Child Maltreatment

虐待儿童
  • 文章类型: Journal Article
    自2010年代智能手机和社交媒体兴起以来,在线格局发生了变化,并改变了儿童使用技术的方式。在线儿童性剥削(OCSE)以及对计算机中介通信(CMC)的依赖。这项范围审查提供了对患病率的最新检查,危险因素,结果,以及自2010年以来OCSE的披露。使用三个数据库对2010年1月至2023年1月之间发表的研究进行了系统搜索。结果表明,令人震惊的患病率,以及全球范围内与OCSE相关的各种风险因素和后果。许多年轻的受害者努力认识到OCSE是一种严重的虐待形式。强调了为年轻用户监控不断变化的互联网环境的必要性。
    The online landscape has shifted since the rise of smartphones and social media in the 2010s and altered the way children use technologies. Along with a reliance on computer-mediated communication (CMC) is the concern of online child sexual exploitation (OCSE). This scoping review provided an updated examination of the prevalence, risk factors, outcomes, and disclosures of OCSE since 2010. Systematic searches were conducted using three databases for studies published between January 2010 and January 2023. Results indicated an alarming prevalence of, and a wide range of risk factors and consequences associated with OCSE worldwide. Many young victims struggled to recognize OCSE as a serious form of abuse. The need to monitor the ever-changing Internet landscape for young users is highlighted.
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  • 文章类型: Journal Article
    边缘性人格障碍(BPD)是一种复杂的心理健康状况,其特征是情绪不稳定,关系,自我形象,和行为。患有BPD的人经常在激烈的情绪中挣扎,冲动,保持稳定的关系。催产素,被称为“爱激素”或“结合激素”,“在社会纽带中起着至关重要的作用,信任,同理心,情绪调节及其失调可能导致BPD困难。本系统综述旨在分析现有文献,检查复杂的相互作用,并鼓励未来的研究和治疗策略。
    对PubMed文献的系统搜索,Embase和Psychinfo,没有任何语言或时间限制,直到2024年3月,将同义词库和与“边缘性人格障碍”和“催产素”相关的免费搜索索引术语组合在一起,产生310个结果(77个在PubMed,Embase中的166和Psychinfo中的67)。分析了94篇全文,共纳入70篇文献进行定性分析。
    催产素可能会影响依恋风格,父母的行为,和应激反应,特别是有童年创伤史的人。催产素之间的相互作用,遗传学,早期生活经历,和环境因素有助于BPD的复杂性。催产素受体基因的遗传变异可能会影响社交和情感能力,并有助于精神病理学的发展。此外,早期不良经历,比如童年的虐待,可以改变催产素的功能,影响社会认知和情绪调节。然而,催产素在BPD治疗中的作用仍不确定,一些研究表明,避免社会威胁等特定症状的潜在益处,而其他人则表明对非语言行为和心理化的不利影响。
    了解催产素在BPD中的作用可以为潜在的治疗干预措施提供见解。虽然基于催产素的治疗可能有望解决特定症状,需要进一步的研究。
    UNASSIGNED: Borderline personality disorder (BPD) is a complex mental health condition marked by instability in mood, relationships, self-image, and behavior. Individuals with BPD often struggle with intense emotions, impulsivity, and maintaining stable relationships. Oxytocin, known as the \"love hormone\" or \"bonding hormone,\" plays a crucial role in social bonding, trust, empathy, and emotional regulation and its dysregulation may contribute to BPD difficulties. This systematic review aims to analyze existing literature, examining the intricate interplay and encouraging future research and treatment strategies.
    UNASSIGNED: A systematic search of Literature in PubMed, Embase and Psychinfo, without any language or time restriction, was performed until March 2024 combining thesaurus and free-search indexing terms related to \"borderline personality disorder\" and \"oxytocin\", producing 310 results (77 in PubMed, 166 in Embase and 67 in Psychinfo). Ninety-four full texts were analyzed, and 70 articles were included in qualitative analysis.
    UNASSIGNED: Oxytocin may influence attachment styles, parental behaviors, and stress responses, particularly in individuals with a history of childhood trauma. The interaction between oxytocin, genetics, early life experiences, and environmental factors contributes to the complexity of BPD. Genetic variations in the oxytocin receptor gene may influence social and emotional abilities and contribute to the development of psychopathology. Additionally, early adverse experiences, such as childhood maltreatment, can alter oxytocin functioning, impacting social cognition and emotional regulation.However, oxytocin\'s role in BPD treatment remains uncertain, with some studies suggesting potential benefits for specific symptoms like social threat avoidance, while others indicate adverse effects on nonverbal behavior and mentalizing.
    UNASSIGNED: Understanding oxytocin\'s role in BPD offers insights into potential therapeutic interventions. While oxytocin-based treatments may hold promise for addressing specific symptoms, further research is needed.
