child abuse

虐待儿童
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:新的证据表明儿童虐待与心血管疾病风险有关;然而,儿童虐待与心律失常之间的关联尚不清楚.此外,心房颤动(AF)的任何遗传易感性,与中风风险升高相关的常见心律失常,心力衰竭,和死亡率,修改此类关联的文件没有记录在案。目的:研究儿童虐待与偶发心律失常之间的关系,以及心律失常的遗传易感性是否改变了这些关联。方法:这项前瞻性分析包括来自英国生物银行的151,741名参与者(平均年龄55.8岁,43.4%男性)。童年虐待,包括五种类型,使用儿童创伤筛查(CTS)进行测量。偶发心律失常(房颤,室性心律失常[VA],和缓慢性心律失常[BA])通过关联的入院和死亡登记处进行记录。计算加权AF遗传风险评分。进行Cox比例风险模型以测试儿童虐待与偶发心律失常之间的关联。结果:在12.21年的中位随访期间(四分位距,11.49-12.90年),6,588AF,2,093BA,发生742例VA事件。与没有儿童虐待相比,有3-5种类型的儿童虐待与房颤事件风险增加相关(HR,1.23;95CI1.09-1.37),VA(HR,1.39;95CI1.03-1.89),和BA(HR,1.32;95CI1.09-1.61)调整人口统计后,社会经济和生活方式因素。儿童虐待的累积类型与房颤风险(总体总体<.001;Pnear=.674)和BA(总体=.007;Pnear=.377)之间的关联显示出线性模式。在中等和高遗传风险组(Ptrend均<0.05)中,但在低遗传风险组(Ptrend=.378)中,儿童虐待和AF风险之间存在梯度关联。与不显著的交互效应无关(P交互效应=.204)。结论:儿童虐待与心律失常的发生风险较高有关,尤其是AF和BA。房颤的遗传风险并没有改变这些关联。
    先前的研究表明,儿童虐待与心血管疾病风险有关。儿童虐待与偶发心律失常的风险增加有关,特别是心房颤动和缓慢性心律失常。房颤的遗传易感性并未显着改变这些关联。童年虐待可能是晚年心律失常的一个新的心理危险因素。对儿童虐待和随后转介心理服务的询问可能会有所帮助。
    Background: Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented.Purpose: To examine the associations between childhood maltreatment and incident arrhythmias, and whether a genetic predisposition to arrhythmias modifies these associations.Methods: This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident arrhythmias (AF, ventricular arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias.Results: During a median follow-up of 12.21 years (interquartile range, 11.49-12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3-5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09-1.37), VA (HR, 1.39; 95%CI 1.03-1.89), and BA (HR, 1.32; 95%CI 1.09-1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (Poverall < .001; Pnonlinear = .674) and BA (Poverall = .007; Pnonlinear = .377) demonstrated a linear pattern. There was a gradient association between childhood maltreatment and AF risks across the intermediate and high genetic risk groups (both Ptrend < .05) but not within the low genetic risk group (Ptrend = .378), irrespective of non-significant interaction effect (Pinteraction = .204).Conclusion: Childhood maltreatment was associated with higher risks of incident arrhythmias, especially AF and BA. Genetic risk of AF did not modify these associations.
    Previous studies indicate that childhood maltreatment is associated with cardiovascular disease risk.Childhood maltreatment was associated with an increased risk of incident arrhythmias, particularly atrial fibrillation and bradyarrhythmia. Genetic predisposition to atrial fibrillation did not significantly modify these associations.Childhood maltreatment could be a new psychological risk factor for cardiac arrhythmias in later life. Inquiries into childhood maltreatment and subsequent referral to psychological services may be helpful.
