Adverse childhood experiences can lead to a number of harmful outcomes throughout an individual’s life, ranging from medical problems to criminal behavior. These traumatic experiences, comprised of different forms of maltreatment and dysfunctional household environments, can affect the development of a child in a variety of different ways. The multitude of developmental changes can produce compounding harmful effects on the child’s life and lead to acutely maladaptive outcomes. Under the perspective of developmental psychopathology, the ever-changing biological, psychological, and social dynamics of children who experience trauma can contribute to deficiencies in all aspects of their subsequent development. Each of these developmental changes can lead to problem behaviors during adolescence and further progress the youth down a path toward both externalized and internalized violent behavior. In this study of youth who came in contact with the Florida Department of Juvenile Justice, the consequences of childhood trauma in the development of juvenile delinquents are examined. This data allowed for the calculation of each child’s Adverse Childhood Experiences (ACE) score (Felitti et al., 1998). Using a generalized structural equation model, the effects of ACE scores are estimated on several aspects of each child’s personality development, adolescent problem behaviors, and violent outcomes. Specifically, the model evaluates both the direct and indirect effects of the culmination of adverse childhood experiences on the initiation of externalized violence (serious, violent, chronic delinquency) and internalized violence (suicidal behavior), as mediated through the development of personality characteristics (such as aggression and impulsivity) and adolescent problem behaviors (such as the imitation of deviant peers, school failure and dropout, substance abuse problems, and symptoms of mental illness). This study aims to contribute to the formation of a more complete understanding of the role of childhood trauma in the development of these two types of violent behaviors to improve our assessment and treatment of children who suffer from early-life trauma.

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Objective: Child maltreatment (CM) is a widespread problem associated with poor mental and physical health outcomes. The underlying mechanisms of this link are not always well understood, however certain biological changes observed in maltreated individuals may play a role in connecting experience and outcome. This review specifically focuses on two markers of biological embedding, DNA methylation (DNAm) and telomere length (TL) in maltreated children and youth. As biomarker changes are not uniform among maltreated children, we additionally discuss biological and environmental resilience factors that may contribute to variability. Methods: We conducted a systematic review of Medline, Embase and PsycInfo databases for studies examining DNAm and/or TL in maltreated children and youth. Methodological quality of the included articles was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) checklists for cohort studies and randomized control trials. Data extraction focused on various factors including population and CM (type, chronicity, severity, and duration) characteristics. Results: The initial search returned 1,688 non-duplicate results, with 417 full text articles reviewed. Twenty-six articles from 16 studies were ultimately included of which 8 examined telomere length and 18 examined DNA methylation. Conclusions: While some heterogeneity of findings was found, evidence supports differential changes in both biomarkers associated with CM. This review enhances understanding of the constellation of biological changes related to CM and consideration of the important role of resilience factors in mitigating risk. Elucidating these factors may highlight targets for future study and intervention development. / Thesis / Master of Science (MSc) / Child maltreatment is a serious problem linked to poor mental and physical health outcomes. The mechanisms of these links are not always clear, however biological changes observed in some maltreated individuals may play a role. Here, we systematically review literature related to two biomarkers of interest in maltreated children, telomere length and DNA methylation. Findings are varied; however, overall, they support an association between child maltreatment and changes in both biomarkers. We additionally discuss factors that may confer resilience related to these changes to highlight potential targets for future study and interventions.

Each year approximately 1,000,000 child become the victims of abuse or neglect. The detrimental effects of child maltreatment (CM) have been well documented and create significant problems for the survivors and for society as well. All fifty states have enacted mandatory reporting laws to combat the CM epidemic. As mandated reporters, nurse practitioners and nurse midwives (APRNs) have the opportunity and responsibilities to identify and refer potential victims of CM, in this study a significant percentage choose not to report their suspicions. Respondents to the study survey identified several potential barriers to APRN reporting such as lack of education and training about CM, negative perceptions of child protective services and lack of physical evidence indicating CM occurred.

Childhood maltreatment is an experience that is likely to have lasting effects on individuals' emotional and behavioral functioning throughout their lifetimes. In particular, childhood maltreatment often is implicated in the etiology of numerous unfavorable psychological outcomes. Other research also suggested that there is a relationship between child maltreatment and the style of attachment that individuals exhibit post-abuse. Lastly, an association exists between individuals' attachment styles and their emotional and behavioral functioning. Despite substantial documentation of these relationships, few studies examine childhood maltreatment, attachment, and emotional and behavioral functioning collectively. As a result, this study examined the relationships among childhood maltreatment, attachment relationships, and later emotional and behavioral functioning, including eating behaviors. In addition, this study examined the role that attachment serves in the relationship between child maltreatment and later functioning. One hundred participants completed five questionnaires assessing experiences of childhood maltreatment, attachment relationships, emotional and behavioral functioning, and eating behaviors. Results of this study indicated that those individuals who report childhood maltreatment are more likely to report unfavorable emotional and behavioral functioning, whereas those who report childhood maltreatment but who exhibit a secure attachment style to either a parent or a peer are less likely to exhibit unfavorable emotional and behavioral functioning. Further, both the experience of childhood maltreatment and attachment were significant predictors of individuals' emotional and behavioral functioning. Finally, attachment contributed unique significant variance to the relationship between childhood maltreatment and emotional and behavioral functioning, particularly participants' internalizing and total problems.; Such findings suggested that secure attachment may serve as a protective factor against problematic emotional and behavioral symptoms as children reach emerging adulthood, even when individuals have had childhood maltreatment experiences earlier in their lives. The importance of studying the relationships among these variables is discussed.