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  • 文章类型: Journal Article
    证据表明,育儿干预措施是减少照料者对儿童虐待的有效方法。最近的COVID-19大流行改变了全球育儿干预措施的提供,许多干预措施适应危机期间继续提供服务。这项全球系统评价研究了在COVID-19大流行期间,针对儿童虐待及其风险和保护因素的育儿干预措施是如何适应的。我们搜索了2020年至2022年发表的研究,并确定了31项符合条件的研究。关于基本原理的数据,process,可行性,可接受性,根据《循证干预措施适应和修改报告框架》,对适应的影响进行了叙述综合。结果表明,大多数适应都是积极主动的,集中在分娩方法上,主要是数字化。虽然普遍观察到可行性和可接受性,适应计划的影响尚无定论。报告不足,特别是关于理由,保真度,促进者能力建设,利益相关者的参与,和决策过程,已注意到。审查建议加强规划,文档,并使用既定准则报告计划改编,以及过程和影响评估。
    Evidence shows that parenting interventions are an effective method of reducing caregiver-perpetrated child maltreatment. The recent COVID-19 pandemic has changed the provision of parenting interventions worldwide, with many interventions adapting to continue providing services during the crisis. This global systematic review examined how parenting interventions targeting child maltreatment and its risk and protective factors were adapted during the COVID-19 pandemic. We searched for studies published between 2020 and 2022 and identified 31 eligible studies. The data on the rationale, process, feasibility, acceptability, and impacts of adaptations were narratively synthesized in accordance with the Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions. Results showed that most adaptations were proactive and focused on delivery methods, predominantly digitalization. While feasibility and acceptability were generally observed, the impacts of adapted programs were inconclusive. Inadequate reporting, especially regarding rationale, fidelity, facilitator capacity building, stakeholder involvement, and decision-making processes, was noted. The review recommends enhanced planning, documentation, and reporting of program adaptations using established guidelines, as well as process and impact evaluations.
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  • 文章类型: Journal Article
    目的:肥胖是成年人中常见的医学实体。越来越多的研究表明,儿童虐待与成人肥胖之间存在显着关系。
    结果:新兴研究表明,各种类型的儿童虐待与成年BMI之间存在潜在的剂量反应关系。最近的工作还探讨了下丘脑-垂体-肾上腺(HPA)轴的潜在作用,和其他激素介质,如性激素结合球蛋白和瘦素。也有研究表明,抑郁,社会经济和环境影响等因素介导了这种关系。已报道的合并症包括心血管和代谢疾病,糖尿病,和胰岛素抵抗。初步工作还表明,虐待对成年肥胖的影响可能存在性别和种族差异。在这篇叙述性评论中,我们总结了描述不同儿童虐待类型的现有工作(身体,性,情感,口头,和儿童忽视)及其与成人肥胖的关系,关于潜在的剂量反应关系,潜在的介质和病理生理学,合并症,以及关于性别和种族/族裔差异的初步工作。我们回顾了已经研究的干预措施的有限数据,最后讨论了对治疗成人肥胖症的临床医生的影响和建议,以及未来潜在的研究方向。
    OBJECTIVE: Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity.
    RESULTS: Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions.
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  • 文章类型: Systematic Review
    背景:有不良童年经历(ACE)病史的个体有随后使用大麻的风险。然而,目前尚无现有的系统评价探讨与大麻使用相关的ACE.
    目的:这篇系统综述论文的目的是研究不良儿童经历(ACE)如何影响发病率,模式,以及成年后使用大麻的性质。
    方法:在PRISMA声明的指导下,本系统综述集中于报道成年期使用大麻的纵向研究.搜索的数据库包括PubMed和Embase。
    结果:最终,28份手稿被选中列入,范围从较小的以社区为重点的研究到具有全国代表性的纵向调查;28项研究中有22项发生在美国,样本量为303至15,960名参与者。用于评估ACEs和大麻使用的仪器在研究中差异很大,导致一致性的丧失。然而,ACEs的存在-特别是儿童时期的性虐待-始终与以后生活中的大麻使用相关。发现ACEs的频率和严重程度对大麻使用的严重程度产生累加累积影响。
    结论:本系统综述奠定了关于ACE和大麻使用的科学现状的基础,这可以进一步深入了解这种关系,并提供潜在的干预机会。
    BACKGROUND: Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use.
    OBJECTIVE: The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood.
    METHODS: Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase.
    RESULTS: Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use.
    CONCLUSIONS: This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.
