensive school with mean (sd) age of 14.83 (0.82) years and students in upper secondary school (age: mean (sd) 16.84 (0.83) years) and vocational school (17.29 (2.43) years). Cisgender, opposite sex‐identifying and non‐binary adolescents were compared. Self‐reports of experiences of sexual harassment, emotional symptoms and externalising behaviours (bullying perpetration, frequent alcohol use, truancy, drug use) were elicited. The data were analysed using cross‐tabulations and logistic regression. When confounders were controlled for, odds ratios were increased for gender harassment (OR 2.0), unwelcome sexual attention (OR 1.7) and sexual coercion (OR 2.0) among adolescents with non‐binary gender identity, and for gender harassment (OR 2.1) among those identifying with the opposite sex. Subjection to sexual harassment is particularly associated with non‐binary gender identity. This may reflect that others use sexual harassment as a form of control of gender‐nonconforming self‐expression.
This article presents data on 1550 children and young people with experiences of child sexual exploitation or who are displaying harmful sexual behaviours (HSB). Data were collected from two recently merged services operating across Wales: one working with children and young people who are at risk of, or abused through, sexual exploitation; and the other providing assessment and intervention services for children and young people displaying HSB. Importantly, the research provided an opportunity for a comparative analysis of key demographic characteristics and abuse histories of two separate cohorts of children and young people. Clear differences exist across the two cohorts in terms of gender. However, our analysis revealed similar patterns in relation to their experiences of prior abuse, and the prevalence of a family history of domestic violence is near identical. We consider how these findings speak to a need to understand the role of gender, and to recognise potential gendered understandings and gendered trajectories of harm for children. Findings also indicate the importance of directing attention to the wellbeing needs of children and young people who have experienced trauma, regardless of the presenting issues of concern. ‘Presents data on 1550 children and young people with experiences of child sexual exploitation or who are displaying harmful sexual behaviours’ Key Practitioner Messages CSE and HSB are different welfare concerns, but the children and young people referred to services for CSE and HSB may have similarly high levels of similar past trauma. There is a need for a greater understanding of how behavioural responses to trauma can be different for boys and girls, and may lead to different risk trajectories. Practitioners should be encouraged to be reflexive about their assumptions of sexual norms and behaviours among children, particularly in relation to gender and their ideas about vulnerability and risk. Practice with children and young people would benefit from recognising and responding to trauma experiences, and also from directing attention to the specific wellbeing needs of individual children and young people, regardless of the presenting areas of concern, that is, CSE or HSB (and gender). Assessment data collected should also reflect the backgrounds, needs and strengths of these children and young people, addressing the underlying issues behind potential vulnerability and harms, and not simply the risks that children and young people may pose or in which they may engage.
BACKGROUND: In DSM 5, three disorders are related to trauma and/or maltreatment: Post-traumatic Stress Disorder (PTSD), Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) but how these disorders relate to each other and to traumatic events is unknown. OBJECTIVE: We examined 1. Prevalence of Potentially Traumatic Events (PTEs) and poly-victimization for youths in foster care. 2. Associations between single/multiple PTEs and PTSD, DSED, and the two symptom-clusters that constitute RAD: Failure to seek/accept comfort (RAD A), and Low social-emotional responsiveness/ emotion dysregulation (RAD B). PARTICIPANTS, SETTING AND METHODS: Foster youth 11-17 years (N = 303) in Norway completed The Child and Adolescent Trauma Screen. Foster parents completed the RAD and DSED Assessment interview. RESULTS: Foster youth reported experiencing, on average, 3.44 PTEs each (range 0-15, SD 3.33), and 52.9 % reported PTSD symptoms at or above clinical cut off. The PTE sum score was associated with the latent factors PTSD (r = .66, p < 0.001), RAD cluster B symptoms (Low social-emotional responsiveness / emotion dysregulation, r = .28, p < 0.001) and DSED (r = .11, p = 0.046), but not with RAD cluster A symptoms (Failure to seek/accept comfort). CONCLUSIONS: These findings raise new questions about the nature, mechanisms and timing of development of RAD and DSED. Maltreatment assessment needs to encompass a wide range of PTEs, and consider poly-victimization.
Stine Lehmann, Kyrre Breivik, Sébastien Monette et al.
Within the literature individuals who use the internet to facilitate the sexual abuse of a minor are generally classified as being fantasy or contact driven. Classification is based upon the intended location for sexual climax: fantasy driven individuals aim to reach sexual climax online, whereas contact driven individuals target minors to achieve physical sex offline. This review systematically investigates whether there is an empirical basis for the distinction between these two proposed discrete types. Comparison of tactics and behaviour are considered to examine whether the contact vs. fantasy distinction is useful. A two-stage literature selection process, considered against pre-determined inclusion criteria, identified a total of twenty-two studies. As methodological heterogeneity limited the ability to conduct pooled analysis, a narrative synthesis of data employing an interpretive approach was conducted. This showed that the contact and fantasy distinction is ambiguous, given that both groups engage in online behaviours that provide them with online sexual gratification that can also lead to offline contact. Furthermore, no clear pattern of behaviour was found to define contact and fantasy individuals idiosyncratically. The European Online Grooming Project typology is thus proposed as a better representation of this behaviour; intimacy seeking, adaptable and hypersexualized groups. The distinction between these groups focuses primarily on the intensity of the relationship, acknowledging that sexual abuse can occur with or without offline contact. This review also highlights the need for larger, methodologically robust studies that examine the behaviour of online child sexual offenders.