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  • 文章类型: Journal Article
    儿童虐待(CM)与成年期的负面健康结果有关,包括故意的自我伤害(DSH),自杀行为,和受害。尚不清楚关联是否扩展到非DSH相关伤害的急诊科(ED)报告。出生队列研究数据与行政健康数据相关联,包括非DSH相关伤害的ED介绍以及机构报告和经证实的CM通知。调整后的分析(n=6087)显示,任何类型的机构报告的CM通知与受伤的ED发生率增加显着相关(aOR=1.57;95%CI1.32-1.87)。在适度分析中,女性被告知并得到证实的身体虐待的几率明显更高,确凿的情感虐待,并且比男性遭受一种以上的有根据的虐待。伤害的ED陈述可能是危险行为的代表,伪装DSH/自杀行为,或身体虐待。妇女的一致发现可能表明通过人际暴力受害。
    Child maltreatment (CM) is associated with negative health outcomes in adulthood, including deliberate self-harm (DSH), suicidal behaviours, and victimisation. It is unknown if associations extend to emergency department (ED) presentations for non-DSH related injuries. Birth cohort study data was linked to administrative health data, including ED presentations for non DSH related injuries and agency-reported and substantiated notifications for CM. Adjusted analyses (n = 6087) showed that any type of agency-reported notification for CM was significantly associated with increased odds of ED presentation for injuries (aOR = 1.57; 95% CI 1.32-1.87). In moderation analyses, women yielded significantly higher odds of notified and substantiated physical abuse, substantiated emotional abuse, and being subject to more than one type of substantiated abuse than males. ED presentations for injuries could be a proxy for risky behaviours, disguised DSH/suicidal behaviours, or physical abuse. The consistent findings in women may point to victimisation via interpersonal violence.
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  • 文章类型: Journal Article
    背景:虐待儿童是指对儿童的任何类型的虐待,由父母犯下的,看护人,或以监护身份的另一个人,这可能会导致身体上的情况,性,或情感虐待。在医疗保健环境中,医生在识别和管理这种现象方面发挥着至关重要的作用,随着全球未报告病例数量的增加。
    方法:在2022年至2023年之间,对在沙特阿拉伯执业的医生进行了一项基于问卷调查的横断面研究,以评估他们的知识,意识,以及对虐待儿童的态度。使用IBMSPSSStatisticsforWindows分析数据,版本26(2019年发布;IBMCorp.,Armonk,纽约,美国)。
    结果:共有153名医生参与了这项研究,其中65名参与者(42.5%)表示对虐待儿童的意识差,79名参与者(51.6%)表示对虐待儿童有中等了解。此外,在87名参与者(56.9%)中,缺乏知识是报告虐待儿童的最常见障碍.意识与知识之间以及知识与态度之间存在正相关。此外,结果发现,较高的态度得分与男性有关,经验较少,在急诊医学部实习,在政府医院工作.
    结论:这些结果突出了实施专门培训计划和研讨会的重要性,重点是识别和报告虐待儿童的情况。以及提供识别虐待迹象和采取适当干预措施的准则。
    BACKGROUND: Child abuse refers to any type of mistreatment of a child, perpetrated by a parent, caregiver, or another individual in a custodial capacity, which may lead to instances of physical, sexual, or emotional abuse. Physicians play a crucial role in identifying and managing this phenomenon in the healthcare setting, as the number of unreported cases increases globally.
    METHODS: A questionnaire-based cross-sectional study was conducted between 2022 and 2023 among physicians practicing in Saudi Arabia to assess their knowledge, awareness, and attitude toward child abuse. The data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).
    RESULTS: A total of 153 physicians were involved in this study, in which 65 participants (42.5%) indicated poor awareness of child abuse, while 79 participants (51.6%) indicated moderate knowledge of child abuse. Additionally, lack of knowledge was the most common barrier to reporting child abuse in 87 participants (56.9%). A positive significant correlation was identified between awareness and knowledge and between knowledge and attitude. Also, it was found that a higher attitude score was more associated with being male, having less experience, practicing in the emergency medicine department, and working in a governmental hospital.
    CONCLUSIONS: These results highlight the significance of implementing specialized training programs and workshops focused on identifying and reporting child abuse, as well as providing guidelines for recognizing signs of abuse and taking appropriate intervention measures.
