Academic literature on the topic 'Childhood Physical Neglect'

The current study investigates the relationship between intimate partner violence (IPV), childhood trauma, trait anxiety, depression, and anxious attachment in college students. Ninety-three male and 161 female undergraduate students at Fairfield University, ranging in age from 17 to 23, with a mean age of 18.8 years, participated. Participants completed five self-report inventories: The Conflict in Adolescent Dating Relationships Inventory (CADRI), the Childhood Trauma Questionnaire (CTQ), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), and the Adult Attachment Scale (AAS). IPV perpetration in college dating relationships was related to childhood emotional and physical abuse, emotional and physical neglect, and trait anxiety. IPV victimization in college dating relationships was related to childhood emotional and physical abuse, childhood emotional and physical neglect, and an anxious attachment style. IPV perpetration and victimization were also significantly correlated with one another. Subscale analyses suggest that childhood emotional abuse was related to being both the perpetrator and victim of verbal or emotional abuse in dating relationships. Childhood physical abuse, physical neglect, and emotional abuse were related to both perpetration and victimization of physical IPV. Threatening behavior perpetration in dating relationships was related to childhood emotional abuse, emotional neglect, physical abuse, and physical neglect; however, being the victim of threatening behavior was only related to childhood emotional abuse, physical neglect, and emotional neglect, not childhood physical abuse. These results support the relationship between childhood trauma and dating violence in college students. They also support a role for anxiety in IPV, although trait anxiety was related to perpetration and an anxious attachment style was correlated with IPV victimization. In addition, they suggest that different experiences of childhood trauma may relate to different aspects of IPV in college dating relationships.

The purpose of this study was to investigate whether high school students’ childhood trauma experiences differ based on individual differences, and whether childhood trauma experiences of adolescents predict empathic tendency and social problem solving. In this study, Childhood Trauma Questionnaire, Adolescent KA-Sİ Empathic Tendency Scale, and Social Problem Solving Inventory were used. Adolescents’ physical abuse, emotional abuse-neglect, and sexual abuse sub-dimensions of childhood trauma experience scores significantly differed based on gender. Adolescents’ physical abuse, emotional abuse-neglect sub dimensions of childhood trauma experience scores significantly differed based on father education-level, number of siblings and income- level of family. Adolescents’ emotional abuse-neglect sub dimension of childhood trauma experiences scores significantly differed based on mother education-level. Also physical abuse, emotional abuse-neglect sub dimensions of childhood trauma experiences predicted cognitive empathy whereas emotional abuse-neglect, sexual abuse sub dimensions of childhood trauma experiences predicted emotional empathy. The results also indicate that adolescents’ emotional abuse-neglect sub dimensions of childhood trauma experiences predicted sub dimensions of social problem solving.

Introduction Numerous authors associate child abuse with serious long-term consequences to the general and psychological well-being in particular. Clinical research to date reveals strong correlation between childhood abuse and neglect and anxiety disorders, especially panic disorder. Material and Methods This study was conducted in order to assess the level of emotional, physical and sexual childhood abuse as well as the physical and emotional childhood neglect in 40 adult patients suffering from panic disorder, diagnosed in accordance with the 10th International Classification of Disorders diagnostic criteria, compared with the control group of 40 healthy test subjects without a history of psychiatric disorders, using the Childhood Trauma Questionnaire. The severity of the clinical manifestation in patients with panic disorder was assessed using the Panic Disorder Severity Scale. Results and Discussion There were no significant differences between the groups as to the level of sexual abuse and physical neglect, whereas in the group of patients with panic disorder, the level of physical and emotional abuse was significantly higher, with emphasis on emotional neglect. With regards to the correlation between the severity of the clinical manifestation in patients with panic disorder and the severity of suffered abuse and neglect in childhood age, significant correlation was found in the physical and emotional abuse as well as emotional neglect. There was no significant correlation in the aspect of the physical neglect and sexual abuse. Conclusion Our research underlines the importance of childhood physical abuse, and especially emotional abuse and emotional neglect in the occurrence of panic disorder later in life.

