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The purpose of this voyage is to explore the phenomenon of resilience with a South African child survivor of abuse. This research may be used to foreground elements in narrative conversations that can be employed to enhance resilience in other child survivors of abuse. The collaborator was identified using a constructivist approach of selection, incorporating the Indigenous Knowledge of the staff involved in the care of abuse survivors in a place of safety. The selection work session led to the generation of an operationalisation of the concept resilience, as well as an observation schedule for resilience specific to this environment. A 16-year-old female collaborator was identified as resilient for the purpose of this research. A number of in-depth interviews with the collaborator were conducted whilst the collaborator was in the place of safety, as well as after her move to a children’s home. Narratives about the collaborator’s life were generated and computer aided qualitative data analysis was undertaken. This facilitated the generation of networks of codes which allow for the representation of the particular resilience processes present in the collaborator. In this study the ability to adapt and utilise new environments is identified as a major factor in the collaborator’s resilience. / Dissertation (MEd(Psychology))--University of Pretoria, 2005. / Educational Psychology / unrestricted

This retrospective descriptive study reviews sexually abused children who presented to the Child Abuse Team at the Red Cross War Memorial Children's Hospital (RCWMCH) between 1 January 1986 and 31 June 1988. During this period 365 children were referred to the Child Abuse Team, of whom 357 were entered into this study. 297 of these were cases of confirmed sexual abuse. There were 48 male children and 123 children under 6 years of age. Most children were victims of a single episode of sexual abuse with only 13, 7% presenting following repeated abuse. More serious forms of sexual abuse, rape or sodomy, were common, accounting for 60% of the cases. Over 70% of the children had physical signs to substantiate their claims of having been sexually abused. Sexually transmitted disease was a common finding, being present in 15,6 % at presentation. All children were accompanied to hospital by an adult, usually a parent. 60% of the children presented directly to RCWMCH. A delay between abuse and presentation was common, only 42% of the children presenting within 48 hours of having been abused. Physical problems frequently required management. Very few children received more than crisis intervention for their emotional state and only 20% needed any form of intervention to ensure their safety. Only 1% of cases involved a female abuser. In general, the age of the abuser was older than previously reported with 18, 6% being under 20 years of age. The relationship between abused and abuser was similar to that described in the literature, as was the reaction of the family against the abuser. 27,4% were prosecuted and of those that appeared in court 7 4, 5% were convicted. Further comparison of the following sub-groups of abused children are presented: male and female, young and old, intrafamilial and extrafamilial abuse, a single episode of abuse and repeated abuse.

Child maltreatment is a public health problem directly linked to poor outcomes across the lifespan, including chronic health conditions and even death. The local population served by the agency in which the project took place experienced an increase in reports of child maltreatment. Agency leadership identified deficiencies in parental knowledge about positive parenting practices as a contributing factor to the problem. To address the problem, the agency implemented a quality improvement evidence-based home visiting pilot initiative. The evaluation of that initiative was the purpose of this project. Bandura's social cognitive learning theory provided the theoretical framework for the project, and the logic model was used to facilitate the practice change in the facility. Evaluation was based on data extracted from the Family Support Program Outcome Survey (FSPOS) tool completed by all 22 program participants. Comprising 7 questions, the FSPOS was a validated and reliable tool and was used to assess the increase in participants' parental knowledge related to positive parenting practices before and after participation in the home visiting program. Survey results revealed that participation in the initiative increased participant knowledge. Using a 7-point Likert scale in which higher scores indicated higher levels of positive parenting practices, participant scores increased from M = 4.71 before participation to M = 6.60 after enrollment. The results reinforce the significance of the nursing profession in health promotion and disease prevention in communities. Findings of this project have the potential to promote positive social change by decreasing child maltreatment, which may reduce cost of care and improve quality of life across the lifespan.