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  • 文章类型: Journal Article
    背景:儿童虐待是一个全球性问题,使儿童面临精神疾病的风险,药物滥用,过早死亡。跨学科合作对于预防和检测虐待儿童很重要。在挪威,儿童接受普遍的预防性健康评估,并在儿童和家庭健康诊所接受专业公共卫生护士的免费随访护理。这些护士进行定期检查和家访,以监测儿童是否有虐待的迹象。
    目的:本研究的目的是描述儿童和家庭保健诊所的公共卫生护士如何遵循国家临床指南来预防和发现儿童虐待,特别关注临床程序和跨学科合作。此外,我们的目标是确定与儿童虐待识别相关的因素。
    方法:对10月24日至12月31日在初级保健工作的公共卫生护士进行了一项横断面在线调查,2022年。与0-5岁儿童一起工作并与家人协商的公共卫生护士有资格参加,产生554个响应。这项研究采用了描述性分析,包括频率,百分比和平均值,以及两步逻辑回归分析。这项研究得到了有关当局的批准,并通过问卷填写获得知情同意。
    结果:本研究中的公共卫生护士表现出对指南的强烈坚持,并利用各种综合评估程序来监测儿童的健康状况,增长,和发展。然而,与其他专业人士的合作有限且不频繁,如儿童保护服务,全科医生,和医院。大多数公共卫生护士报告偶尔怀疑虐待儿童,年龄和在儿童和家庭诊所的经验影响了这些怀疑。年长的公共卫生护士更有可能怀疑身体暴力,而那些有不到两年经验的人报告说,怀疑虐待的经验较少。额外的教育增加了怀疑性暴力的可能性。
    结论:这项研究提供了对挪威公共卫生护士在儿童和家庭诊所中发现和预防儿童虐待行为的见解。虽然坚持准则很强烈,虐待的嫌疑相对罕见。各机构之间的合作对于解决虐待儿童的问题至关重要。年龄和经验可能会影响虐待的检测。改进协作,有针对性的指导方针,需要持续的专业发展来加强儿童保护。
    BACKGROUND: Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment.
    OBJECTIVE: The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment.
    METHODS: A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0-5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion.
    RESULTS: The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence.
    CONCLUSIONS: This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.
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  • 文章类型: Journal Article
    我们的目的是估计童年父母忽视的比例,滥用,和拒绝,并评估这些经历在里约热内卢的变性妇女中的共同发生,巴西。这是一项横断面研究,在2019年7月至2020年3月期间纳入了便利样本,使用了儿童创伤问卷的改编版。计算比例和相应的置信区间(CI)。在双变量分析中使用Kendall与Tau-b估计器的相关性。我们收集了139名参与者的数据。最普遍的童年创伤类型是情感虐待(60.43%,95%CI[51.79,68.62]),身体虐待(57.55%,95%CI[48.90,65.89])和性虐待(44.60%,95%CI[36.18,53.27])。在40.29%(95%CI[32.06,48.93])和5.75%(95%CI[2.51,11.02])的参与者中发生了严重至极端的身体和情感虐待,分别。父母拒绝(驱逐)的比例为32.37%(95%CI[25.04,40.69]),发生在其他形式的虐待中,除了性虐待.多种类型的童年虐待,疏忽,在我们的样本中,跨性别女性中观察到了父母的排斥反应。儿童虐待对跨性别人口中的人的身心健康的有害影响令人关注,特别是考虑到这些事件的共同发生及其有害的终生影响所产生的累积效应。迫切需要辩论和制定公共政策,以确保从小就享有性别表达权。
    We aimed to estimate the proportions of childhood parental neglect, abuse, and rejection and to evaluate the co-occurrence of these experiences among transgender women in Rio de Janeiro, Brazil. This was a cross-sectional study with a convenience sample enrolled between July 2019 and March 2020, using an adapted version of the Childhood Trauma Questionnaire. Proportions and corresponding confidence intervals (CI) were calculated. Kendall correlation with Tau-b estimator was used in the bivariate analyses. We gathered data from 139 participants. The most prevalent types of childhood traumas were emotional abuse (60.43%, 95% CI [51.79, 68.62]), physical abuse (57.55%, 95% CI [48.90, 65.89]) and sexual abuse (44.60%, 95% CI [36.18, 53.27]). Severe to extreme physical and emotional abuse occurred among 40.29% (95% CI [32.06, 48.93]) and 5.75% (95% CI [2.51, 11.02]) of participants, respectively. The proportion of parental rejection (eviction) was 32.37% (95% CI [25.04, 40.69]) and occurred with the other forms of abuse, except sexual abuse. Multiple types of childhood abuse, neglect, and parental rejection were observed among transgender women in our sample. The harmful effects of childhood abuse on the mental and physical health of people in the transgender population are of concern, particularly considering the cumulative effect produced by the co-occurrence of such events and their harmful lifetime effects. It is urgently necessary to debate and formulate public policies to ensure the right to gender expression from childhood.