AbstractPrevious research suggests that the experience of abuse and neglect in childhood has negative implications for physical health in adulthood. Using data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 115), the present research examined the predictive significance of childhood physical abuse, sexual abuse, and physical/cognitive neglect for multilevel assessments of physical health at midlife (age 37–39 years), including biomarkers of cardiometabolic risk, self-reports of quality of health, and a number of health problems. Analyses revealed that childhood physical/cognitive neglect, but not physical or sexual abuse, predicted all three health outcomes in middle adulthood, even when controlling for demographic risk factors and adult health maintenance behaviors. We discuss possible explanations for the unique significance of neglect in this study and suggest future research that could clarify previous findings regarding the differential impact of different types of abuse and neglect on adult health.

Introduction. Recent research has drawn attention to the link between childhood maltreatment and schizophrenia. Child abuse and neglect may have an impact on symptoms and physical health in these patients. This association has not been studied to date in India.Materials and Methods. Clinically stable patients with schizophrenia (n=62) were assessed for childhood adversity using the Childhood Trauma Questionnaire. The association of specific forms of adversity with symptomatology and associated variables was examined.Results. Emotional abuse was reported by 56.5% patients and physical abuse by 33.9%; scores for childhood neglect were also high. Persecutory delusions were linked to physical abuse, while anxiety was linked to emotional neglect and depression to emotional abuse and childhood neglect. Physical abuse was linked to elevated systolic blood pressure, while emotional abuse and neglect in women were linked to being overweight.Conclusions. Childhood adversity is common in schizophrenia and appears to be associated with a specific symptom profile. Certain components of the metabolic syndrome also appear to be related to childhood adversity. These results are subject to certain limitations as they are derived from remitted patients, and no control group was used for measures of childhood adversity.

Objective: This study was designed to explore the relationship between five forms of childhood trauma and medically self-sabotaging behaviors (i.e., the intentional induction, exaggeration, and/or exacerbation of medical symptoms). Method: Using a cross-sectional sample of convenience, 120 psychiatric inpatients were surveyed about childhood sexual, physical, and emotional abuses, the witnessing of violence, and physical neglect, as well as 19 medically self-sabotaging behaviors (i.e., intentional behaviors that represent attempts to sabotage medical care). Results: As expected, in this sample there were high prevalence rates of trauma (62.5% emotional abuse, 58.3% witnessing of violence, 46.7% physical abuse, 37.5% sexual abuse, 28.3% physical neglect). Simple correlations demonstrated statistically significant relationships between sexual abuse and physical neglect and medically self-sabotaging behaviors. Using multiple regression analysis, only physical neglect remained a unique predictor of medically self-sabotaging behaviors. Conclusions: These findings indicate that among psychiatric inpatients there appears to be a relationship between physical neglect in childhood and the generation of medically self-sabotaging behaviors in adulthood. Perhaps physical neglect in childhood contributes to the generation of somatic behaviors in adulthood for the purpose of eliciting caring responses from others.

AbstractChildhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features (MAbuse = 23.5, MNeglect = 18.8, MControl = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.

Objective: To examine the relationship between childhood trauma and dissociative experience in adulthood in patients with borderline personality disorder. Method: Dissociative experiences scale scores and subscale scores for the Childhood Trauma Questionnaire were correlated in 139 patients. Patients were dichotomized into high or low dissociators using the Median Dissociative Experiences Scale score as the cut-off. Results: Childhood Trauma Questionnaire Subscale scores for emotional and physical abuse and emotional neglect but not sexual abuse correlated significantly with Dissociative Experiences Scale scores. High dissociators reported significantly greater levels of emotional abuse, physical abuse, emotional neglect and physical neglect but not sexual abuse than low dissociators. Conclusion: Patients with borderline personality disorder therefore demonstrated levels of dissociation that increased with levels of childhood trauma, supporting the hypothesis that traumatic childhood experiences engender dissociative symptoms later in life. Emotional abuse and neglect may be at least as important as physical and sexual abuse in the development of dissociative symptoms.

Introduction: While the relationship between childhood trauma and employment disability has undergone very limited study, existing data suggest a possible correlation. Method: In this study of 91 outpatients in an internal medicine setting, we surveyed participants and inquired about their childhood histories of sexual, physical, and emotional abuse, of physical neglect, and of witnessing violence. We also asked whether participants had ever been on employment disability, either psychiatric or non-psychiatric, and the length of that disability. Results: Being or having been on disability was significantly related to childhood histories of emotional abuse, physical neglect, and witnessing violence. Being or having been on psychiatric disability was significantly related to childhood emotional abuse and physical neglect while being on non-psychiatric medical disability was significantly related to witnessing violence. The percent of one's lifetime on disability was significantly related to physical and emotional abuse as well as witnessing violence. Conclusions: Maltreatment in childhood appears to have a relationship to employment disability in adulthood. The authors discuss the implications of these findings.

