Several organizations actively work for children's rights to a safe and secure upbringing (WHO, 2022b; UNICEF, 2021). Despite this, over 1 billion children were exposed to physical, sexual, or psychological/emotional harm in 2021 (WHO, 2022c). Children exposed to maltreatment, abuse, and neglect during childhood are affected in their attachment, self-esteem, and trust. They are also at risk for higher vulnerability to physical illness, mental illness, eating disorders, alcohol- or drug abuse, and developing criminal behavior. The current systematic literature review aims to provide further knowledge about how professionals identify child maltreatment and which influencing factors affect the professionals’ actions to the suspicions. The study reviews nine articles together with a literature background to identify patterns and shortcomings. The current study highlights that indications of maltreatment are recognizable, despite if the definition of maltreatment is occasionally viewed as non-specific. Recognized indications are, among other things, visible changes, damage to the body, and changes in behavior and actions. The study also shows that professionals often lack knowledge and awareness of child maltreatment. Factors that inhibit action include culture, values, fear of misjudging the situation, or negative impact on the relationship with the child's network. It could also be due to organizational deficiencies such as time and resources. / Barns rättigheter till en trygg och säker uppväxt, arbetar flera organisationer aktivt för (WHO, 2022b; UNICEF, 2021). Trots detta utsattes över 1000 miljarder barn för fysisk-, sexuellt-, eller psykiskt/känslomässigt skada, under 2021 (WHO, 2022c). Barn som exponeras för misshandel och försummelse under dess uppväxt, påverkas såväl i deras anknytning, självkänsla och tillit. De löper även högre risk för fysiska sjukdomar, psykisk ohälsa, ätstörning, alkohol- och drogmissbruk samt utveckla kriminellt beteende. Aktuell systematiska litteraturöversikt syftar till att tillgodose ytterligare kunskap om hur yrkesverksamma identifierar barnmisshandel samt vilka faktorer som påverkar dess agerande på misstankarna. Studien granskar nio forskningsartiklar, tillsammans med bakgrunds litteratur för att identifiera mönster och brister. Aktuell studie påvisar att indikationer på misshandel är igenkännbara, trots att definitionen utav misshandel ibland ses som ospecifik. Indikationerna är bland annat synliga förändringar och skador på kroppen samt förändringar i beteende och agerande. Studien påvisar också att yrkesverksamma saknar kunskap och medvetenhet om barnmisshandel. Faktorer som hämmar agerande var bland annat kultur, värderingar, rädsla att missbedöma situationen eller negativ påverkan på relation till barnets nätverk. Det kunde även vara utifrån organisatoriska brister så som tid och resurser.

No description available.

No description available.

Whenever there have been wars, children were a result of intimate relationships between deployed (foreign/ enemy) soldiers and local women ranging from love affairs to systematic sexual violence. These children born of war (CBOW) are a common phenomenon of war, yet their fate has not experienced much attention in research during the last decades (Lee, 2012). At the end of World War II (WWII) and thereafter, maximum 400,000 children were born to German women fathered by soldiers of the four occupying forces (Britain, France, USA, Soviet Union) (Stelzl-Marx & Satjukow, 2015). These are called “children born of occupation” or “occupation children” in research, yet the term is still under debate, since after all, these individuals are not children anymore today. Several archival and case studies from historical and social sciences have been describing the hardship these children had to face, being born “child of the enemy” and “born out of wedlock” into a defeated and contrite former National Socialist society, where losing the war however did not necessarily mean a change in mindset. Their results hint at disorientation regarding the question of belonging, and emotional as well as mental distress in the experiences of many of these children (Glaesmer, Kaiser, Freyberger et al., 2012; Mochmann et al., 2009; Satjukow, 2009, 2011; Stelzl-Marx, 2009). Nevertheless, a psychosocial perspective had been missing so far. When assessing psychosocial consequences of growing up as child in this societal context, a study needs to focus on three main aspects: Identity development, stigmatization/ discrimination, and child maltreatment (Glaesmer, Kaiser, Freyberger et al., 2012). In 2013, the study “Occupation children: identity development, stigma experience, and psychosocial consequences growing up as a ‘German occupation child’” launched and recruited 164 people via press release (App. 8.6) and contact to platforms of occupation children of which 146 were included in the analyses (mean age 63.4, 63.0% women). Since GOC are difficult to reach, their population size is small and can only be estimated; they can be considered a „hidden population“. These