Progress in preventing child maltreatment in Europe

Sethi, Dinesh; Nikesh, Parekh; Yon, Yongjie; Mikkelsen, Bente

doi:10.1016/s2352-4642(18)30280-3

Cited by 43 publications

(72 citation statements)

References 3 publications

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“…Two of the United Nations Sustainable Development Goals (SDGs, Gender Equity and, Peace, Justice and Strong Institutions [56]) and a recent World Health Resolution [57] for instance, focus on addressing violence against children and women. Early years parental support and pre-school enrichment programmes have been shown to improve child-parent relations and reduce child maltreatment [58]. Equally, other initiatives including paediatric screening for child abuse, maternal depression, domestic violence and parental substance use have also reported positive ACE prevention outcomes (e.g.…”

Section: Discussionmentioning

confidence: 99%

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being

et al. 2017

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BackgroundAdverse childhood experiences (ACEs) including child abuse and household problems (e.g. domestic violence) increase risks of poor health and mental well-being in adulthood. Factors such as having access to a trusted adult as a child may impart resilience against developing such negative outcomes. How much childhood adversity is mitigated by such resilience is poorly quantified. Here we test if access to a trusted adult in childhood is associated with reduced impacts of ACEs on adoption of health-harming behaviours and lower mental well-being in adults.MethodsCross-sectional, face-to-face household surveys (aged 18–69 years, February-September 2015) examining ACEs suffered, always available adult (AAA) support from someone you trust in childhood and current diet, smoking, alcohol consumption and mental well-being were undertaken in four UK regions. Sampling used stratified random probability methods (n = 7,047). Analyses used chi squared, binary and multinomial logistic regression.ResultsAdult prevalence of poor diet, daily smoking and heavier alcohol consumption increased with ACE count and decreased with AAA support in childhood. Prevalence of having any two such behaviours increased from 1.8% (0 ACEs, AAA support, most affluent quintile of residence) to 21.5% (≥4 ACEs, lacking AAA support, most deprived quintile). However, the increase was reduced to 7.1% with AAA support (≥4 ACEs, most deprived quintile). Lower mental well-being was 3.27 (95% CIs, 2.16–4.96) times more likely with ≥4 ACEs and AAA support from someone you trust in childhood (vs. 0 ACE, with AAA support) increasing to 8.32 (95% CIs, 6.53–10.61) times more likely with ≥4 ACEs but without AAA support in childhood. Multiple health-harming behaviours combined with lower mental well-being rose dramatically with ACE count and lack of AAA support in childhood (adjusted odds ratio 32.01, 95% CIs 18.31–55.98, ≥4 ACEs, without AAA support vs. 0 ACEs, with AAA support).ConclusionsAdverse childhood experiences negatively impact mental and physical health across the life-course. Such impacts may be substantively mitigated by always having support from an adult you trust in childhood. Developing resilience in children as well as reducing childhood adversity are critical if low mental well-being, health-harming behaviours and their combined contribution to non-communicable disease are to be reduced.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1260-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being

et al. 2017

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“…Child abuse is a wide spread phenomenon, occurs in every culture and community, remains undiscovered in 90% of the cases and has serious long-term effects [1][2][3][4]. Physicians generally underidentify and underreport child abuse [5].…”

Section: Introductionmentioning

confidence: 99%

GPs’ suspicion of child abuse: how does it arise and what is the follow-up?

Stolper

Verdenius²,

Dinant

et al. 2020

Scandinavian Journal of Primary Health Care

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Background: Child abuse is widespread, occurs in all cultures and communities, remains undiscovered in 90% of cases and has serious long-term effects. Physicians generally underidentify and underreport child abuse. To understand this low reporting rate and how the suspicion of child abuse arises, we examined GPs' experiences. Research questions: How does the suspicion of child abuse arise in GPs' diagnostic reasoning? How do they act upon their suspicion and which barriers do they encounter in their management? Methods: Twenty-six GPs participated in four focus groups. We used purposive sampling to include GPs with different levels of experience. We performed a thematic content analysis. Results: Suspicion of child abuse arose from common triggers and a gut feeling that 'something is wrong here'. GPs acted upon their suspicion by gathering more data, through history taking and physical examination. They often found it difficult to decide whether a child was abused, because parents, despite good intentions, may simply lack parenting skills and have different values. Clear signs of sexual abuse and physical violence were institutionally reported by GPs, whereas in less clear-cut cases they followed them up and built a supporting network of professionals around the family. Conclusions: A low child abuse reporting rate by GPs to CACRC does not mean a low detection rate. In trying to improve a child's situation, GPs make use of patients' trust in their doctor by involving other professionals. Awareness of the role of gut feelings in developing a suspicion may increase early detection and preventive actions. KEY POINTS Physicians generally underidentify and underreport child abuse. Suspicion of child abuse arose from common triggers and a gut feeling that 'something is wrong here'. GPs acted upon their suspicion by gathering more data, through history taking and physical examination. GPs found it difficult to decide whether a child was abused, because parents, despite good intentions, may lack parenting skills.

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“…Nearly a quarter of adults (22.6%) suffered physical abuse as a child, and 36.3% suffered emotional abuse [1]. The lifelong consequences of child maltreatment include impaired physical and mental health, poorer school performance, and job and relationship difficulties [3–6]. The WHO has listed a range of health risks associated with interpersonal violence in childhood [7].…”

Section: Introductionmentioning

confidence: 99%

Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

Hansen

Schei

Sørlie

et al. 2018

International Journal of Circumpolar Health

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The main objectives of this study were to investigate the association between childhood violence and psychological distress and post-traumatic stress symptoms (PTS) among Sami and non-Sami adults, and to explore a possible mediating effect of childhood violence on any ethnic differences in mental health. This study is part of a larger questionnaire survey on health and living conditions in Mid- and Northern Norway (SAMINOR 2) which included 2116 Sami and 8674 non-Sami participants. A positive association between childhood violence and psychological distress and PTS in adulthood was found regardless of ethnicity. For women, childhood violence may have mediated some of the ethnic differences in psychological distress (53.2%) and PTS (31.4%). A similar pattern was found for men as to psychological distress (45.5%) and PTS (55.5%). The prevalence of psychological distress was significantly higher in the Sami than in the non-Sami group: 15.8% vs. 13.0% for women, and 11.4% vs. 8.0% for men. Likewise, PTS showed a higher prevalence in the Sami group, both for women (16.2% vs. 12.4%) and for men (12.2% vs. 9.1). Conclusion: A positive association between childhood violence and adult mental distress was found for both Sami and Norwegian adults. More mental problems were found among the Sami. Childhood violence may have mediated some of the ethnic differences.

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Progress in preventing child maltreatment in Europe

Cited by 43 publications

References 3 publications

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being

Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being

GPs’ suspicion of child abuse: how does it arise and what is the follow-up?

Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

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