AbstractBackgroundChildhood maltreatment is robustly associated with increased risk of poor mental health outcome and changes in brain function. The authors investigated whether childhood experience of abuse (e.g. physical, emotional and sexual abuse) and neglect (physical and emotional deprivation) was differentially associated with neural reactivity to threat.MethodsParticipants were drawn from an existing study and allocated to one of four groups based on self-report of childhood maltreatment experience: individuals with childhood abuse experiences (n = 70); individuals with childhood neglect experiences (n = 87); individuals with combined experience of childhood abuse and neglect (n = 50); and non-maltreated individuals (n = 207) propensity score matched (PSM) on gender, age, IQ, psychopathology and SES. Neural reactivity to facial cues signalling threat was compared across groups, allowing the differential effects associated with particular forms of maltreatment experience to be isolated.ResultsBrain imaging analyses indicated that while childhood abuse was associated with heightened localised threat reactivity in ventral amygdala, experiences of neglect were associated with heightened reactivity in a distributed cortical fronto-parietal network supporting complex social and cognitive processing as well as in the dorsal amygdala. Unexpectedly, combined experiences of abuse and neglect were associated with hypo-activation in several higher-order cortical regions as well as the amygdala.ConclusionsDifferent forms of childhood maltreatment exert differential effects in neural threat reactivity: while the effects of abuse are more focal, the effects of neglect and combined experiences of abuse are more distributed. These findings are relevant for understanding the range of psychiatric outcomes following childhood maltreatment and have implications for intervention.

The purpose of the current study was to investigate the relationship between Borderline Personality Disorder (BPD) symptoms and childhood experiences, and to explore the role of Early Maladaptive Schemas and core beliefs as variables possibly mediating this relationship. Previous research with clinical samples has established a strong link between childhood maltreatment and adult BPD (& other PD) symptoms in clinical samples. However, difficulties with these studies limit the specificity of results. For example, BPD has been shown to be highly comorbid with other axis I and axis II psychiatric conditions. Given that studies examining the relationship between BPD and childhood maltreatment generally fail to control for these comorbid conditions, the specificity of their results must be questioned. Furthermore, it has been well established that childhood familial environment is strongly related to childhood maltreatment. Again studies examining the relationship between BPD and childhood maltreatment have generally failed to concurrently assess childhood familial environments, hence opening the possibility that the relationship between BPD and childhood maltreatment may be due to family functioning rather than childhood maltreatment per se. Finally, studies linking childhood maltreatment with adult BPD have primarily utilized clinical samples. However, the primary use of clinical samples to examine the aetiology of disorders in this context ignores the vast literature showing adequate psychological functio ning for the majority of individuals exposed to childhood maltreatment. Hence, the primary aim of the current study was to examine the relationship between childhood maltreatment and adult BPD symptoms in a primarily non-clinical sample whilst statistically controlling for commonly comorbid axis I and axis II symptomatology and concurrently measuring childhood familial functioning. It was a secondary aim of the current study to examine the mediating effects of beliefs on the relationship between childhood factors (i.e., childhood maltreatment & childhood familial functioning) and adult BPD symptomatology. That is, cognitive-behavioural theorists argue that personality disorders may be triggered by adverse childhood experiences leading to maladaptive beliefs (or schemas) related to the self, others, and the world, and it is these beliefs which lead to the behavioural disturbances evident in personality disorders. One hundred and eighty-five primarily non-clinical participants completed questionnaires measuring a variety of axis I and axis II symptoms, early maladaptive schemas and core beliefs, as well as retrospective reports of family functioning and childhood maltreatment. Results showed a significant relationship between childhood factors and adult BPD symptomatology. For example, the largest correlation between BPD symptoms and a childhood factor was .27 (for childhood emotional abuse). Furthermore, early maladaptive schemas and core beliefs were found to mediate the relationship between childhood factors and adult BPD symptomatology thus supporting cognitive-behavioural theories of personality disorders. However, early maladaptive schemas and core beliefs were also found to mediate the relationship between childhood factors and other Axis I and Axis II symptoms. Hence, it was concluded that while there was some support for a cognitive mediation hypothesis for BPD symptoms, future research is needed in exploring the specificity of the cognitive mediation hypothesis for BPD.