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  • 文章类型: Journal Article
    背景:生活在贫困中的儿童遭受虐待的风险增加。具有反贫困目标的社会安全网(SSN)计划可以通过减少粮食不安全等途径减少儿童虐待,减轻照顾者的压力,和改善照顾行为和能力,以满足儿童的基本需求。这项研究的目的是对SSN计划减少美国(US)儿童虐待的能力的证据进行系统审查。
    方法:本系统综述采用PRISMA方案进行。在1996年至2022年之间发表的研究中,最初的搜索返回了1873篇文章。27篇论文被纳入最终分析。摘要主要是在6月24日确定的,2022年,2022-2023年进行了数据的提取和合成。
    结果:在评估的27篇论文中,16项研究发现,SSN程序可以防止儿童虐待。其中三项审查的研究没有发现安全网计划的影响,四项研究提出了不同的发现,4项研究发现了对儿童虐待结果的不利影响.当仅限制高质量研究时,12人中有10人发现了保护性影响,没有人发现对虐待儿童的不利影响。
    结论:SSN与儿童虐待的保护作用相关。扩大SSN计划可能会带来超越贫困相关目标的积极好处,包括减少虐待儿童的发生率。
    BACKGROUND: Children living in poverty are at an increased risk for maltreatment. Social safety net (SSN) programs with antipoverty objectives may reduce child maltreatment through pathways such as reduced food insecurity, lessened caregiver stress, and improved caregiving behaviors and ability to meet children\'s basic needs. The objective of this study is to conduct a systematic review of evidence on the ability of SSN programs to reduce child maltreatment in the United States (US).
    METHODS: This systematic review was conducted using PRISMA protocol. Among studies published between 1996-2022, the initial search returned 1,873 articles, and 27 papers were included in the final analysis. Abstracts were identified primarily on June 24th, 2022, and extraction and synthesis of data was conducted in 2022-2023.
    RESULTS: Of the 27 papers assessed, 16 studies found that SSN programs were protective against child maltreatment. Three of the reviewed studies found no effect of safety net programs, 4 studies presented mixed findings, and 4 studies found adverse impacts in terms of child maltreatment outcomes. When restricting to high-quality studies only, 10 out of 12 found protective impacts and none found adverse impacts on child maltreatment.
    CONCLUSIONS: SSNs are associated with protective effects against child maltreatment. Expansion of SSN programs would likely have positive benefits beyond poverty-related objectives, including reducing incidence of child maltreatment.
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  • 文章类型: Journal Article
    背景:虐待儿童是一个紧迫的公共卫生问题,对儿童和社会造成长期的健康和经济影响。虽然一些预防性干预措施已经证明了它们在减少虐待儿童的发生及其相关的经济影响方面的有效性,此类干预措施的成本效益尚不清楚.
    目的:本研究旨在对高收入国家和中低收入国家儿童虐待预防干预措施的现有经济证据进行全面概述和叙述性综合。
    方法:在MEDLINE中进行了系统搜索,PsycINFO,Embase,CINAHL,WebofScience,和Econlit确定关于儿童虐待预防干预措施的全面经济评估和投资回报研究。使用Drummond的10点检查表评估合格研究的方法学质量。这项审查遵循了PRISMA指南,并在叙事综合中总结发现。
    结果:26项研究符合纳入标准。其中,八人评估了家访,四人评估幼儿教育(ECE),四个评估多组分(MC),和三个检查了基于小组的家长教育(GPE)干预措施。其余研究评估了预防虐待性头部创伤的干预措施(AHT;n=2),儿童性虐待(n=2),在学校的身体虐待(n=1),以及个性化强化育儿(IIP;n=2),和咨询(n=1)干预措施。在中低收入国家进行了两项研究,而其他人都在高收入国家。
    结论:纳入的研究总体上具有较高的方法学质量。只有AHT,ECE,IIP,和MC干预在预防儿童虐待方面显示了有希望的成本效益证明.需要对结果参差不齐的干预措施(例如GPE)和中低收入国家进行更多的经济评估。
    BACKGROUND: Child maltreatment is a pressing public health concern that poses long-lasting health and economic impacts on children and society. While several preventive interventions have demonstrated their effectiveness in reducing the occurrence of child maltreatment and its associated economic impacts, the cost-effectiveness of such interventions remains unclear.
    OBJECTIVE: This study aims to provide a comprehensive overview and a narrative synthesis of the available economic evidence on child maltreatment preventive interventions in both high-income and low-middle-income countries.
    METHODS: Systematic searches were conducted in MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, and Econlit to identify full economic evaluations and return-on-investment studies on child maltreatment preventive interventions. The methodological quality of eligible studies was assessed using Drummond\'s 10-point checklist. This review adhered to the PRISMA guidelines, and summarized findings in a narrative synthesis.
