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Child maltreatment is not a new issue. It has existed in various forms in every society since the early days in history. However, it is only in the past four decades that abuse and neglect of children has attracted widespread interest among health professionals and the general public. There is now a large body of evidence that identifies four main maltreatment forms: physical, sexual, emotional maltreatment and neglect. Child maltreatment is a substantial public health problem, as it is associated with immediate and long-term health problems. Most research into child maltreatment has been conducted in English-speaking, developed countries. Although there has been a small but steady increase in the number of studies from less developed countries over the past decade, there remains a relative dearth of research in these populations, especially in Asia. Over the years, most research projects around the world tend to be focused on only one type of child maltreatment (usually either child sexual abuse or child physical maltreatment), and many studies do not examine risk factors in depth, or address the possible outcomes of various forms of maltreatment. Children have always held a very important place in the culture and traditions in Vietnam. In 1989, Vietnam was the first Asian country and the second country in the world to sign and ratify the United Nations Convention on the Rights of the Child. Since then Vietnam has adopted various measures to promote children's rights and particularly children's rights to be protected from abuse and exploitation. Despite strong political support for the rights of children, there is little formal research into child maltreatment. From the small amount of available evidence and media reports, it appears that children in Vietnam are vulnerable to maltreatment, just as they are all over the world. It is clear that information about the extent and health consequences of different forms of child maltreatment from scientifically sound studies is still far from sufficient. Thus, more research is essential to ensure effective and culturally appropriate responses to protect children from maltreatment. The primary aim of this research was to examine the nature and co-occurrence of four forms of child maltreatment including sexual, physical, emotional maltreatment and neglect among Vietnamese secondary and high school adolescents in both urban and rural settings, and determine the extent to which such adverse experiences impact on self-reported health risk behaviours and physical and mental health. A mixed methods design including qualitative interviews and focus group discussions, and a cross-sectional survey was employed in this study. Incorporation of qualitative inquiry added a cultural dimension on child maltreatment and informed to develop appropriate quantitative measures. Following 8 focus group discussions and 16 in-depth interviews as well as a pilot study of 299 adolescents in Vietnamese schools, a cross-sectional survey of 2,591 adolescents randomly selected from eight secondary and high schools in one urban district and one rural district was undertaken between 2004 and 2005. Data were collected by self-administered questionnaires in class rooms. Key information included demographics, family characteristics and environment, and four scales measuring sexual abuse, emotional and physical maltreatment and neglect as well as standard brief assessments of health related risk behaviours, mental and general physical health. The study clearly revealed that experiences of different forms and co-occurrence of child maltreatment among school adolescents were prevalent in Vietnam. The prevalence estimates of at least one type of physical and emotional maltreatment, neglect and sexual abuse were 47.5%, 39.5%, 29.3% and 19.7% respectively. A significant proportion of respondents (41.6%) was exposed to more than one form of child maltreatment, of which 14.5% and 6.3% experienced three or four maltreatment forms. Results from multivariate logistic regression analyses showed that the prevalence of child physical and emotional maltreatment and neglect among adolescents was not statistically different between urban and rural districts. However, children from rural schools were more likely to report unwanted sexual experiences than their counterparts in urban schools. There was no significant gender difference in reports of adverse sexual experiences. In contrast, girls were more likely to report emotional maltreatment and neglect whereas boys were more likely to experience physical maltreatment. Furthermore, family environment assessed by parental quarrelling, fighting, perceived quality of parental relationship and emotional support appeared to be the most consistent factors significantly predicting each form of child maltreatment. After controlling for a wide range of potential confounding factors, many significant correlates between each type of maltreatment, each level of maltreatment co-occurrence and each health risk behaviour were found. In general, the pattern of correlations between child maltreatment and health risk behaviours was similar for females and males. Emotional maltreatment significantly correlated with most behaviours examined. Physical maltreatment seems more likely to be associated with involvement in