Laura Jayne Broome, Cristina Izura, Nuria Lorenzo-Dus
Though child sexual abuse (CSA) is a global problem, victims are treated differently across the world. In the UK, there is a dominant assumption that victims are passive, which risks further marginalising those who do not identify themselves in line with prominent understanding of ‘vulnerability’. Drawing upon ethnographic fieldwork and in‐depth interviews, this paper shares the perspectives of girls who were placed in secure accommodation for their own protection, owing to professional concerns of CSA. Despite their experiences being reported almost identically in their files, this sensitive research shows that girls understood and narrated their journeys in strikingly different ways. Each shared complex relationships with their abuser and admitted to absconding with them on multiple occasions. Despite disparate narratives, the girls unanimously rejected being labelled as ‘vulnerable’ and instead felt that they were responsible for the abuse that they had endured. I argue that limited understanding of CSA problematises girls who claim sexual agency, meaning that they are consequently forced to shoulder responsibility for their own exploitation. By sharing the voices of those who are usually unheard, this paper concludes by calling for a radical reframing of the way that victims are treated, both by professionals working with them and by policies written about them. ‘This paper shares the perspectives of girls who were placed in secure accommodation for their own protection, owing to professional concerns of CSA’ Key Practitioner Messages Girls believed that professionals held them accountable for being sexually abused. The structural disadvantages of childhood meant that children sometimes relied on their abusers for food and shelter. Victims sometimes felt that their abuser was their only friend. Professionals sometimes mistook resilience for culpability.
The significant mental health needs of young people in out-of-home care has been well-documented. However, there is little empirical evidence on the timing or development of these difficulties, once these young people have been removed from the maltreatment-environment. Such information may provide useful clinical insight in to how problems develop and persist and whether intervention timings may allow for the prevention of later mental health problems. The current service-data study explored the emotional and behavioural symptom trajectories of 207 young people under the long-term care of a local authority in the South West of England, over their first five years in the care system. Data were extracted from the yearly carer-completed strengths and difficulties questionnaire - providing an index of emotional problems, peer problems, conduct problems and hyperactivity. Trajectories were analysed using growth mixture modelling. For most domains the largest trajectories were chronic symptom profiles, where young people were rated in the abnormal range from their first year in care and remained in this range across the full five years. These young people had significantly more placement moves than their peers on resilient trajectories. There was some evidence that later age of removal was associated with more chronic internalising problems. Overall, findings demonstrate the significant mental health needs of young people in care and particularly highlight that, in many cases, the removal from the adverse environment is simply not enough to expect a young person in care to be resilient to their earlier experiences.
This study aimed to explore primary school teachers' and family support workers' experiences of working with families and children with suspected or confirmed child neglect. Two in‐depth, semi‐structured focus groups with four primary school teachers and six family support workers explored the experiences of the two separate professions. Two hypothetical vignettes describing emotional and physical neglect were used to aid discussion. A qualitative, inductive thematic analysis was used to analyse the focus group data. Despite professionals wanting to act when neglect is first identified (early intervention), this was often not common practice. Professionals highlighted that child neglect, in particular emotional neglect, was often not deemed ‘serious enough’ to report, and would not be reported until a bigger ‘jigsaw puzzle’ of evidence had been collated. Professionals struggled with policies and funding that impact on their ability to respond in every case of child neglect as well as multiagency working difficulties, including perceived confidence in their roles and how other professionals view their work and professional opinions. Child neglect, especially emotional neglect, must be rated as equally serious as other forms of child maltreatment necessitating intervention, and professionals must be given support and funding to achieve this. ‘Explore[s] primary school teachers' and family support workers' experiences of working with families and children with suspected or confirmed child neglect’ Key Practitioner Messages The consequences of prolonged child neglect should be better understood and recognised. Resources and support provided early may prevent long‐term serious harm. Training on sensitively discussing with parents how to provide appropriate care for their children and how to challenge appropriately other professionals may help enhance professionals' confidence in speaking up and taking action. Innovative use of universal provisions such as breakfast or after‐school clubs may be welcomed more by parents.
Lydia Bullock, Miriam Ruth Stanyon, Danya Glaser et al.
Participation of children, birth parents and foster carers in matching decision‐making has the potential to improve the outcomes of a foster care placement. When practitioners choose which foster family is the best fit for a foster child, those affected by the foster care placement should be involved in decision‐making when possible. This research paper examines the influence of children, birth parents and foster carers on the matching decision from a practitioner's perspective. Semi‐structured interviews were conducted with 22 practitioners from 17 of the 28 foster care organisations in the Netherlands responsible for matching children with foster families. The analysis identified three themes that diminished the influence of children, birth parents and foster carers on the matching decision: assumptions, timing and feasibility. The findings emphasise that the influence of stakeholders on the matching decision is highly contextual. In the matching process, practitioners can be seen as key figures in facilitating the influence of stakeholders, yet they are also confronted with the difficulty of dealing with more than one stakeholder, who can have opposing interests, in an often compromised setting with limited choices. ‘Examines the influence of children, birth parents and foster carers on the matching decision from a practitioner's perspective’ Key Practitioner Messages Despite policy to stimulate the involvement of children, birth parents and foster carers in decisions, their influence on the matching decision is sometimes futile. Assumptions made by practitioners, timing in the matching process and a compromised setting diminish the stakeholders' influence on the matching decision. Practitioners are key figures in improving participatory practice to make sure that stakeholders feel understood, valued and taken seriously.
Kirti Zeijlmans, Mónica López López, Hans W. E. Grietens et al.