populations cannot be investigated by standardized instruments only but need a participative research approach to tailor instruments to their reality (Heckathorn, 1997; Salganik & Heckathorn, 2004). Participative research enhances chances of acceptance and compliance among the target population (Brendel, 2002). Therefore, the applied instrument (App. 8.7) consists of two parts: a self-developed part on experiences specific for this group of CBOW deducted from literature and developed in a participative approach with the help of occupation children themselves as well as experienced researchers in this field. Part two contains standardized psychometric instruments assessing current mental distress and traumatic childhood experiences among others (please refer to publication I for a detailed description of the instruments). This dissertation focused on the specific living and developmental conditions for GOC in post-WWII Germany (change of attachment figures, financial situation, knowledge of biological background etc.) as well as experiences of stigmatization/ discrimination and traumatic experiences during their life and childhood specifically. Furthermore, this work investigated current mental distress and attachment in close adult relationships. The following is a summary for each of the five articles this dissertation is based on: 1. Growing up as an occupation child of World War II in Germany: Rationale and methods of a study on German occupation children A specific instrument was developed in a participative research approach to investigate German occupation children as a hidden population. It consists of a self-developed part assessing specific experiences described for CBOW during childhood and adolescence (e.g. attachment figures and change of attachment figures, knowledge about biological father and his background, housing situation, experiences of stigmatization) and a second part with standardized instruments assessing mental disorders, attachment in close adult relationships, traumatic experiences, and childhood maltreatment. Overall, the developed questionnaire was well accepted by the target group and topics covered were of high relevance. Finally, N=146 subjects with fathers from all four occupation forces were included in the study (48.6% American, 22.6% French, 21.9% Soviet, 4.1% British). The distribution of each subgroup can be ascribed to the sampling method of contacting platforms of occupation children. Concerning their procreation background the majority (75.3%) stated their parents had a positively defined relationship. Only 10 (6.8%) children born out of rape participated. 2. Depression, Somatization, and Posttraumatic Stress Disorder in Children Born of Occupation After World War II in Comparison With a General Population The comparison of findings for GOC with a representative birth-cohort-matched sample (BCMS) from the German general population (N=977) showed that GOC report significantly higher prevalence rates of most traumatic experiences, higher one-month prevalence rates of full and partial PTSD, depression and somatization than the control group. Especially high impact traumatic events (e.g. childhood abuse, rape, and physical violence) were more frequent among GOC. Furthermore, GOC reported growing up under difficult conditions (e.g. poverty, single mothers, change of attachment figures in childhood, and stigmatization). These findings show that even decades after these experiences have ended, they suffer from higher rates of depression, somatization and posttraumatic stress as well as comorbid conditions. The results thereby underline the complex and long-term impact of their burdened social, financial and familial conditions on current mental health. 3. Long-term effects on adult attachment in German occupation children born after World War II in comparison with a birth-cohort-matched representative sample of the German general population The linear and binary logistic regression analyses of adult attachment and its association with current depression in GOC (N=146) in comparison to a birth-cohort-matched representative sample (BCMS) of the German population (BCMS; N=786) show that GOC are less comfortable with closeness/ intimacy and report a lowered ability to depend on others in close relationships. This shows in more dismissive and fearful attachment compared to BCMS. In line with existing research, insecure adult attachment is associated with current depression. These results are discussed in relation to the difficult circumstances under which GOC grew up (e.g. single mothers, change of attachment figures in childhood, adverse events, stigmatization) and thus underline the complex and long-term impact of the developmental conditions on attachment and current mental health. 