physical fights and being threatened. Sexual abuse was significantly related to smoking, drinking, being drunk, and involvement in fighting. Statistically significant associations between neglect and self-harm such as involvement in fighting, feeling sad and hopeless, suicidal thoughts and attempts were found. Clearly, co-occurrence of child maltreatment was significantly associated with almost all examined health risk behaviours and a dose-response relationship was observed in most of the dependent variables. Regarding continuous measures of mental and physical health, multivariate regression analyses revealed that presence of four types of child maltreatment explained a small but significant proportion of variance (from 5% to 9%), controlling for a wide range of background variables. Additionally, while each form of child maltreatment had independent effects on depression, anxiety problems, low self-esteem and poor physical health emotional maltreatment appeared to be the strongest influence on mental and physical health of both female and male adolescents. Analysis of variance also clearly suggested that exposure to increasing numbers of maltreatment forms significantly increased the risk of mental and physical health problems in a dose-response fashion. The present study extends a small body of previous research examining poly-victimization in developed nations to an Asian country. The data contribute new knowledge on cross-cultural child maltreatment problems. Considerable commonalities as well as some differences in the findings in Vietnam compared with earlier research were found. One important conclusion concerns the significant independent associations between various types of child maltreatment, as well as the cumulative effects of poly-victimization on a wide range of health risk behaviours, depression, anxiety, self-esteem, and general physical health. This pioneering research in Vietnam provides timely and substantial evidence that can be used to raise public awareness of the nature of child maltreatment and the harmful effects of not only sexual and physical abuse but also other forms of emotional maltreatment and neglect which have not received attention before. These results from a community-based sample have demonstrated the urgent need for prevention programs. The current study provides an impetus for more comprehensive research in this sensitive area in the near future so that culturally and politically relevant evidence-based responses to child maltreatment can be developed in Vietnam.

Objectif: Explorer l’association entre différentes expériences de maltraitance subie dans l’enfance chez un groupe de mères adolescentes québécoises et les conditions observables chez ces dernières qui sont reconnues comme pouvant mener à l’Adoption de pratiques parentales maltraitantes (APPM) envers leur enfant, en cohérence avec les repères mis de l’avant par la théorie axée sur le traumatisme. Devis: Analyses secondaires de données quantitatives tirées d’une étude évaluative portant sur le Programme de Soutien aux Jeunes Parents (PSJP) des Services intégrés en périnatalité et pour la petite enfance à l’intention des familles vivant en contexte de vulnérabilité (SIPPE). Échantillon: 288 mères adolescentes québécoises, âgées en moyenne de 18 ans, recevant ou ayant reçu des services par le biais du PSJP. Méthodologie: Les données ont été recueillies en quatre temps de mesure, soit à deux reprises durant la grossesse, ainsi qu’à 5 et 17 mois postpartum, sur une période d’environ deux ans. L’expérience de maltraitance subie dans l’enfance a été mesurée à l’aide de la version abrégée de l’échelle Childhood Trauma Questionnaire (CTQ). Une analyse de partitionnement des données a été menée en utilisant les variables relatives à l’expérience de maltraitance subie dans l’enfance (cinq formes de maltraitance et leur classification d’intensité). Dans un deuxième temps, des analyses de variance, par tableaux de contingence et de régression logistique binaire ont été menées afin d’évaluer l’association entre les différentes expériences de maltraitance subie dans l’enfance et les variables identifiées comme étant des conditions associées à l’APPM chez les mères adolescentes. Résultats: Nos résultats mettent de l’avant la fréquence élevée de l’expérience de maltraitance subie dans l’enfance et font ressortir trois types distincts d’expérience. Un premier type est caractérisé par une expérience de négligence émotionnelle sans cooccurrence; un deuxième par une expérience d’abus sexuel et de négligence émotionnelle; et un troisième par une expérience composée de toutes les formes de maltraitance en cooccurrence mais avec une plus faible intensité de négligence émotionnelle. En général, malgré certaines distinctions, ce seraient les mères s’inscrivant dans les deuxième et troisième types qui présenteraient significativement plus de conditions associées à l’APPM pour ce qui est de la pauvreté matérielle, de la fragilisation de la santé mentale, du fonctionnement parental et de la précarité du réseau de soutien. Constats: Ces résultats suggèrent l’importance d’arriver à une compréhension exhaustive de l’expérience de maltraitance subie dans l’enfance chez les mères adolescentes puisque, selon sa nature et sa cooccurrence, ses conséquences peuvent varier. Ces conséquences peuvent être persistantes et placer