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1.
OBJECTIVE: To examine abuse specific variables among homeless and runaway adolescents and to look at perpetrators of childhood abuse. METHOD: A total of 372 homeless and runaway adolescents were interviewed using a systematic sampling strategy in metropolitan Seattle. Young people were interviewed on the streets and in shelters by outreach workers in youth service agencies. RESULTS: Approximately one-half of these young people reported being physically abused and almost one-third experienced sexual abuse. Females experienced significantly higher rates of sexual abuse compared to males, and sexual minority youth experienced significantly higher rates of physical and sexual abuse compared to heterosexual youth. Average duration of physical and sexual abuse was 5 and 2 years, respectively. Both types of abuse were rated as extremely violent by more than half of those who were abused. The average number of different perpetrators of physical and sexual abuse was four and three, respectively. Biological parents were the majority of perpetrators for physical abuse whereas nonfamily members most often perpetrated sexual abuse. Average age of perpetrators was late 20s to early 30s and the majority of perpetrators were male for both types of abuse.CONCLUSIONS: The pattern of exploitation and victimization within the family may have serious and cumulative developmental consequences for these youth as they enter the street environment. Early intervention programs are needed to break the cycle of exploitation and abuse that adolescents experience within the family. Without intervention, many of these youth may be at risk of future exploitation and re-victimization out on the street. 相似文献
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《Structural equation modeling》2013,20(4):609-621
This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a general risk factor) and 3 factors for women (sexual intercourse with men, substance abuse, and a high risky sex behavior factor). All factors except women engaging in risky sex with men strongly predicted known HIV status of clients for men and women. The findings from this investigation highlight the use of structural equation modeling for applied problems involving overlapping and complex sets of risk behaviors in youth who present at community health programs. 相似文献
3.
This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a general risk factor) and 3 factors for women (sexual intercourse with men, substance abuse, and a high risky sex behavior factor). All factors except women engaging in risky sex with men strongly predicted known HIV status of clients for men and women. The findings from this investigation highlight the use of structural equation modeling for applied problems involving overlapping and complex sets of risk behaviors in youth who present at community health programs. 相似文献
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Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities. 相似文献
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OBJECTIVE: Child maltreatment has been linked to negative adult health outcomes; however, much past research includes only clinical samples of women, focuses exclusively on sexual abuse and/or fails to control for family background and childhood characteristics, both potential confounders. Further research is needed to obtain accurate, generalizable estimates and to educate clinicians who are generally unaware of the link between childhood abuse and adult health. The purpose of this project is to examine how childhood physical abuse by parents impacts mid-life mental and physical health, and to explore the attenuating effect of family background and childhood adversities. METHODS: We analyzed population-based survey data from over 2,000 middle-aged men and women in the Wisconsin Longitudinal Study using self-reported measures of parental childhood physical abuse, mental health (depression, anxiety, anger), physical health (physical symptoms and medical diagnoses), family background, and childhood adversities. RESULTS: Parental physical abuse was reported by 11.4% of respondents (10.6% of males and 12.1% of females). In multivariate models controlling for age, sex, childhood adversities, and family background, we found that childhood physical abuse predicted a graded increase in depression, anxiety, anger, physical symptoms, and medical diagnoses. Childhood physical abuse also predicted severe ill health and an array of specific medical diagnoses and physical symptoms. Family background and childhood adversities attenuated but did not eliminate the childhood abuse/adult health relationship. CONCLUSIONS: In a population-based cohort of middle-aged men and women, childhood physical abuse predicted worse mental and physical health decades after the abuse. These effects were attenuated, but not eliminated, by age, sex, family background, and childhood adversities. 相似文献
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OBJECTIVE: Much research has been done to examine the long-term effects of being victimized by sexual, physical, and/or emotional abuse in childhood, but much less research has focused on the impact of childhood neglect experiences. This study examines the role that childhood neglect has on adult women's involvement in HIV-related risky behaviors. METHODS: The data come from a study of 250 "at risk" women living in the Atlanta, GA metropolitan area, most of whom were African American. Data were collected in face-to-face interviews between 1997 and 2000. Multiple regression was used to explore the relationship between childhood neglect experiences, self-esteem, attitudes toward condom use, and involvement in HIV-related risky behaviors. RESULTS: Overall, the model tested received strong support by the study data. Childhood neglect led to reduced self-esteem. Neglect was associated with worsened attitudes toward condom use and women who experienced childhood neglect also reported more involvement in HIV risk behaviors. CONCLUSIONS: HIV intervention programs ought to target women who have experienced childhood neglect, as neglect experiences have adverse impacts upon their self-esteem, condom-related attitudes, and HIV risk behavior practices in adulthood. 相似文献