Introdução: A dor pélvica crônica é uma condição clínica de elevada prevalência, cuja compreensão da fisiopatologia envolvida, ainda é parcial. A IASP (International Association for Study of Pain) define DPC como: dor crônica ou persistente percebida em estruturas relacionadas à pelve (sistema digestório, urinário, genital, miofascial ou neurológico), frequentemente associada com consequências emocionais, sexuais, comportamentais e cognitivas negativas, assim como com sintomas sugestivos de disfunções daqueles sistemas. Incluem-se tanto dor cíclica, como dismenorreia, quanto acíclica. Do ponto de vista temporal, considera-se crônica, via de regra, quando a duração é igual ou superior a seis meses (http://www.iasp-pain.org/files/Content/ContentFolders/Publications2/ClassificationofChronicPain/Part_II-F.pdf; acessado em 13 de novembro de 2014). Está associada a diversas comorbidades e impacto conjugal, social e econômico desfavorável. Embora sugestivo, não temos dados objetivos de países em desenvolvimento sobre a associação de maus tratos sofridos na infância com dor pélvica crônica e sua relação com sintomas de ansiedade e depressão. Objetivos: Investigar a prevalência de maus tratos na infância em mulheres com dor pélvica crônica e sua correlação com os transtornos do humor. Casuísticas e Métodos: Foi realizado um estudo do tipo transversal, no qual foram incluídas 77 mulheres com DPC atendidas consecutivamente em um ambulatório especializado de dor pélvica crônica. Optamos também por avaliar um grupo de 77 mulheres saudáveis atendidas no ambulatório de ginecologia geral. Utilizamos o Questionário Sobre Traumas na Infância (QUESI) para avaliar a prevalência de maus tratos gerais e específicos, enquanto que os escores de risco para ansiedade e depressão foram obtidos pela Escala de Medida de Ansiedade e Depressão Hospitalar (HAD) e a intensidade de dor foi avaliada a partir da Escala Analógica Visual (EVA). A análise estatística dos dados se deu pelo teste DAgostino para averiguar se as variáveis contínuas apresentavam distribuição normal. Optamos por avaliarmos a diferença entre os grupos através do teste de Wilcoxon (Mann-Whitney) e a análise de diferenças entre proporções utilizamos o teste Qui-Quadrado. Para atingir o objetivo foi proposto uma análise de correspondência múltipla Foi utilizado a plataforma multivariada para avaliar a correlação entre o QUESI e os escores de ansiedade e depressão com estimativa de robustez para não considerar eventuais outliers. Resultados: A prevalência de maus tratos na infância foram 77,9% e 64,9%, respectivamente para mulheres com e sem DPC (p = 0.05). Em relação a exposição a 3 e/ou 4 eventos múltiplos de maus tratos na infância, obtivemos as seguintes prevalências para as mulheres com e sem DPC, respectivamente: 23,4% e 15,6% (p= 0.05); 18,2% e 10,4% (p= 0.03). A prevalência de abuso sexual, abuso físico, abuso emocional, negligência física e negligência emocional, respectivamente para mulheres com DPC e saudáveis, foram: 29,9% e 20,8% (p= 0.19); 45,4% e 31,2% (p= 0.07); 48% e 35,1% (p= 0.10); 58,4% e 44,1% (p= 0.08) e 58,4% e 41,5% (p= 0.04). Somente o subtipo negligência emocional apresentou diferença estatisticamente significativa. A prevalência de sintomas significativos de ansiedade e depressão nos grupos com dor e controle foram respectivamente: 55,8% (43/77) e 40,2% (31/77) (p= 0.05); 45,4% (35/77) e 23,4% (18/77) (p= <0.01). Quando correlacionamos os dados obtidos nos instrumentos QUESI e HAD no grupo de DPC e controle, observamos uma correlação positiva entre elas, porém não identificamos a mesma correlação nos subtipos abuso sexual (HAD-D) e negligência física (HAD-A) no grupo controle. A análise de correspondência múltipla mostra uma correspondência entre presença de dor pélvica crônica e raça (cor não branca) e escolaridade abaixo de 10 anos; e correspondência entre sintomas significativos de ansiedade e depressão com múltiplos maus tratos (mais que dois ou três) e, especificamente com negligência emocional, abuso emocional, abuso físico e abuso sexual. Conclusões: Mulheres com DPC apresentam índices de negligência emocional maiores que o grupo de mulheres saudáveis e maiores indices de risco de transtornos de humor específicos quando correlacionados ambos instrumentos. Pacientes com DPC apresetaram sintomas de depressão e ausência de atividade laboral remunerada que se associam de modo independente, sendo fatores de riscos que podem levar, à longo prazo, o desenvolvimento de DPC na população feminina.