4. German Occupation Children: Experiences of Stigmatization after World War II Experiences of stigmatization and discrimination were a shared truth for GOC. More than half of the sample (54.6%) stated having experienced stigmatization, one-fifth of them „frequently“ or „constant­ly“. Major reasons were father’s origin, physical attributes or illegitimacy at birth. Stigmatization took place in children’s immediate social environment, in public institutions and in their own families, mostly in childhood and adolescence. The majority stated withdrawal and avoidance as coping behaviors. Findings indicate the magnitude of stigmatizing experiences in this subgroup of the German population in frequency of experiences as well as in terms of impact on all levels of social interaction. 5. Childhood maltreatment in children born of occupation after WWII in Germany and its associ­ation with mental disorders Experiences of emotional abuse/ neglect, physical and sexual abuse are significantly higher in GOC compared to the representative birth-cohort-matched sample (BCMS) from the German general population (N=920). All five subtypes of childhood maltreatment (CM) increase the risk of PTSD and somatoform syndrome. Depressive syndromes are associated with emotional abuse/ neglect and physical abuse. GOC were at high risk of CM. Findings underline the complex, long-term impact of developmental conditions and CM on mental disorders even decades later.:Table of contents 1. Background 1.1 Historical background 1.2 Theoretical background 2. Research objectives 3. Methods 3.1 Study design & samples 3.2 Instruments 4. Outline of publications 5. Discussion 5.1 Limitations 5.2 Outlook 6. Summary/ Zusammenfassung 7. References 8. Appendix 8.1 Erklärung über die eigenständige Abfassung der Arbeit 8.2 Darstellung des eigenen Beitrags 8.3 Curriculum vitae 8.4 Publikationsverzeichnis 8.5 Danksagung 8.6 Press release 8.7 GOC Questionnaire

Background: Child abuse in South Africa is a significant public health concern with severe negative outcomes for children; however, little is known about risk and protective factors for child abuse victimisation. This thesis investigates prevalence rates, perpetrators, and locations as well as predictors of physical, emotional and sexual child abuse victimisation. It also examines the influence of potential mediating and moderating variables on the relationships between risk factors and child abuse. Methods: In the first study, a systematic review of correlates of physical, emotional and sexual child abuse victimisation in Africa was conducted. The review synthesised evidence from 23 quantitative studies and was used to inform the epidemiological study. For study two to four, anonymous self-report questionnaires were completed by children aged 10-17 (n=3515, 57% female) using random door-to-door sampling in rural and urban areas in two provinces in South Africa. Children were followed-up a year later (97% retention rate). Abuse was measured using internationally recognised scales. Data were analysed using descriptive statistics, multivariate logistic regressions, and mediator and moderator analyses. Results: The first study, the systematic review, identified high prevalence rates of abuse across all African countries. It identified a number of correlates which were further examined using the study data from South Africa. The second study found lifetime prevalence of abuse to be 54.5% for physical abuse, 35.5% for emotional abuse, 14% for sexual harassment and 9% for contact sexual abuse. Past year prevalence of abuse was found to be 37.9% for physical abuse, 31.6% for emotional abuse, 12% for sexual harassment and 5.9% for contact sexual abuse. A large number of children experienced frequent (monthly or more regular) abuse victimisation with 16% for physical abuse, 22% for emotional abuse, 8.1% for sexual harassment and 2.8% for contact sexual abuse. Incidence for frequent abuse victimisation at follow-up was 12% for physical abuse, 10% for emotional abuse and 3% for contact sexual abuse. Perpetrators of physical and emotional abuse were mostly caregivers; perpetrators of sexual abuse were mostly girlfriends/boyfriends or other peers. The third study found a direct effect of baseline household AIDS-illness on physical and emotional abuse at follow-up. This relationship was mediated by poverty. Poverty and the ill-person’s disability fully mediated the relationship between household other chronic illnesses and physical and emotional abuse, therefore placing children in families with chronic illnesses and high levels of poverty and disability at higher risk of abuse. The fourth study found that contact sexual abuse in girls at follow-up was predicted by baseline school drop-out, physical assault in the community and prior sexual abuse victimisation. Peer social support acted as a protective factor. It also moderated the relationship between baseline physical assault in the community and sexual abuse at follow-up, lowering the risk for sexual abuse victimisation in girls who had been physically assaulted from 2.5/1000 to 1/1000. Conclusion: This thesis shows clear evidence of high levels of physical, emotional and sexual child abuse victimisation in South Africa. It also identified risk and protective factors for child abuse victimisation which can be used to inform evidence-based child abuse prevention interventions.