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BackgroundAlthough most children experience at least one adversity, it is the experience of multiple adversities that produces a context of disadvantage that increases the risk of various negative outcomes in adulthood. Previous measures of cumulative childhood adversity consider a limited number of adversities, overlook potential differences across experiences of adversity, and fail to measure the effects of multiple co-occurring childhood adversities. These limitations have led to inconsistent and incomplete conclusions regarding the impact of multiple adverse childhood experiences on adult mental health.ObjectiveThis study assesses how the operationalization and modeling of exposure to cumulative childhood adversity (CCA) influences estimates of the association between CCA and adult psychological distress and develops an improved measure of CCA.MethodsWe use data from the Panel Study of Income Dynamics, a nationally representative sample of households in the United States, and its supplement, the Childhood Retrospective Circumstances Study (N = 4219). We compare four measures of CCA that consider various distinct aspects of adverse experiences (additive, severity, type, and patterns of experience using latent class analysis).ResultsAll measures of CCA were associated with increases in adult psychological distress, but effects depend on the measurement of CCA. Results suggest the sum score overestimates the overall impact of CCA. Latent class analysis captures the co-occurrence of adversities across severity and type, providing an improved measure of CCA.ConclusionsThe heterogeneity across adversities impacts estimates of adult psychological distress. Measuring CCA as patterns of co-occurring adverse experiences is a promising approach. 相似文献
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Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004–2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives. 相似文献
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Youth involved in the child welfare system experience multiple early adversities that can contribute to increased risk of substance use and delinquency. Although adverse childhood experiences (ACEs) have been associated with poorer behavioral outcomes among youth, less is known about the possible protective factors that may influence the relationship between early adversity and risk-taking behavior. This study examined whether protective adult relationships moderated the link between cumulative ACEs and substance use and delinquency after controlling for demographic characteristics in child welfare-involved youth. The sample included 1054 youth, ages 11–17, from the National Survey of Child and Adolescent Well-Being II who were in the first wave of data collection. Results showed that protective adult relationships moderated the relationship between ACEs and substance use, but not for delinquency. Specifically, under lower levels of protective adult relationships, cumulative ACEs related to increased substance use among youth. Implications for child welfare practices to target youths' support systems are discussed. 相似文献
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This paper takes up the concern that sexual health programs targeting adolescents may actually increase HIV risk among youth by reinforcing dominant versions of masculinity that portray males as sexually irresponsible and unconcerned about their health. If a key aim in HIV prevention education is a renegotiation of high‐risk behavioral norms, an important consideration is the ways young people resist stereotypical gender norms that can lead to risky sexual practices. From this perspective, opening up spaces for the expression of counter‐hegemonic masculinities may be an important health prevention strategy. In a study conducted in three urban Toronto high schools, we explore the ways students in mixed‐sex groups supported or challenged dominant discourses of masculinity expressed through three themes: notions of male sexuality as unrestrained and unrestrainable; narrow definitions of sex; and concepts of ‘risk’ and resistance to condom use. We argue that designing HIV prevention programs that begin with the exploration of alternative masculinities may be one way to fashion a framework for gender relations that can offer youth more effective prevention strategies. 相似文献
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To determine whether different types of childhood adversity are associated with body mass index (BMI) in adolescence, we studied 147 adolescents aged 13–17 years, 41% of whom reported exposure to at least one adversity (maltreatment, abuse, peer victimization, or witness to community or domestic violence). We examined associations between adversity type and age- and sex-specific BMI z-scores using linear regression and overweight and obese status using logistic regression. We adjusted for potential socio-demographic, behavioral, and psychological confounders and tested for effect modification by gender. Adolescents with a history of sexual abuse, emotional abuse, or peer victimization did not have significantly different BMI z-scores than those without exposure (p > 0.05 for all comparisons). BMI z-scores were higher in adolescents who had experienced physical abuse (β = 0.50, 95% CI 0.12–0.91) or witnessed domestic violence (β = 0.85, 95% CI 0.30–1.40). Participants who witnessed domestic violence had almost 6 times the odds of being overweight or obese (95% CI: 1.09–30.7), even after adjustment for potential confounders. No gender-by-adversity interactions were found. Exposure to violence in childhood is associated with higher adolescent BMI. This finding highlights the importance of screening for violence in pediatric practice and providing obesity prevention counseling for youth. 相似文献
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Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N = 3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51 cm greater waist circumference (95% confidence interval [CI]: 0.02 cm, 1.00 cm, p = 0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women. 相似文献
14.