Background: Chronic pelvic pain is a clinical condition of high prevalence, whose understanding of the pathophysiology involved, is still partial. IASP (International Association for the Study of Pain) define CPP as chronic or persistent pain perceived in the pelvis related structures (digestive system, urinary, genital, myofascial or neurological), often associated with emotional, sexual, behavioral and cognitive negative consequences, as well as with symptoms suggestive of dysfunction of those systems. Include both cyclic pain, such as dysmenorrhoea, the acyclic. The time point of view, it is considered chronic, as a rule, when the duration is less than six months (http://www.iasp-pain.org/files/Content/ContentFolders/Publications2/ClassificationofChronicPain/Part_II-F.pdf; accessed on November 13, 2014). Is associated with several comorbidities and marital impact, social and economic unfavorable. Although suggestive, we have no objective data from developing countries on the involvement of abuse suffered in childhood with chronic pelvic pain and its association with symptoms of anxiety and depression. Objectives: To investigate the prevalence of child maltreatment in women with chronic pelvic pain and its correlation with mood disorders. Patients and Methods: We conducted a cross-sectional study, in which were included 77 women with CPP seen consecutively in an outpatient clinic for chronic pelvic pain. We chose also evaluate a group of 77 healthy women attended the general gynecology outpatient clinic. We use the Childhood Trauma Questionnaire (QUESI) to assess the prevalence of poor general and specific treatment, while the risk scores for anxiety and depression were obtained by the Hospital Anxiety and Depression Rating Scale (HAD) and pain intensity was evaluated from the Visual Analogue Scale (VAS). Statistical analysis of data was by D\'Agostino test to see if continuous variables normally distributed. We chose to evaluate the difference between the groups using the Wilcoxon test (Mann-Whitney) test and the analysis of differences between proportions used the chi-square test. To achieve the goal has been proposed a multiple correspondence analysis. We used multivariate platform to evaluate the correlation between the QUESI and the scores of anxiety and depression with robustness estimated not to consider any outliers. Results: The prevalence of childhood maltreatment were 77.9% and 64.9% respectively for women with and without CPP (p = 0.05). Regarding exposure to 3 and / or 4 multiple events of childhood maltreatment, we obtained the following rates for women with and without CPP, respectively: 23.4% and 15.6% (p = 0.05); 18.2% and 10.4% (P = 0.03). The prevalence of sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect, respectively for women with CPP and healthy, were 29.9% and 20.8% (p = 0.19); 45.4% and 31.2% (p = 0.07); 48% and 35.1% (p = 0.10); 58.4% and 44.1% (p = 0.08) and 58.4% and 41.5% (P = 0.04). Only the emotional neglect subtype showed a statistically significant difference. The prevalence of significant symptoms of anxiety and depression in groups with pain control and were, respectively, 55.8% (43/77) and 40.2% (31/77) (p = 0:05); 45.4% (35/77) and 23.4% (18/77) (p = <0.01). When we correlate the data from the instruments QUESI and HAD in CPS and control groups, we observed a positive correlation between them, but did not identify the same correlation in subtypes sexual abuse (HAD-D) and physical neglect (HAD-A) in the control group. Multiple correspondence analysis shows a correlation between the presence of chronic pelvic pain and race (non-white) and schooling below 10 years; and correspondence between significant symptoms of anxiety and depression with multiple abuse (more than two or three) and specifically with emotional neglect, emotional abuse, physical abuse and sexual abuse. Conclusions: Women with CPP have higher emotional neglect rates that the group of healthy women and higher indices of risk specific mood disorders when correlated both instruments. Patients with CPP show symptoms of depression and lack of paid work activity that are associated independently, and risk factors that can lead in the long run, the CPP development in the female population.