les mères à risque de transmission intergénérationnelle de la maltraitance envers leur enfant. Dans une optique de prévention de l’APPM, ceci met de l’avant la pertinence d’étudier la problématique de la maltraitance chez les mères adolescentes non pas seulement en fonction du risque de perpétration mais également en fonction de la maltraitance qu’elles ont elles-mêmes subie. Les implications pour l’intervention en travail social et dans le domaine psychosocial sont également discutées. / Objective: To explore the association between histories of childhood maltreatment types among a group of adolescent mothers and recognized variables linked to the Adoption of maltreating parental behavior (AMPB) towards their child in accordance with Trauma-focused theory landmarks. Design: Secondary analysis of quantitative data from an evaluative study of the Programme de Soutien aux Jeunes Parents (PSJP) des Services intégrés en périnatalité et pour la petite enfance à l’intention des familles vivant en contexte de vulnérabilité (SIPPE). Sample: 288 adolescent mothers from Québec, Canada, 18 years old on average, receiving or having received services through the PSJP. Method: Data was collected four times (twice during pregnancy, as well as at 5 and 17 months postpartum) over an average period of two years. Childhood maltreatment history was measured by using the short version of Childhood Trauma Questionnaire (CTQ). Cluster analysis was performed using variables related to childhood trauma history (forms of maltreatment experience and severity classification). Analyses of variance, cross tables and binary logistic regression were then conducted to assess the association between the different types of childhood maltreatment and recognized variables linked to AMPB in adolescent mothers. Results: Results show a high occurrence of childhood maltreatment experience among the adolescent mothers that took part in our study. Further, they highlight three distinct types of childhood maltreatment. The first type is characterized by emotional neglect without cooccurrence; the second one, by sexual abuse and emotional neglect; and the third one, by a cooccurrence of all forms of abuse but with a lower intensity of emotional neglect. Overall, despite certain distinctions, mothers from the second and third types present significantly more risk factors for AMPB than mothers from the first type (i.e. higher levels of poverty, fragile mental health, parental difficulties, and lower satisfaction of social network). Conclusion: From a prevention perspective of AMPB, our results put forward the importance of focusing on and understanding adolescent mothers’ diversity of childhood maltreatment experiences. Difficulties related to a history of childhood maltreatment vary according to its nature and the co-occurrence of forms of maltreatment. These consequences can be persistent and put mothers at risk of intergenerational transmission of maltreatment towards their children. This puts forth the relevance of studying maltreatment among adolescent mothers not only according to the risk of perpetration but also according to the abuse they have themselves suffered in their childhood. The implications for social work and psychosocial intervention are also discussed.

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Hugh Lafollette’s theoretical justification of parental licensing hinges upon consideration of the harms associated with raising children. If we understand Lafollette’s stance as one in which the moral status of children is equal to that of other human beings, we must consider what such a commitment might require of social institutions such as the family. Unlike other licensing programs, I argue that Lafollette’s parental licensing program serves as a tool by which fair equality of opportunity can be acquired for those living within a given society. I attempt to demonstrate how the normative views as to the sovereignty of parents serve to discount the moral status of children, thus limiting the protections offered against child maltreatment. I will show how Lafollette’s theoretical justifications align with concerns addressed in John Stuart Mill’s harm principle and Rawlsian views as to the importance of access to fair equality of opportunity.

This study explored the relationship between childhood interpersonal trauma and coping self-efficacy, coping styles, and emotion regulation difficulties among male and female offenders in detention and diversion centers (N = 183). The coping-relapse model of recidivism posits that offenders’ coping ability plays a pivotal role in successful reentry (Zamble & Quinsey, 1997). Past research reveals that childhood maltreatment is associated with avoidant coping and emotion regulation difficulties, which could negatively impact reentry (e.g., Cloitre et al., 2009; Min, Farkas, Minnes, & Singer, 2007). The relationship between childhood maltreatment and coping self-efficacy has not been addressed. This study found that childhood interpersonal trauma was significantly related to emotion regulation difficulties (r = .20), but not coping self-efficacy, active coping, or avoidant coping. Coping self-efficacy was significantly related to emotion regulation difficulties (r = -.61), active coping (r = .60), and avoidant coping (r = -.30). Research and practice implications are discussed.