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  • 文章类型: Journal Article
    不良的童年经历包括儿童遭受身体虐待,身体上的忽视,情感上的忽视,情感虐待,和性虐待。在儿童早期遭受严重虐待和创伤的儿童患精神疾病的风险较高。
    了解精神病患者儿童期不良经历的患病率及其与感知的社会支持和自杀企图的关系。
    在喀拉拉邦一家三级保健医院的精神科门诊部进行了一项横断面观察性研究。被诊断为物质使用障碍的患者,精神病,情绪障碍,根据ICD-10(F10-F45)和缓解期的神经系统疾病被纳入研究。获得机构伦理委员会的批准和参与者的知情同意。获得社会人口统计学和临床细节。采用儿童创伤问卷-感知社会支持的简短形式和多维量表。采用描述性统计和卡方检验进行数据分析。
    85%的受试者有至少一种童年创伤史。情绪虐待是最常见的创伤类型。在儿童创伤患者中,47.2%的人表示感知到的社会支持水平很高,而18.5%的人报告有至少一次自杀未遂的历史。
    在印度环境中,相当比例的精神疾病患者经历过童年创伤。精神疾病中的儿童创伤与尝试自杀的风险较高有关。
    UNASSIGNED: Adverse childhood experiences include exposure of children to physical abuse, physical neglect, emotional neglect, emotional abuse, and sexual abuse. Children exposed to severe maltreatment and trauma during their early childhood are at a higher risk of early onset of psychiatric disorders.
    UNASSIGNED: To find the prevalence of childhood adverse experiences in psychiatric patients and its association with perceived social support and suicidal attempts.
    UNASSIGNED: A cross-sectional observational study was conducted in the psychiatry outpatient department at a tertiary care hospital in Kerala. Patients with a diagnosis of substance use disorders, psychotic disorders, mood disorders, and neurotic disorders according to ICD-10 (F10-F45) and in remission were included in the study. Institutional Ethical Committee approval and informed consent from the participants were obtained. Socio-demographic and clinical details were obtained. Childhood Trauma Questionnaire-Short Form and Multidimensional scale of Perceived Social Support were administered. Descriptive statistics and Chi-square test were employed for data analysis.
    UNASSIGNED: Eighty-five per cent of the subjects had a history of at least one type of childhood trauma. Emotional abuse was the most commonly reported type of trauma. Among patients with childhood trauma, 47.2% reported high levels of perceived social support, whereas 18.5% individuals reported a history of at least one suicide attempt.
    UNASSIGNED: A significant proportion of patients with psychiatric disorders in an Indian setting have experienced childhood trauma. Childhood trauma in psychiatric disorders is associated with a higher risk of attempting suicide.
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  • 文章类型: Comparative Study
    背景:我们试图确定良好的学校工具包-初级暴力预防干预措施是否与四年后减少同伴和亲密伴侣暴力的受害和实施有关,如果有任何关联是按性别和青春期早期调节的:家庭联系,社会经济地位,以及校外暴力的经历。
    方法:利用参与干预的随机对照试验的学校,我们使用准实验设计来比较在试验期间接受干预的人之间的暴力结果(n=1388),以及在试验期间或之后未接受干预的患者(n=522).数据收集于2014年(平均年龄13.4岁,SD1.5岁),来自卢韦罗区42所学校的参与者,乌干达,和2018/19来自同一参与者,无论是在学校内外(平均年龄18岁,SD:1.77岁)。我们比较了收到好学校工具包的孩子-小学,整个校园暴力预防干预,在一项随机对照试验中,对于在试验期间或之后未接受干预的人。使用国际预防虐待儿童协会和忽视虐待儿童筛查工具-儿童机构改编的项目来衡量结果。我们使用混合效应多变量逻辑回归,学校被拟合为随机效应来解释聚类。
    结果:1910名年龄约16-19岁的青少年纳入我们的分析。我们没有发现对我们的主要结局有平均长期干预效果的证据,随访时的同伴暴力受害情况(aOR=0.81,95CI=0.59-1.11);或任何次要结局.然而,接触干预措施与以下因素有关:后来同伴暴力的减少,对于家庭连通性高的青少年(aOR=0.70,95%CI0.49至0.99),但对于家庭联系较低的人则不然(aOR=1.07,95%CI0.69至1.6;p互动=0.06);并且在社会经济地位较高的男性中减少了后来的亲密伴侣暴力行为(aOR=0.32,95CI0.11至0.90),但社会经济地位并不低(aOR=1.0195CI0.37至2.76,p交互作用=0.05)。
    结论:在有联系的家庭和社会经济地位较高的年轻青少年可能会更好地将预防暴力的技能从小学转移到新的关系,随着年龄的增长。
    背景:Clinicaltrials.gov,NCT01678846,注册日期2012年8月24日。本文的协议:https://www.researchprotocols.org/2020/12/e20940。
    BACKGROUND: We sought to determine whether the Good School Toolkit-Primary violence prevention intervention was associated with reduced victimisation and perpetration of peer and intimate partner violence four years later, and if any associations were moderated by sex and early adolescent: family connectedness, socio-economic status, and experience of violence outside of school.