Text in English
The rationale for the study was to investigate the symbiotic connection of trauma and addiction. The focus is on childhood trauma and the turn to addictive practices to quell the memories and experiences endured as children. Chapter One discusses the methodology regarding the approach of the study and includes an introductory literature review of the phenomena. Additional literature is included in the ensuing chapters. A personal account of the motivation behind the research is chronicled in Chapter Two. In this chapter, I share with the readers my personal experiences around trauma and addiction in my family of origin. The notion of the blending of trauma and addiction is the focus of Chapter Three. It includes the approach to treatment of trauma and addiction as well as addiction counsellor training in the South African context. The storied lives of the participants and their experiences of trauma and addiction are encapsulated in Chapter Four. Finally, Chapter Five rounds off the study with the analyses of the narratives of the unique individuals who contributed to this research undertaking.
Psychology
M.A. (Psychology)

This essay reviews the evidence regarding the impact of childhood abuse (e.g., physical, sexual, psychological, maltreatment, and neglect) on long-term outcomes, such as violence, criminality, abuse, mental health problems, and physical health problems, in adolescence and adulthood. Overall, childhood abuse is highly detrimental to these outcomes, with evidence suggesting that “more is worse” when it comes to its lasting effects. This essay also briefly reviews the theoretical bases upon which the research regarding childhood abuse and later outcomes is founded and discusses the evidence regarding moderating variables, such as age, gender, and race/ethnicity. Finally, it concludes with a discussion of the theoretical and methodological limitations in the research and suggests avenues for future endeavors to consider.

Obesity is a highly visible yet neglected chronic health problem affecting developed and developing nations, particularly nations undergoing nutritional transition. The term ‘globesity’ has been coined to describe this international phenomenon, which primarily results from persistent energy imbalance typically characterized as reduced energy expenditure relative to energy intake. Conversely, disordered eating characterized by low energy intake, which is often paired with high levels of energy expenditure, are features of the opposite extreme to obesity and can manifest as eating disorders like anorexia nervosa or bulimia nervosa. Identification, treatment, and management of young people along the spectrum from frank eating disorders represents a persistent and growing health challenge. This chapter provides an overview of the range of factors contributing to inappropriate eating and activity disorders in childhood and adolescence, and how these problems might be managed.

There are five main types of childhood trauma: physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. Since childhood trauma can affect the child’s health and well-being even long after the trauma has occurred, it is essential for social workers to be able to categorize the trauma to develop better interventions that will help prevent long-term traumatic effects. However, it is also important to understand the three major manifestations a trauma can take form of in children. Childhood trauma can cause, influence, or exacerbate how people cope with mental illness. It can increase the risk of developing risky, addictive, or criminogenic behavior like substance abuse later in life. Trauma can also harmfully affect a child’s development, resulting in negative life outcomes. Social workers need to be able to implement trauma-informed care programs while also making use of the findings about the relationship between neuroscience and childhood trauma for further practice.

Adolescence, the second decade of life, is a period of transition from childhood to adulthood marked by rapid changes, which are physical, social, and psychological in nature. Of the 12 million girls born in India every year, 1.5 million girls die before the age of one and one out of every four does not live to celebrate her fifteenth birthday due to gender discrimination and gross neglect. This can be linked to neglect of females as infants, as children, as adolescents, and as mothers. Impaired mental and emotional health is a precursor or consequence of many health-risk behaviors such as physical, sexual, social, or emotional abuse. These dilemmas arise out of everyday issues like peer influence, dating identity, emerging sexuality, independence, separation, identity crises, anxiety, and responsibility as well as more serious ones like violent behavior, experimental sex, teenage suicides, and other health-related disorders.

This case focuses on the effects of trauma on the language and social pragmatic communication of a 10-year-old girl who was one of the many children separated from familial caregivers between 2016 and 2019 when she and her parents came to the U.S. from Central America seeking asylum due to gang violence and economic reasons. The child spent 8 months in the detention center without her parents and then was transferred to a foster home where she suffered neglect as well as physical and psychological abuse. This case study focuses on the long-term effects of structural violence and maltreatment on child development, and specifically on language and social pragmatic communication.

At baseline, borderline patients reported higher rates of adult rape and physical assault by a partner than Axis II comparison subjects. Four risk factors were found to significantly predict whether borderline patients had an adult history of being a victim of physical and/or sexual violence before their index admission: female gender, a substance use disorder that began before the age of 18, childhood sexual abuse, and emotional withdrawal by a caretaker (a form of neglect). At six-year and 10-year follow-up, borderline patients reported higher rates of being verbally, emotionally, physically, and sexually abused or assaulted than did Axis II comparison subjects. However, each of these forms of abuse declined significantly over time. The clinical implications of these prevalence and predictive findings are discussed.