Child abuse and neglect (i.e., maltreatment) affect a considerable number of children and can negatively impact how children learn and behave in the classroom. Knowledge gaps, false beliefs, and limited skills with regard to child maltreatment are commonly found among teachers, despite their vital role in the lives of maltreated children. In Canada, little has been done to develop training or other supports for teachers around detecting and responding to child maltreatment. This two-study dissertation brings awareness to the training needs of Canadian-based teachers regarding child maltreatment, as well as to the feasibility of developing, implementing, and evaluating child maltreatment teacher training. Study 1 involved a multi-informant assessment of (1) teachers’ child maltreatment training needs and (2) factors that may influence teachers’ training participation and use of maltreatment-related knowledge and skills. Using surveys and focus groups, qualitative information was gathered from three informant groups in a major urban region in Ontario (i.e., 19 school social workers, 9 child welfare practitioners, and 21 foster caregivers). Study 1 findings highlighted gaps in maltreatment-related knowledge and skills among local elementary school teachers in various areas related to child maltreatment detection and intervention (e.g., trauma-sensitive classroom practices, reporting). Beyond identifying training content needs, Study 1 results also identified multi-level factors that might influence teachers’ participation in child maltreatment training, as well as their use of maltreatment-related knowledge and skills. Most commonly, factors included teacher workload issues, teacher beliefs (e.g., negative attitudes toward child welfare), school internal supports (e.g., unavailability of social workers), and school resource structures (e.g., unmet demand for assessments). Building on these results, Study 2 designed, piloted, and evaluated a child maltreatment training curriculum for teachers. The training evaluation followed Kirkpatrick’s (1994) model for evaluating training programs, wherein the first three of four levels were addressed: (1) reaction (participants’ perceptions about the training); (2) learning (change in knowledge and/or attitudes); and (3) behaviour (change in actual work practices). A quasi-experimental design was used to gather data from a sample of 45 local teachers (19 intervention and 26 wait-list comparison group participants) with total experience in education ranging from 2 to 39 years. To explore participants’ feedback on the training, quantitative and qualitative information was gathered using surveys administered during the training (n = 19). To explore preliminary training outcomes, quantitative and qualitative information was gathered using pre- and post-training questionnaires (n = 45), as well as post-training interviews (n = 13). Training feedback findings supported the usefulness and relevance of training content for local elementary school teachers. Study 2 results also suggest that relatively brief child maltreatment training has the potential to improve teachers’ attitudes, knowledge, and likelihood of responding effectively to maltreatment-related issues at school. Although replication with additional samples and more rigorous methodology are needed, these findings represent an important first step in establishing improved training for Canadian school professionals regarding child maltreatment. Collectively, dissertation results also have several research and clinical implications. Foremost, this dissertation offers recommendations for future maltreatment training development, implementation, and evaluation efforts that include teachers and other school-based professionals. Dissertation results also highlight a need for complementary efforts to explore and address the intersection of factors and systems that may influence teachers’ participation in maltreatment training and research, as well as their responses to child maltreatment at school.