Tidigare forskning har visat att barn som far illa innan 18 års ålder är signifikant mer associerade med ett flertal olika mått på kriminalitet, t.ex. självrapporterad kriminalitet, officiella arresteringar, brottsfrekvens, våldsbrott samt droganvändning. Att reducera antalet barn som far illa kan därför ses som brottsförebyggande åtgärd. I Sverige har vissa yrkesprofessionella en lagstadgad skyldighet att anmäla till socialtjänsten vid misstanke om barn som far illa. Tidigare forskning har visat att yrkesprofessionella ofta misslyckas med att anmäla till myndigheter. Den här studien tar sikte på att fördjupa kunskapen och förståelsen av anmälningsprocessen. Den här studien använder kvalitativ analys och intervjuar skolpersonal om deras upplevelser av anmälningsprocessen. Intervjuerna analyseras genom kvalitativ innehållsanalys. Resultaten av denna studie återspeglar den tidigare forskningen i många aspekter. Analysen resulterade i fyra olika kategorier; utbildning, erfarenhet av socialtjänsten, rädsla för konsekvenser av att anmäla och anmälningsrutin. Vidare visar resultaten att skolpersonalen inte är tillräckligt utbildade om barn som far illa eller hur man ska anmäla det, att man har negativa erfarenheter av socialtjänsten, har rädsla för konsekvenserna av en anmälan samt att man har en rutin som inte underlättar anmälningsprocessen. Konklusionen av dessa resultat är att utbildningen bör förbättras samt att anmälningsrutinen bör förändras för att säkerställa att fler misstankar om barn som far illa når socialtjänsten i form av en anmälan. Vidare bör skolan och socialtjänsten samarbeta i en högre utsträckning än vad som sker idag. / Previous research has shown that children suffering from abuse, neglect or maltreatment before turning 18 are significantly associated with several measurements of delinquency, such as self-reported and official incidence of arrest, offending frequency, violent crimes and drug-use. Thus, reducing child maltreatment can be seen as a crime prevention strategy. In Sweden, certain professionals have a mandatory responsibility to report child maltreatment to authorities. Previous research has shown that professionals often fail to report to authorities. This thesis aims at deepen the knowledge and understanding of the process of reporting and adopts a qualitative approach, interviewing school personnel about their experience, and their perceived barriers to report. The interviews are analyzed using qualitative content analysis. The results of this thesis mirrors in many aspects what have been found in previous research. The analysis found four main categories, education, experience of the social services, fear of consequences of making a report and reporting routine. The results indicate that school personnel are not sufficiently educated on child maltreatment or how to report it, have negative experience of the social services, holds fear about various aspects of reporting and deploy reporting routines that might not facilitate reporting. The implications drawn from this thesis is that school personnel need to be educated to facilitate reporting, but also that reporting routines need to be altered in order to increase reporting. Further, schools and the social services need to collaborate to a greater extent than today.

Childhood maltreatment by a caregiver can occur in many forms, ranging from overt abuse to more subtle neglect. Amidst a primary focus on the outcome of posttraumatic stress disorder (PTSD), less research attention has been given to understanding the impact of maltreatment on one's developing sense of self, internal working model (IWM) of relationships, and emotion regulation capacities. Difficulties experiencing, regulating, and enjoying a full range of affect are common transdiagnostic features among adult survivors of child maltreatment, who frequently display emotional reactivity (e.g., mood swings, anger) and/or disengagement (e.g., numbing, dissociation). What makes the difference between individuals who lash out in emotional outbursts, those who tend to withdraw or dissociate, and those who frequently alternate between these two affective poles? In a mixed college and community sample of 417 adults, we explored two covert forms of childhood emotional maltreatment (e.g., chronic emotional disengagement and frightened/helpless parenting) as potentially linked to adult psychological and relational functioning. Controlling for the effects of childhood physical and sexual abuse, path analysis indicated that these types of maltreatment were significantly associated with insecure attachment patterns, emotional reactivity, and dissociation in adulthood. These findings inform therapeutic work with survivors of childhood trauma, signifying the importance of thorough assessment to uncover potential psychological legacies of emotional abuse and/or neglect, which can at times be overlooked or assumed to be less pathogenic than other more obvious forms of maltreatment.

Suicide is the second leading cause of death worldwide for adolescents and emerging adults. Despite knowledge of distal risk factors for suicide (i.e., childhood maltreatment), there is a dearth of developmentally informed psychobiological theories of suicide that test potentially modifiable proximal risk factors. Utilizing a multi-method design, this study integrates cognitive and biological risk factors into a model of suicide risk following maltreatment. Undergraduates completed a screener assessing medical history, trait reward and threat sensitivities, history of suicidal thoughts and behaviors (STBs), and childhood maltreatment. Participants without a history of autoimmune disease completed a reward and threat-salient acute stress task with pre- and post-task blood draws to measure peripheral inflammatory biomarkers. Utilizing ecological momentary assessment, a subset of participants with a history of suicidal ideation completed daily measures (three per day) of STBs and state reward and threat sensitivities for two-weeks before completing follow-up measures of STBs. Mediation models found that inflammatory reactivity to acute stress did not explain the relationship between maltreatment and ideation across the two-week follow-up, but those participants with greater TNF-α reactivity to an acute stress task reported more severe ideation at the study visit. Moderated mediation models showed that the association between inflammatory reactivity and suicidality was not significantly amplified by reward or threat sensitivity. But, at trait and state levels, those with histories of maltreatment who were less sensitive to rewards and more aware of potential threats experienced the most severe ideation. This investigation aimed to understand the processes that immediately precede STBs to inform future prevention and intervention efforts. / Psychology

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