Child abuse has been shown to have a detrimental effect on the emotion development of the abused child. Due to a history with the parent that includes a high proportion of negative interactions and an impaired parent-child relationship, the child who has been subjected to physical abuse often manifests psychological symptoms. The purpose of this study was to investigate the effect that treatment aimed at increasing the frequency of positive interaction in the parent-child relationship had on the emotional status of the abused child. Results showed that parent-child interaction play sessions were effective in increasing positive interaction and decreasing subsequent abusive behavior in the parent-child dyad. Self-reported parental attitudes toward the child became more positive. Treatment did not generalize totally and was not maintained totally during follow-up. The effect that treatment had on the emotional status of the abused child was less clear, although some improvement was noted. The results of this study have important clinical implications for therapists working with abusive parents in terms of providing an effective intervention for treatment of child abuse. Further investigation of the treatment is warranted. Suggestions for future research are offered.

This is a creative work in the genre of non-fiction writing, in the sub-genre of memoir. When Again Comes Back to You is a memoir that traces the effects of abuse as it works upon the life of a young girl who grows in the shadow of an abusive family. As the girl grows, and becomes a mother herself, the story explores how the effects of abuse can extend into the next generation.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: The objective of this study was to evaluate the association between (1) different types of ACEs and migraine, and (2) the number of ACEs and migraine among adolescent mothers in Lima, Peru. Methods: Our cross-sectional study included 787 adolescent mothers (14- to 18-years of age) in Peru. In-person interviews were conducted postpartum, in hospital, within 2-days of delivery. Nine types of ACEs were assessed, including exposure to three categories of abuse, two categories of neglect, and four categories of household dysfunction. Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between ACEs and migraine while adjusting for putative confounders. Results: Approximately 75% of adolescent mothers reported having experienced at least one type of ACE. Adolescent mothers who reported any childhood abuse had 1.49-fold increased odds of migraine (aOR = 1.49; 95% CI 1.03–2.18) compared to those with no history of childhood abuse. Adolescent mothers who reported experiencing household dysfunction had 1.56-fold increase odds of migraine (aOR = 1.56; 95% CI 1.09–2.24). Compared to participants who reported no ACE, those who experienced four or more ACEs had 3.09-fold (aOR = 3.09; 95% CI 1.80–5.40) increased odds of migraine (ptrend < 0.001). Conclusion: Exposure to ACEs is highly prevalent in adolescent-aged mothers postpartum and is associated with increased odds of migraine. These findings support the importance of screening for ACEs and migraine among adolescent mothers; and the need for providing culturally appropriate, trauma-informed headache care. / National Institutes of Health / Revisión por pares

In my essay, I have considered whether the data in publications on sexual violence against children reflectreality. I suspect that there are cases of child sexual abuse that goes underreported, and I try to investigate why this happens and the key possible reasons that lower the statistics. My essay focuses on the community in Western Kenya, yet I think the presumptions I made can be generalised and applicable to other contexts. I analyse material from research in Kisumu County and national data, and I support myself with information about child abuse from UNICEF. I name four key reasons why the data may not reflect reality: the taboo of being a sexual victim, economic dependency, psychological manipulation, and how society defines rape and sexual abuse. I use critical feminism as a framework to tackle the issue of a marginalised group of people.

The aim of this thesis is to map self-harm characteristics of adolescents with personal history of traumatic experience including the purpose and development of self-harm over time. First, in the theoretical section of this paper, the developmental stage of adolescence and its risks for engaging in self-harm is portrayed. Then, the topic of trauma, its diagnostic background and neurobiological impact is described, followed by chapter about self-harming itself, its forms, frequencies, functions, etiology and its association with suicide. By the end of this section the role of adolescent resilience in coping with the impact of trauma and self-harm is discussed. The follow up empirical research project of qualitative nature conducted under Dětské krizové centrum includes a set of case studies that were holistically evaluated for all aspects of self- harm and its development over time. Keywords Adolescence; trauma; child abuse neglect; self-harm; suicide; resilience.