This chapter offers a wide overview of the most prominent findings regarding child sexual abuse (CSA), and suggestions for providing support and intervening appropriately in schools. Studies show that one out of 8 adults was sexually abused during childhood or teenage years, which confirms that CSA is a widespread type of maltreatment. CSA is a substantial risk factor in the development of a host of short and long-term negative consequences, including school-related problems and mental health difficulties. Intervention strategies are now well established in the field, along with school-based prevention programs that have been shown to be effective in increasing student’s knowledge on CSA and self-protection skills, although there is little evidence that primary prevention programs do prevent CSA from occurring in the first place. This chapter will highlight research findings that speak to teachers’ knowledge and perceived ability to intervene among CSA victims, and to the disclosure processes in the context of school settings. For a more comprehensive understanding of child maltreatment and the range of educational supports, readers are encouraged to also review Chapters 14 (neglect) and 15 (physical and emotional abuse).

The black and Latina women who migrate to the coal region leave behind traumatic histories—stories of early childhood abuse and neglect, poverty, extreme neighborhood violence, and drug abuse. Upon arrival, these women face accusations that they are unfit mothers, have poor work ethics, and are undeserving of government aid. They nonetheless fight to get a fleeting shot at opportunities for their children that they themselves never had. These women encounter multiple predatory institutions waiting to take advantage of their optimism. Through small, everyday acts of civic engagement, they hold the police, their neighbors, local businesses, and schools accountable for their loved ones’ futures. Living a life of emotional turmoil, relationship flux, racial hostility, and poverty, however, leaves these women emotionally raw, deeply distrustful, and physically depleted. They can devote themselves only to their immediate kinship circles, determined to heal themselves on their own.

Treating sick children creates a range of ethical and legal considerations that are different from adult medicine. Paediatrics adapts as children develop cognitively, physically, and in autonomy. The introduction of new vaccines, therapies, and technology has improved the outcome for many conditions, including preterm birth, CHD, and oncology. At the same time as improvements in medicine and technology has come increased societal expectation, the impact of social media, and the rise of obesity in childhood. There are complex and blurred lines to be negotiated in parental, individual clinician, and institutional responsibility, especially when things go wrong. Paediatrics involves complex cases of neglect and abuse of children that have occurred in all societies and cultures. In this chapter, some of these aspects are discussed, including an outline of ethical principles that allow us to frame decision-making, how the law in the United Kingdom has evolved, and some of the principles of the Children Act 1989 and the Human rights Act 1998.

Each year an estimated one billion children (one out of two children worldwide) suffer some form of physical, sexual or psychological violence or neglect (Hillis, Mercy, Amobi, & Kress, 2016). Being a victim of violence in childhood has lifelong impacts on education, health, and well-being. Exposure to violence can lead to poor academic performance due to cognitive, emotional, and social problems (WHO, 2019). The right of the child to freedom from all forms of violence is affirmed by the United Nations Committee on the Rights of the Child, in its General Comment No. 13 (UNCRC, 2011). Moreover, the Sustainable Development Goals contain a clear call to eliminate violence against children, most explicitly in Target 16.2 (UN, 2015). Many efforts have been made globally to achieve these goals. Schools have been identified as one of the crucial contexts for conducting violence prevention efforts. They offer an important space where children, teachers and educators can learn and adopt pro-social behaviors that can contribute to preventing violence (WHO, et al., 2016). Teachers can play a key role, helping to build a “violence-free world” (UNESCO, WHO, UNICEF, End Violence Against Children, 2020), both by promoting positive relationships and by identifying signs of violence early. In fact, while international strategies provide a necessary framework for the promotion and protection of children's rights, it is the people who can make a difference in the prevention and detection of violence against children (Biffi, 2018). Based on these premises, the paper will focus on how teacher training can help prevent, report and address violence against children. Teachers are often not trained on this: some of them know the contents, but have doubts about how to deal with certain situations. Teachers should learn what to do with students who have gone through a traumatic experience because children choose someone who can see and recognize them (Miller, 1979, En. transl. 1995; Miller, 1980, En. transl. 1983). To be able to really recognize the child, a training course with teachers is necessary, to raise awareness and help them see the signals that children send (The Alliance for Child Protection in Humanitarian Action, End Violence Against Children, UNICEF, WHO, 2020). This paper, through literature and presentation of a training course with teachers in Italy, will offer a pedagogical reflection on teacher training in the prevention, reporting and addressing of violence against children, in order to start building a common shared strategy.