<p dir="ltr">Exposure to child maltreatment and neglect have lifelong negative impacts (Child Welfare Information Gateway, 2016; Sheffler et al., 2020; Vig et al., 2020). While there are known risk factors that make a child more likely to experience abuse, there is little examination of the potential influence of parent or caregiver religious beliefs on the perpetration of child maltreatment (Beller et al., 2021; Ellison & Bradshaw, 2009; Rodrigues & Henderson, 2010; Centers for Disease Control and Prevention, 2022a). The prevalence of religiously related child maltreatment (RRCM) in the United States is unknown, and research has been limited to examinations of outlying Christian groups (Asser & Swan, 1998; Bottoms et al., 2015; Bullis, 1991; Simon et al., 2012; Sinal et al., 2008). However, there are some indications that instances of religiously related child maltreatment have been found to occur in mainstream sects such as Protestant denominations (Bottoms et al., 1995; Bottoms et al., 2015). This dissertation sought to examine how mainstream Protestant Christian parents (Evangelical & Mainline) conceptualized what was harmful or not to children in relation to their religious belief systems. Furthermore, this research examined the potential factors of influence on how Protestant Christian parents perceived child maltreatment and their perceptions of religious exemption applications to children.</p><p dir="ltr">An exploratory qualitative research design was taken to examine these research questions. A total of 23 semi-structured interviews were conducted with Indiana Protestant Christian parents. Interviews were transcribed and then analyzed using reflective thematic analysis (Braun & Clarke, 2019; Braun & Clarke, 2020a, 2020b). Findings indicated that Protestant Christian parents across both denominations considered their religious beliefs to be a positive influence on how they raise their children, in particular, how they modeled showing love without judgment to others. Denominational differences were seen in modeling of love without judgment to marginalized communities. The personal experiences of Protestant Christian parents and their religious beliefs were influential factors on how these parents perceived what was harmful to children. When examining parents' awareness of religious exemption applications to childcare and parenting, most Protestant Christian parents indicated limited awareness. Thematic tensions were present when examining parents’ discussions of the use of religious exemptions for childcare and parenting practices. One tension was the parental right to religious exemption use versus the potential harm that could befall children through the use of such religious exemptions. These findings provide direction for future research to improve understanding of how mainstream Protestant Christian parents conceptualize what is harmful to children and the factors of influence.</p>

Denna studie undersökte samarbetet mellan tandvård och socialtjänst i att identifiera barn som utsatts för våld. Syftet med studien var att identifiera hinder, utmaningar och möjligheter för förbättringar i samarbetet. Semistrukturerade intervjuer genomfördes med fyra tandvårdspersonal, två socialtjänstarbetare och en universitetsadjunkt som även är tandläkare med specialistutbildning. Resultatet visade fyra huvudteman: utbildning, hinder och utmaningar, dokumentation och samarbete. Respondenterna betonade vikten av utbildning om våld och samarbete mellan professionella grupper för att förbättra samarbetet mellan tandvård och socialtjänst. De hinder som identifierades var brist på riktlinjer för tandvårdspersonal att rapportera oro för ett barn och undviker skyldigheten att rapportera. Dessutom ansågs detaljerade journalanteckningar inom tandvården vara avgörande för socialtjänsten för att få ett helhetsperspektiv för barn som utsatts för våld. Samarbetet betraktades som avgörande för att få en övergripande bild av situationen och tillhandahålla adekvat vård. Dessa resultat kan användas för att utveckla och förbättra samarbetet mellan tandvård och socialtjänst i att identifiera våld mot barn. / This study examined the collaboration between dental care and social services in identifying children exposed to violence. The purpose of the study was to identify obstacles, challenges, and opportunities for improvement in cooperation. Semi-structured interviews were conducted with four dental care professionals, two social service workers, and one university lecturer. The results showed four main themes: education, barriers and challenges, documentation, and collaboration. Respondents emphasized the importance of education on violence and cooperation between professional groups to improve collaboration between dental care and social services. The obstacles identified included the lack of guidelines for dental professionals on reporting concerns about a child and the absence of exemptions from the obligation to report. Additionally, detailed journal entries in dental care were deemed essential to investigating the overall situation of children exposed to violence. Collaboration was considered crucial to obtaining an overall picture of the situation and providing adequate care. These findings can be used to develop and enhance collaboration between dental care and social services in identifying abused children.