Barnmisshandel är ett världsomfattande problem i dagens samhällen och mörkertalet är stort eftersom alla fall inte anmäls. I flera länder råder anmälningsplikt vid misstanke att barn utsätts för misshandel och akutpersonal har en viktig roll i skyddandet av utsatta barn. Akutpersonal möter ofta barnen i hemmiljön och är därför den första instansen som kommer i kontakt med det utsatta barnet. Detta ställer höga krav på akutpersonalen, att de kan göra adekvata bedömningar och dokumentera sina misstankar eftersom deras bedömning kan komma att ligga till grund för en anmälan.   Syftet var att belysa akutpersonalens erfarenhet av situationer där barn misstänkts utsatta för barnmisshandel.   Metoden var en litteraturöversikt där vetenskapliga artiklar söktes fram genom databasen PubMed. Artiklarna kvalitetsgranskades och 15 stycken valdes ut för analys och samtliga av dessa låg till grund för resultatet, som redovisas i kategorier samt subkategorier.   Litteraturöversiktens resultat delades in i två kategorier, som består av tre respektive två subkategorier. Den första kategorin var akutpersonalens bristande kunskap avseende barnmisshandel. Subkategorierna som här framkom var identifiering av tecken som kan tyda på barnmisshandel, dokumentation och anmälan samt utbildning inom ämnet. Akutpersonal upplevde att det var svårt att identifiera tecknen, som kunde härledas till misshandel och det kunde bero på en osäkerhet kring vad som var naturliga skador eller vilka skador som åsamkats av annan person. Likaså upplevdes svårigheter kring vad som ska dokumenteras och hur en anmälan ska göras. Utebliven anmälning kunde också bero på osäkerheten i tillvägagångssätt. Akutpersonal önskade mer utbildning i ämnet och om hur barnmisshandel ska upptäckas och anmälas. Den andra kategorin som framkom var akutpersonalens emotionella upplevelser av barnmisshandel, under vilken subkategorierna rädslor och stress identifierades. Akutpersonal upplevde rädsla för att anmäla och det kunde härledas till deras rädsla att göra fel, för rättsliga påföljder eller rädsla för anhörigas reaktioner. Slutligen upplevde akutpersonalen stress i olika varianter relaterade till fall där barnmisshandel förekommit. Själva mötet med utsatta barn skapade stress men även att göra en anmälan kunde verka stressande.   Slutsatsen var att barnmisshandel är ett svårt ämne, som behöver lyftas fram och uppmärksammas. Akutpersonal upplever otillräckliga kunskaper kring barnmisshandel och att situationer, där misstankar fanns att barn utsattes för misshandel, kunde skapa stress och rädslor. Med en klar bild hur akutpersonalen ska upptäcka tecken, vilka frågor och undersökningar som ska ställas/ bli gjorda och var anmälan ska göras, finns möjligheterna för att akutpersonal ska upptäcka och våga anmäla mer än de gör. / Child abuse is a worldwide problem within the society today and the problem is larger than we are aware of due to all cases are not reported. In several countries there is a duty to report suspicions of child abuse and ambulance staff have an important role in protecting vulnerable children. Emergency staff often meet the children in the home environment and is therefore the first instance to meet the vulnerable child. This imposes high demands on emergency staff, that they can make adequate assessments and document their suspicions as their assessment will form the basis for a notification. The aim was to highlight the emergency staff experience of situations where children were suspected of being exposed to child abuse. The method was a literature review where scientific articles were sought through the PubMed database. The articles were quality-reviewed and 15 were selected for analysis, and all of them were selected to the results, which are reported in categories and subcategories. The results of the literature review were divided into two categories and three subcategories. The first category was of emergency staff's lack of knowledge regarding child abuse. The subcategories that emerged were the identification of signs that could indicate child abuse, documentation and notification as well as education in the subject. Emergency staff found that it was difficult to identify the signs that could be traced to abuse, and it could be due to uncertainty about what was natural injuries or injuries caused by another person. Likewise, difficulties were experienced regarding what to document and how a notification should be made. An unsubscribed notification could also be due to the uncertainty in the approach. Emergency staff wanted more education on the subject and how child abuse should be detected and reported. The other category that emerged was the emotional experiences of emergency staff of child abuse, under which subcategories fears and stress were identified. Emergency staff experienced fear of reporting and it could be derived from their fear of wrongdoing, for legal penalties or for fear of relatives' reactions. Finally, emergency staff experienced stress in different variants related to cases of child abuse. The actual encounter with vulnerable children created stress but also making a notification could seem stressful.   The conclusion was that child abuse is a difficult subject which needs to be highlighted. Emergency staff experience insufficient knowledge of child abuse and situations, where suspicions were found, that children were abused could create stress and fears. With a distinct plan how the ambulance staff will detect signs, what questions and investigations should be made / where to be notified, there are opportunities for emergency staff to detect and have the courage to report more than they do.