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1.
In suspected child sexual abuse some professionals recommend multiple child interviews to increase the likelihood of disclosure or more details to improve decision-making and increase convictions. We modeled the yield of a policy of routinely conducting multiple child interviews and increased convictions. Our decision tree reflected the path of a case through the health care, welfare, and legal systems and estimated the increased probability of conviction with additional interviews. We populated our decision analysis model using literature-based estimates. We simulated the experiences of 1,000 cases at 250 sets of plausible parameter values representing different hypothetical communities. Multiple interviews increase by 6.1% the likelihood that an offender will be convicted in the average community. We estimate that one additional conviction will follow if 17 additional children are multiple interviewed. Implications for the children, costs of care, protection of other children, and the risk of false prosecution are discussed.  相似文献   

2.
Animal-assisted invention (AAI) in gaining attention as a therapeutic modality; however, the effect of it has not been well studied in the child welfare system. The purpose of this study was to examine the effects of AAI on stress indicators (as measured by salivary alpha-amylase (sAA), immunoglobulin A (IgA), and heart rate) in children undergoing forensic interviews for alleged sexual abuse. A repeated measures design was used in this study. Upon receiving signed, informed consents and assents, children were enrolled in the study. Children (n = 42), whose ages ranged from 5 to 14 years (M = 8.91, SD = 2.33), were assigned to either the intervention condition (n = 19; AAI during forensic interview) or the control condition (n = 23; standard practice forensic interview). Each child's parent/guardian completed a demographic form, and saliva samples and heart rate measures were obtained from each child before and after the forensic interview. Mixed linear models were tested, with the level of significance set at p ≤ 0.05. There was an interactive effect regarding the duration of the interview and the presence of the dog on sAA after the forensic interview (p = 0.047). There also was a significant interaction between age and length of interview (p = 0.01). Salivary immunoglobulin A tended to be lower (p = 0.055) when the therapy dog was present during the forensic interview. Results further indicated that the drop in heart rate was greater in longer interviews and with older children (p = 0.02) when the dog was present. Individuals working in child welfare systems can use the results of this study to advocate for the use of therapy dogs as a therapeutic intervention. More research is needed to further examine the relationships among AAI, salivary biomarkers, and stress responses in children to improve child welfare.  相似文献   

3.
OBJECTIVE--To determine the reliability of judgments about the likelihood of child sexual abuse based only on video recorded interviews. DESIGN--Blinded rating of likelihood of abuse by seven professional groups and comparison with consensus rating. SETTING--Child and adolescent psychiatry centre. SUBJECTS--Four people from each of seven professional disciplines: specialist psychiatrists, general psychiatrists, experimental psychologists, trainee social workers, trainee clinical psychologists, lawyers, and police. MAIN OUTCOME MEASURE--Rating of 12 recorded interviews. RESULTS--Agreement between the consensus panel and professional groups was 83% (151/183) for high likelihood cases (seven cases) and 89% (118/132) for low likelihood cases (five). Specialist psychiatrists and the police were better able to identify high likelihood cases than were other groups with less experience of interviewing sexually abused children (91% (48/53) v 79% (102/129); p = 0.05). CONCLUSIONS--Raters could accurately distinguish children with low likelihood of abuse on interview evidence alone, but those with more experience of dealing with sexual abuse were better at identifying high likelihood cases.  相似文献   

4.
Childhood maltreatment has been implicated as a risk factor for adult obesity. We describe the first prospective assessment of adult obesity in individuals with documented histories of childhood physical and sexual abuse and neglect and a matched comparison group in a 30‐year follow‐up. Using a prospective cohort design, children with court substantiated cases of physical and sexual abuse and neglect (ages 0–11 years) from a Midwest county during 1967–1971 (n = 410) were matched with children without histories of abuse or neglect on age, sex, race/ethnicity and approximate family social class (n = 303) and followed up and assessed at mean age 41. Outcome measures include BMI and obesity assessed in 2003–2004 as part of a medical status examination and interview. Childhood physical abuse predicted significantly higher BMI scores in adulthood (β = 0.14, P < 0.05), even controlling for demographic characteristics, cigarette smoking, and alcohol consumption (β = 0.16, P < 0.01). Childhood sexual abuse (β = 0.07, not significant) and neglect (β = 0.02, not significant) were not significant predictors of adult BMI scores. These results demonstrate the long‐term impact of childhood physical abuse on weight into adulthood and suggest that physically abused children may be at risk for other adverse health outcomes associated with increased weight. Health professionals need to understand this risk for physically abused children and researchers should identify and evaluate strategies for effective interventions.  相似文献   

5.

Background

Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes.