OBJECTIVE: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. SAMPLE: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did not. MEASURES: Standardized scales were utilized to assess AIDS-related knowledge, attitudes, and self-efficacy. In addition, the adolescents reported the extent of their engagement in various high-risk behaviors and their lifetime experience of being sexually or physically abused. RESULTS: As the level of abuse experienced by the adolescents increased, their level of knowledge about HIV/AIDS, tendency to hold positive attitudes toward prevention, and level of self-efficacy regarding HIV/AIDS prevention decreased. Most importantly, when controlling for socio-demographic variables, findings indicate that past abuse was a key factor predicting participation in high-risk behaviors associated with HIV infection. CONCLUSION: Physical and sexual abuse of adolescents in Zambia is significantly related to HIV risk behaviors. Future studies should investigate which factors mediate between the experience of abuse and the tendency to engage in risky behaviors. 相似文献
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OBJECTIVE: The prevalence of childhood sexual abuse among Latino adult men who have sex with men who live in the US was estimated because a history of childhood sexual abuse increases HIV sexual risk behaviors and other negative health outcomes in adulthood. METHOD: The Urban Men's Health Study is a random-digit telephone probability survey of 2881 adult men who have sex with men (MSM) aged 18 years or older residing in San Francisco, New York, Los Angeles, and Chicago. Self-reported history of childhood sexual abuse was the main outcome measure gathered from 2692 MSM. RESULTS: A significantly higher proportion of Latino MSM reported sexual abuse before age 13 (22%) than did non-Latino MSM (11%). CONCLUSIONS: Latino MSM are twice as likely to report a history of childhood sexual abuse than are non-Latino MSM. Given the association between childhood sexual abuse and increased risk for HIV and other negative health outcomes, health providers must remain vigilant to the possibility of childhood sexual abuse histories among their Latino patients. 相似文献
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Mothers with a substance use disorder (SUD) are at risk for maladaptive parenting practices, and have heightened likelihood of having experienced childhood adversity themselves. In addition, parental reflective functioning (PRF), a capacity underlying sensitive caregiving, is often low in mothers with SUD. This study examines the relationship between PRF and aversive (emotional, physical, sexual abuse and neglect) and adaptive (safety and competence) experiences, in different developmental phases (early childhood, latency, and adolescence) in mothers with a SUD. A sample of 43 mothers with small children were interviewed with the Parental Developmental Interview to assess PRF, and they completed the Traumatic Antecedents Questionnaire regarding aversive and adaptive experiences. In addition, we used the Hopkins Symptoms Checklist-10 to control for mental health status and a battery of neuropsychological tests to control for executive functions. Results indicated that adaptive experiences in early childhood were positively related to PRF, and that experience of emotional abuse was negatively related to PRF. When separating the group of mothers in two sub-groups based on PRF level, results showed that mothers with negative to low PRF had significantly more experiences of adversities in early childhood and latency, and significantly less adaptive experiences in early childhood, latency and adolescence, compared to mothers with moderate to high PRF. In addition, mothers with adequate to high PRF reported experiencing significantly more types of adaptive experiences, and significantly less adversities compared to mothers with negative to low PRF. Results are discussed in relation to developmental trauma, resilience, epistemic trust and mistrust. 相似文献
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Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N = 5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2–5 (preschool age), 6–10 (school age), and 11–18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed. 相似文献
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OBJECTIVE: Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior. METHOD: Seventy-four subjects, 65% of whom were women, consecutively admitted to a general hospital after having made a suicide attempt, were interviewed as part of the intake interview about prior suicide attempts and self-mutilation and received DSM-IV diagnoses. Sexual abuse, physical abuse, neglect, antipathy from parents, loss of parents, and severe discord in the family before the age of 18, were covered by the Childhood Experience of Care and Abuse (CECA) interview schedule. RESULTS: The prevalence of severe sexual abuse was 35%, severe physical abuse 18%, neglect 27%, antipathy 34%, loss of caregiver 37% and exposure to family violence 31%. Physical and sexual abuse were independently associated with repeated suicide attempts when controlling for the effects of the other childhood adverse factors. No other childhood adversity was related to chronic suicidal behavior. The odds ratio of exposure to sexual or physical abuse was highest among those who both repeated suicide attempts and self-mutilated. CONCLUSION: Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior. 相似文献
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Research has demonstrated the negative impact of Adverse Childhood Experiences (ACEs) on long-term trajectories of mental and physical health. Yet existing literature on this topic is limited in its understanding of outcomes among youth samples, optimal measurement items and methods, and differences in adverse experiences across race/ethnicity. The current study used a person-centered approach to measure ACEs and their impact on youth health outcomes across three different racial/ethnic groups from a large national database. Patterns of exposure to adverse experiences among Black, Latinx, and White youth (N = 30,668, ages 12–17) were determined empirically using latent class analysis (LCA). Significant differences in class membership by demographic indicators (age, household income, sex) and concurrent health outcomes were identified. Different models emerged for Black (2 classes), Latinx (3 classes), and White youth (3 classes). Older and lower-income youth were more likely to have experienced adversities, but there were no differences in adversity likelihood by sex. Additionally, racial/ethnic minority youth were at greater risk of experiencing higher levels of adversity, poverty, and poor health when compared to their White counterparts. Rather than occuring in meaningful clusters, adverse experiences among youth reflected a cumulative risk model such that classes were defined by the overall intensity of adverse experiences (i.e., low, moderate, high). Findings provide greater knowledge regarding the relationship between ACEs and health and future research directions to inform more targeted and culturally-appropriate screening, prevention, and intervention programs. 相似文献
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In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N = 278, 95.3% women, mean age at first abusive incident = 6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way. 相似文献