    METHODS: Drawing on schools involved in a randomised controlled trial of the intervention, we used a quasi-experimental design to compare violence outcomes between those who received the intervention during our trial (n = 1388), and those who did not receive the intervention during or after the trial (n = 522). Data were collected in 2014 (mean age 13.4, SD 1.5 years) from participants in 42 schools in Luwero District, Uganda, and 2018/19 from the same participants both in and out of school (mean age 18, SD: 1.77 years). We compared children who received the Good School Toolkit-Primary, a whole school violence prevention intervention, during a randomised controlled trial, to those who did not receive the intervention during or after the trial. Outcomes were measured using items adapted from the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used mixed-effect multivariable logistic regression, with school fitted as a random-effect to account for clustering.
    RESULTS: 1910 adolescents aged about 16-19 years old were included in our analysis. We found no evidence of an average long-term intervention effect on our primary outcome, peer violence victimization at follow-up (aOR = 0.81, 95%CI = 0.59-1.11); or for any secondary outcome. However, exposure to the intervention was associated with: later reductions in peer violence, for adolescents with high family connectedness (aOR = 0.70, 95% CI 0.49 to 0.99), but not for those with low family connectedness (aOR = 1.07, 95% CI 0.69 to 1.6; p-interaction = 0.06); and reduced later intimate partner violence perpetration among males with high socio-economic status (aOR = 0.32, 95%CI 0.11 to 0.90), but not low socio-economic status (aOR = 1.01 95%CI 0.37 to 2.76, p-interaction = 0.05).
    CONCLUSIONS: Young adolescents in connected families and with higher socio-economic status may be better equipped to transfer violence prevention skills from primary school to new relationships as they get older.
    BACKGROUND: Clinicaltrials.gov, NCT01678846, registration date 24 August 2012. Protocol for this paper:  https://www.researchprotocols.org/2020/12/e20940 .
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  • 文章类型: Journal Article
    目的:本研究的目的是评估性虐待儿童父母的应对策略和心理弹性。
    方法:该研究的样本是从土耳其北部省份(N=75)儿童倡导中心接受法医采访的性虐待儿童的父母那里收集的。数据收集时间为2022年5月至9月。横断面设计用于评估心理弹性和应对技巧。介绍性信息问卷,家庭压力源量表的应对策略,成人心理弹性量表在个人访谈中进行口头管理。该研究得到了机构伦理委员会的批准。
    结果:根据结果,父母的心理韧性和应对能力发挥了重要作用,特别是关于基于触摸的滥用,一次虐待,以及没有家庭暴力。此外,压力源应对能力与心理韧性呈正相关(p<0.05)。
    结论:结论:事实证明,赋予遭受虐待的儿童的父母权力对于减少对受害儿童的创伤性影响至关重要。进一步研究,确定儿童和家庭的风险因素,并制定后续行动的战略,教育,和咨询倡议可以在这方面加强整体卫生服务的提供。
    结论:这项研究强调不仅需要重组性虐待受害者儿童的创伤问题,而且需要重组父母在针对性虐待受害者儿童的护理方法中的应对技能和心理韧性问题。
    OBJECTIVE: The aim of this study is to assess the coping strategies and psychological resilience of parents of children who are victims of sexual abuse.
    METHODS: The study\'s sample was compiled from parents of sexually abused children admitted to the Child Advocacy Centre for forensic interviews in a Northern Turkish province (N = 75). Data were collected from May to September 2022. A cross-sectional design was used to assess psychological resilience and coping skills. The Introductory Information Questionnaire, the Strategies for Coping with Family Stressors Scale, and the Psychological Resilience Scale for Adults were administered verbally during individual interviews. The study was approved by the institutional ethics committee.
    RESULTS: According to the results, the psychological resilience and coping skills of parents played a significant role, particularly concerning touch-based abuse, a single occurrence of abuse, and the absence of family violence. Moreover, there was a positive correlation between coping skills with stressors and psychological resilience (p < 0.05).