Thesis advisor: James Lubben / Thesis advisor: Sara M. Moorman / Every year, more than three million allegations of childhood maltreatment are received by child protective services, many of which involve cases of abuse or neglect inflicted by the victims’ parents. A number of studies found that negative consequences of childhood maltreatment can last for a lifetime. Despite the long-term impact of childhood maltreatment, later-life relationships between adult victims of childhood maltreatment and their abusive parent have rarely been examined. This dissertation aims to address the gap in the literature by examining how adult victims of childhood maltreatment relate to their abusive parent when the parent becomes old and requires long-term care assistance. This three-paper dissertation utilized existing data sources: Wisconsin Longitudinal Study and National Survey of Midlife Development in the United States. The first paper examined the mediating effect of intergenerational solidarity with the aging mother in the association between maternal childhood maltreatment and adult psychological functioning. The second paper used longitudinal data analysis to compare long-term changes in affectual solidarity with aging mothers between adults with a history of childhood abuse and those without. This paper also examined moderating effects of the correlates of childhood abuse (i.e., poor social competency and lack of emotional regulation) in the association between childhood abuse and affectual solidarity with the aging mother. The third paper focused on the caregiving situation in which adult victims of childhood abuse provided care to their abusive parent. This paper investigated whether and how providing care to the abusive parent was associated with psychological distress among abused adult children, and whether self-esteem mediated the association. By revealing the dynamics of later-life relationships between adult victims of childhood maltreatment and their abusive parent, this three-paper dissertation not only contributes to creating new knowledge to the aging literature, but also provides future direction for social work practice and policy. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Childhood maltreatment predicts mental health problems and stress responses. To design better intervention/prevention programs, it is important to explore mechanisms that may mediate those relationships. Some evidence indicates that emotion regulation strategies (suppression and reappraisal) may play this role. Using self-report, observational, and biological measures and stress manipulation in female and male college students (Study 1: N=267; Study 2: U.S.= 264; Korean=211; Study 3: N=211), I tested the following hypotheses: Study (1) habitual suppression and reappraisal strategies will mediate the relation between childhood maltreatment and perceived stress; Study (2) parental emotional neglect will be positively associated with habitual suppression and internalizing problems, and negatively associated with habitual reappraisal, in both U.S. and Korean participants; Study (3) childhood maltreatment will be associated with heightened physio-emotional responses to the Trier Social Stress Test, mediated by spontaneous suppression and reappraisal. In Study 1, partially supporting my hypotheses, habitual suppression and reappraisal mediated the relationship between self-reported maternal/paternal emotional neglect and perceived stress, though in females only; habitual suppression also mediated the relationship between maternal psychological maltreatment and perceived stress in females. In Study 2, structural equation modeling revealed that, as hypothesized, in both countries parental emotional neglect was positively associated with internalizing problems and negatively associated with habitual reappraisal; habitual reappraisal was negatively associated and habitual suppression was positively associated with internalizing problems. The positive association between parental emotional neglect and suppression was significant only in U.S. participants. In Study 3, partially supporting hypotheses, childhood maltreatment was associated with lower spontaneous reappraisal, higher negative affect at stress-test baseline, and higher behavioral expression during recovery; spontaneous suppression and reappraisal were associated with reduced emotional responsivity. Contrary to hypothesis, no mediating roles for spontaneous suppression and reappraisal were found. Together, results showed that habitual use of some emotion regulation strategies can mediate the relation between childhood maltreatment and later perceived stress (at least in females) and internalizing problems; habitual suppression mediates the association between parental emotional neglect and internalizing problems in U.S. young adults; and childhood maltreatment is related to emotional and behavioral responses to stress and effectiveness of spontaneous reappraisal strategy use during stress. / 2022-02-28T00:00:00Z

Research over the past 30 years suggests that sport can provide a context in which children are subjected to several forms of maltreatment. Various countries, regions, sports and individual organisations have responded to this evidence, causing a proliferation of methods used to safeguard children from harm. However, one approach that is yet to be considered is the safety culture approach. This is despite its potential to address all of the potential risk factors of child maltreatment in sport, and its evidenced ability to tackle a wide range of safety concerns in fields as far-reaching as healthcare, aviation and energy production. Based on this, the aim of this thesis was to conceptualise safety culture in sport from a child safeguarding perspective. A total of 45 interviews and 7 focus groups were conducted with participants from five organisations which differed on the grounds of size, mission and geographical location. Data was analysed using thematic analysis. Findings suggested that safety culture in sport is influenced by the presence and nature of; safety management systems, committed leadership and stakeholder engagement. Findings also suggested that these factors have an interconnected relationship, which influences the nature and strength of the safety culture. These factors and their subsequent safety culture were also found to be influenced by a multitude of internal and external contextual factors. Therefore, the findings of this thesis are used to present the Safety Culture Model for Safeguarding Children. This is the first of its kind as both a model of safety culture in sport, and a safety culture model that specifically relates to safeguarding children. Practical implications and avenues for future research are also presented.