A history of childhood sexual abuse (CSA) is a risk factor for adult emotional distress, including symptoms of depression, anxiety, dissociation, and trauma. However, CSA is likely associated with adult distress indirectly through an impact on mediating variables. In a review of the empirical literature, the authors found support for the roles of shame or self-blame, interpersonal difficulties, and avoidant coping strategies as mediators. In addition, emotional distress appears to mediate links between CSA and other adverse outcomes, such as alcohol abuse and revictimization. The authors conclude with a number of methodological and conceptual recommendations.

This study explored Emotionally Focused Therapy (EFT) for couples with childhood sexual abuse survivors (CSA) and their partners. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction and clinically significant decreases in trauma symptoms, and thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT process. Results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated.

This goal of this review was to explore empirical research examining the question of whether borderline personality disorder (BPD) is a disorder of "personality" or a disorder arising out of experiences of childhood trauma. The review highlighted the complexities in the relationship between childhood disorder (CT) and BPD and identified important implications for research and practice. Although relationships between specific trauma types and outcomes in adulthood are inconsistent, overall associations between CT and the development of BPD are strong and consistently identified. Research exploring the specific mechanisms through which CT may be related to the development of BPD in adulthood is beginning to untangle the complex web of interrelated factors such as heritable personality traits, affect regulation and dissociation, and trauma symptoms as mediators in the relationship between CT and BPD. Our strongest recommendation is for future researchers to further explore transdiagnostic factors such as the self capacity of affect regulation to further disentangle the complex pathways between CT, inherited personality traits, and the development of all forms of traumatogenic psychopathologies in adulthood.

The objective of this article is to describe the implementation of the Skills Training in Affective and Interpersonal Regulation (STAIR), a manualized, evidence-based cognitive behavioral group treatment for childhood trauma at Cedar Centre, a community-based trauma treatment center, and describe the preliminary evaluation of the effectiveness of the treatment. Method: Pre-and postmeasurements of emotion regulation, interpersonal problems, and traumatic stress symptoms using psychometrically validated instruments were collected. Outcomes were assessed for 85 individuals who experienced childhood sexual abuse and participated in the first cycles of intervention at the center. Results: Results indicated significant reductions in difficulties in emotion regulation, interpersonal problems, and trauma symptoms among participants from pretreatment to posttreatment. Discussion: Overall, there was a positive response to the adoption and integration of the STAIR intervention into the program. Qualitative assessment identified the benefits perceived by both facilitators and group participants.

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Background: Malaria is a leading cause of morbidity and mortality among children under 5 years in Malawi, and especially among those from rural areas of central Malawi. The goal of this study was to examine the prevalence and determinants of malaria infection among children in rural areas of Dowa district in central Malawi. Methods: A multistage, cross-sectional study design was used to systematically sample 523 child-mother dyads from postnatal clinics. A survey was administered to mothers and a rapid malaria infection diagnostic test was administered to children. The main outcome was positive malaria diagnostic tests in children. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months. Results: The prevalence of malaria among children under 5 years was 35.4%. Results suggest that children of mothers who experienced recent intimate partner violence (IPV) were more likely to be diagnosed with malaria (AOR: 1.88, 95% CI 1.19-2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria (AOR: 2.77, 95% CI 1.24-6.19; P = 0.013) than children of mothers who had received secondary education. Children aged 2 to 5 months and 6 to 11 months were less likely to be diagnosed with malaria (AOR: 0.21, 95% CI 0.10-0.46; P = 0.000 and AOR: 0.43; 95% CI 0.22-0.85; P = 0.016, respectively) than children aged 24 to 59 months. Conclusion: The prevalence of malaria infection among children in the study area was comparable to the national level. In addition to available malaria control programmes, further attention should be paid to children whose mothers have no formal education, children aged 24 to 59 months, and children of mothers that are exposed to IPV in the area.

It is critical to ensure that long-term care (LTC) homes are sensitive to the needs of lesbian, gay, bisexual, and transgender (LGBT) older adults. However, the extent to which the LTC home sector has adopted recommended strategies is unknown. This qualitative study reports findings from two initiatives: Semi-structured telephone interviews with Canadian LTC home administrators on strategies adopted to support LGBT inclusivity (n = 32), and discussions with participants attending a 2-day meeting on supporting LGBT inclusivity in LTC (n = 25). We found that LGBT inclusivity training was the most commonly adopted strategy among the LTC homes surveyed. Study findings further suggested that practices more visible to residents and families, such as LGBT-themed programming, inclusive language and symbols, or joint initiatives with LGBT communities, were less commonly adopted because of anticipated negative resident/family reactions. The importance and benefits of comprehensive strategies that include staff, residents, and family are discussed.