    CONCLUSIONS: In conclusion, empowering parents of children exposed to abuse proves crucial for reducing the traumatic impact on the victimized child. Further research, identifying risk factors for both the child and the family, and strategizing follow-up, educational, and counseling initiatives can enhance the provision of holistic health services in this context.
    CONCLUSIONS: This study emphasizes the need to restructure issues of not only trauma in children who are victims of sexual abuse but also coping skills and psychological resilience in parents within nursing approaches aimed at children who are victims of sexual abuse.
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  • 文章类型: Journal Article
    背景:儿童虐待(CM)与青少年自杀风险相关。此外,暴露于双酚AF(BPAF)可能会增加这种风险。然而,CM和BPAF暴露的联合作用尚不清楚,需要进一步研究.
    方法:在本研究中,纳入了来自中国早期青少年队列的1,475名早期青少年(平均年龄=12.48岁)。数据是在2019年至2021年之间的三个时间点收集的,间隔为12个月。使用自我报告问卷评估参与者的CM和自杀史(包括自杀意念和自杀企图)。从参与者获得血样以测量基线时的血清BPAF浓度。采用基于组的轨迹建模来识别三个波中自杀性的不同发展轨迹。在调整了潜在的混杂因素后,使用logistic回归和Poisson回归分析评估了CM和BPAF暴露与自杀意念和自杀企图之间的相关性.
    结果:CM参与者与一年和两年的事件自杀风险相关(所有ps<0.05),BPAF水平与2年自杀意念呈正相关(校正OR=1.68,95%CI:1.13~2.50)。此外,中高水平的BPAF暴露会协同增加CM参与者的1年和2年事件自杀意念的风险(校正OR=2.00-3.83).同样,暴露于高水平BPAF和CM的参与者比暴露于低水平BPAF和无CM的参与者有更高的1年和2年自杀未遂事件风险(校正发生率比[IRRs]=2.82~4.34).此外,与三波自杀性低发展轨迹的参与者相比,在持续高自杀意念轨迹和增加自杀企图轨迹中,高BPAF暴露对CM参与者表现出显著的协同作用(所有ps<0.05).性别亚组分析显示,女性比男性更容易受到BPAF和CM暴露对自杀的协同作用。
    结论:环境因素和个体的心理状态可能协同增加他们对自杀的易感性。这些结果为增强我们对青少年自杀行为的理解提供了新的见解。
    BACKGROUND: Child maltreatment (CM) is correlated with suicidality risk among adolescents. Additionally, exposure to bisphenol AF (BPAF) may increase this risk. However, the combined effect of CM and BPAF exposure remains unknown and should be further investigated.
    METHODS: In this study, 1,475 early adolescents (mean age = 12.48 years) from the Chinese Early Adolescents Cohort were enrolled. Data were collected at three time points with an interval of 12 months between 2019 and 2021. Participants\' history of CM and suicidality (including suicidal ideation and suicidal attempts) were evaluated using a self-report questionnaire. Blood samples were obtained from participants to measure serum BPAF concentrations at baseline. Group-based trajectory modeling was employed to identify different developmental trajectories of suicidality across the three waves. After adjusting for potential confounders, the association between CM and BPAF exposure on suicidal ideation and suicidal attempts was assessed using logistic regression and Poisson regression analyses.
    RESULTS: Participants with CM were associated with a risk of one- and two-year incident suicidality (all ps < 0.05), and BPAF levels were positively associated with two-year incident suicidal ideation (adjusted OR = 1.68, 95% CI: 1.13-2.50). Additionally, middle and high levels of BPAF exposure synergistically increase the risk for one- and two-year incident suicidal ideation among participants with CM (adjusted ORs = 2.00-3.83). Similarly, participants exposed to high-level BPAF as well as CM were at a greater risk of one- and two-year incident suicidal attempts than those with low-level BPAF exposure and no CM (adjusted incidence rate ratio [IRRs] = 2.82-4.34). Moreover, compared with participants with a low developmental trajectory of suicidality across the three waves, high BPAF exposure exhibited a significant synergistic effect on participants with CM in the persistently high suicidal ideation trajectory and the increasing suicidal attempts trajectory (all ps < 0.05). Sex subgroup analysis revealed that females were more susceptible to the synergistic effect of BPAF and CM exposure on suicidality than males.
    CONCLUSIONS: Environmental factors and the psychological status of individuals may synergistically increase their susceptibility to suicidality. These results offer novel insights into enhancing our understanding of suicidality among adolescents.
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