Methods and Findings

A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16–2.04], emotional abuse [OR = 3.06; 95% CI 2.43–3.85], and neglect [OR = 2.11; 95% CI 1.61–2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67–2.20], emotional abuse [OR = 1.41; 95% CI 1.11–1.79], and neglect [OR = 1.36; 95% CI 1.21–1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17–5.32], emotional abuse [OR = 3.37; 95% CI 2.44–4.67], and neglect [OR = 1.95; 95% CI 1.13–3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50–2.10], emotional abuse [OR = 1.75; 95% CI 1.49–2.04], and neglect [OR = 1.57; 95% CI 1.39–1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships.

Conclusions

This overview of the evidence suggests a causal relationship between non-sexual child maltreatment and a range of mental disorders, drug use, suicide attempts, sexually transmitted infections, and risky sexual behaviour. All forms of child maltreatment should be considered important risks to health with a sizeable impact on major contributors to the burden of disease in all parts of the world. The awareness of the serious long-term consequences of child maltreatment should encourage better identification of those at risk and the development of effective interventions to protect children from violence. Please see later in the article for the Editors'' Summary  相似文献   

6.
《应用发育科学》2013,17(1):6-15
Two studies examined discussions of truth and lying during interviews with children. In Study 1, truth-lie discussions (TLDs) during 132 actual sexual abuse interviews were analyzed, focusing on the types of questions asked and their developmental appropriateness. TLDs, which were fairly common for all ages of children interviewed, typically involved asking children closed-ended questions and did not differ in quality or form by age of child interviewed. Study 2 compared the typical TLDs (found in Study 1) to either no discussion or a more elaborate discussion in their effects on preschoolers' (n = 67) reports of an interactive event. Children given the extended TLD were significantly more accurate than those questioned following a typical or no TLD. The results suggest that discussing truth and lying with young children is effective only if the discussion is more elaborate than those typically conducted in forensic interviews.  相似文献   

7.
Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96%) of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers’ communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver’s perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child’s level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to facilitate the disclosure process as important avenues for further research.  相似文献   

8.
ObjectiveWe examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women.MethodsIn-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI).ResultsAny childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71).ConclusionThese data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence.  相似文献   

9.
Two studies investigated the role of group allegiances in contributing to the failure of institutions to appropriately respond to allegations of child sexual abuse. In Study 1, 601 participants read a news article detailing an allegation of child sexual abuse against a Catholic Priest. Catholics were more protective of the accused–and more skeptical of the accuser—than other participants, an effect that was particularly pronounced among strongly identified Catholics. In Study 2 (N = 404), the tendency for Catholics to be more protective of the accused and more skeptical of the accuser than non-Catholics was replicated. Moreover, these effects held independently of the objective likelihood that the accused was guilty. Overall, the data show that group loyalties provide a psychological motivation to disbelieve child abuse allegations. Furthermore, the people for whom this motivation is strongest are also the people who are most likely to be responsible for receiving and investigating allegations: highly identified ingroup members. The findings highlight the psychological mechanisms that may limit the ability of senior Church figures to conduct impartial investigations into allegations of child abuse within the Church.  相似文献   

10.
OBJECTIVE--To investigate general practitioners'' attendance at and views on child protection conferences and their confidence in dealing with sexual abuse in children. DESIGN--Anonymous postal questionnaire sent to all general practitioners in Tower Hamlets and review of consecutive case conferences held by social services for three months in 1989. SETTING--Tower Hamlets health district. SUBJECTS--91 general practitioners, 56 of whom (62%) responded. MAIN OUTCOME MEASURES--Number of conferences attended, reasons for non-attendance, and reported confidence in dealing with sexual abuse. RESULTS--General practitioners estimated that 202 child protection conferences had been held in 1989 on their patients and that they had attended 85 of these. Information from social services for three months suggested that general practitioners had attended only nine of the 114 conferences reviewed. Timing of the conference was the most important reason for non-attendance. All respondents wanted access to the minutes of these conferences irrespective of their own attendance. Most general practitioners were very or moderately confident of their ability to detect child sexual abuse and non-accidental injury and to communicate with the family. CONCLUSION--More effort should be made to ensure that general practitioners are notified of case conferences and that the timing and location of conferences is compatible with their other commitments.  相似文献   

11.
BackgroundUnprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.MethodsWe employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.ResultsSome men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing lovers or stable partners, the fear of losing partners in a context of non-serostatus disclosure was testified to be a major concern. MSM with casual partners reported that anonymous sexual encounters and moral judgments played a significant role in their sexual risk behaviors. Simultaneously, self-reported negative emotional and psychological status, perception and idiosyncratic risk interpretation, as well as substance abuse informed the intrapersonal context for UAI.ConclusionUAI among these HIV positive MSM was embedded in an intrapersonal context, related to partner type, shaped by anonymous sexual encounters, psychological status, and moral judgments. It is important that prevention and intervention for secondary HIV transmission among newly diagnosed HIV positive MSM in China take into account these contextual factors.  相似文献   