    RESULTS: Twenty-six studies met the inclusion criteria. Of these, eight evaluated home visiting, four evaluated early childhood education (ECE), four assessed multi-component (MC), and three examined group-based parent education (GPE) interventions. The remaining studies assessed interventions to prevent abusive head trauma (AHT; n = 2), child sexual abuse (n = 2), physical abuse at school (n = 1), as well as individualized intensive parenting (IIP; n = 2), and counseling (n = 1) interventions. Two studies were conducted in low-middle-income countries, while the others were all in high-income countries.
    CONCLUSIONS: The included studies generally exhibited high methodological quality. Only AHT, ECE, IIP, and MC interventions demonstrated promising cost-effectiveness credentials in preventing child maltreatment. More economic evaluations are needed for interventions with mixed findings (e.g. GPE) and in low-middle-income countries.
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  • 文章类型: Journal Article
    背景:在过去的几十年中,大量研究调查了童年逆境与精神病的关系。本系统综述严格审查了过去十年来用于调查精神病中儿童逆境的方法,包括操作定义,测量工具和特性,以及这些研究中使用的仪器的心理测量特性。
    方法:本系统综述遵循PRISMA指南(注册号CRD42022307096),搜索使用了以下电子数据库:PsychINFO,Scopus,WebofScience,非洲医学指数(AIM),LILACS,CINAHL,EMBASE,和MEDLINE。搜索包括针对儿童逆境和精神病的术语的变体和组合。
    结果:在2010年至2023年之间发表的585项确定的研究中,有341项采用了经过验证的工具来调查儿童的逆境。我们的发现表明“童年创伤”是最常检查的结构,其次是“虐待儿童”或“虐待儿童”。“儿童创伤问卷的简短版本是主要的工具。身体虐待,情感虐待,性虐待最常被调查,事实上,该领域似乎普遍关注虐待儿童和忽视其他逆境。在工具项目的选择和总结中观察到显著的心理测量学异质性,只有59%的研究记录了原始的心理测量验证,22%的研究报告了数据集的可靠性。
    结论:这篇综述强调了该领域的实质性方法学异质性,指出童年逆境和精神病研究中的偏见。这些发现强调了标准化定义和高质量测量工具的必要性,以提高该领域未来研究的有效性。
    BACKGROUND: During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies.
    METHODS: This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis.
    RESULTS: Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show \"childhood trauma\" being the most frequently examined construct, followed by \"child maltreatment\" or \"child abuse.\" The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets.
    CONCLUSIONS: This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area.
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  • 文章类型: Journal Article
    家庭中对儿童的暴力行为(VAC),或家庭成员,是一个对个人和社会有长期影响的人权和社会问题。像INSPIRE一揽子计划这样的全球政策工具已经提出了预防VAC的策略,包括法律的实施和执行,规范和价值观,安全环境,父母和照顾者的支持,收入和经济增长,响应和支持服务,教育和生活技能。这篇系统的综述旨在综合最近的证据基础(即,自2000年以来发布),用于减少家庭或家庭成员的VAC的每个INSPIRE策略。我们使用受控词汇和关键字搜索了四个数据库,并在先前的评论中搜索了其他记录。本综述共纳入67项研究,包括文献综述,荟萃分析,系统评价,和其他类型的评论。我们发现大量证据支持父母和照顾者支持干预的有效性。然而,对其他激励策略的评论很少。我们还发现来自中低收入国家的样本代表性不足,残疾儿童,受强迫流离失所和冲突影响的家庭。总之,这项系统评价表明,有几种有希望的策略可以预防VAC(例如,家访和家长教育),但需要进一步的研究,以加强现有的证据体系,并有效地为实施和扩大基于证据的干预措施提供信息,以保护全球儿童免受暴力侵害。
    Violence against children (VAC) in the home, or by household members, is a human rights and social problem with long-lasting consequences for individuals and society. Global policy instruments like the INSPIRE package have proposed strategies to prevent VAC, including Implementation and enforcement of laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, and Education and life skills. This systematic review of reviews aimed to synthesize the recent evidence base (i.e., published since 2000) for each INSPIRE strategy to reduce VAC in the home or by household members. We searched four databases using controlled vocabularies and keywords and searched for additional records in prior reviews of reviews. A total of 67 studies were included in this review, including literature reviews, meta-analyses, systematic reviews, and other types of reviews. We found extensive evidence supporting the effectiveness of parent and caregiver support interventions. However, reviews on other INSPIRE strategies were scarce. We also found a vast underrepresentation of samples from low- and- middle-income countries, children with disabilities, and families affected by forced displacement and conflict. In sum, this systematic review suggests that there are several promising strategies to prevent VAC (e.g., home visiting and parent education), but further research is necessary to strengthen the current body of evidence and effectively inform the implementation and scale-up of evidence-based interventions to protect children from violence globally.
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