12.
《应用发育科学》2013,17(1):28-42
In investigative interviews concerned with allegations of sexual abuse, open-ended prompts by interviewers elicit more information than focused prompts. We attempted to explore these effects in investigations of physical abuse. Interviews with 50 children from 2 age groups (5–6-year-olds, 9–10-year-olds) who made subsequently substantiated allegations of physical abuse by their parents were subjected to detailed psycholinguistic analysis. The overall productivity (number of words spoken) and informativeness (number of details elicited) of these children were remarkably low. The children were also relatively unresponsive to the investigators' individual utterances, and many of the interviewers' utterances were nonsubstantive (15%). The interviewers were more likely than those included in studies of sexual abuse investigations to use open-ended as opposed to focused prompts. These open-ended utterances elicited significantly more words but not more details than focused prompts. Older children also provided longer and richer utterances than younger children. The discussion examines the reasons why open-ended utterances appear less fruitful in investigations of physical as opposed to sexual abuse.  相似文献   

13.
Parthenogenesis often evolves in association with hybridization, but the associated ecological consequences are poorly understood. The Australian gecko Heteronotia binoei is unusual because triploid parthenogenesis evolved through reciprocal crosses between two sexual lineages, resulting in four possible cytonuclear genotypes. In this species complex, we compared the performance of these parthenogenetic genotypes with their sexual progenitors for a suite of physiological traits (metabolic rate, thermal tolerance, locomotor performance, and in vitro activity and gene sequence divergence of a cytonuclear metabolic pathway, cytochrome C oxidase). Mass‐specific metabolic rate scaled differently with body mass for parthenogens and sexuals, while heat tolerance provided the only evidence for cytonuclear incompatibility in hybrid parthenogens. The most prominent phenotypic effects were attributable to nuclear genome dosage. Overall, our results suggest that the hybrid/polyploidy origin of parthenogenetic H. binoei has had surprisingly few negative fitness consequences and may have produced a broader overall niche for the species.  相似文献   

14.
Although young children may frequently be asked “How” and “Why” questions, it is unclear whether they have the ability to respond well enough to justify the use of these words during investigative interviews. The range of possible uses and interpretations of the words “How” and “Why” makes it critical to examine their use when communicatively immature children are interviewed. In this study, police interviews of 3- to 5-year-old suspected victims of sexual abuse (n = 49) were examined. The use of How/Why prompts by interviewers and children’s responses to interviewers’ How/Why prompts were coded. How/Why prompts represented 22% of all interviewer prompts. Of all details provided by children, however, 8.5% were in response to How/Why prompts. In addition, children provided the information sought in response to only 20% of the interviewers’ How/Why prompts, whereas uninformative responses were relatively common. Children responded to more How/Why prompts with the information sought by interviewers as they grew older. The findings suggest that How/Why prompts may not be particularly effective when interviewing preschool children.  相似文献   

15.
16.

Background:

Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.

Methods:

We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%).

Results:

The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose–response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.

Interpretation:

We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.Child abuse is a major public health problem worldwide with serious adverse effects at later ages. The best estimates of the prevalence of child abuse in Canada come from 2 representative samples from Ontario, 1 from 1990 (Ontario Health Supplement, n = 9953, age ≥ 15 yr)1 and 1 from 2000–2001 (Ontario Child Health Study, n = 1893, age 21–35 yr).2 The 1990 study indicated that 31% of males and 21% of females had experienced physical child abuse, and 4% of males and 13% of females had experienced sexual child abuse.1 Similar trends were noted in data collected in 2000–2001.2 Prevalence of sexual abuse was found to be higher in the Ontario Child Health Study, but this was thought to be related to the inclusion of sexual abuse committed by anyone (e.g., adolescents), rather than only adults, as was the case with the Ontario Health Supplement.1,2 Data from Quebec collected in 2006 indicated that 23% of men and 17% of women had experienced physical child abuse; 10% of men and 22% of women had experienced sexual child abuse; and 22% of men and women had experienced psychological child abuse, including exposure to intimate partner violence.3,4 Unfortunately, these estimates are dated, restricted to only 2 provinces, based on limited assessments of child abuse and, in the case of the Quebec data, involve a low response rate of 30%.Although the association between child abuse and subsequent mental conditions (including disorders, suicidal ideation and suicide attempts) is well established,59 we know little about differential effects associated with several abuse types and specific mental disorders, and we currently have no nationally representative Canadian data. Filling this gap in knowledge would produce evidence-based Canadian findings that could inform policy, prevention and intervention efforts specifically aimed at reducing both child abuse and poor mental health outcomes.Our overall objective was to extend our understanding of the relation between child abuse and mental conditions (i.e., mental disorders, suicidal ideation and suicide attempts)68,1019 with a more detailed examination of child abuse severity and mental health outcomes. We used a nationally representative Canadian sample to examine 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and 14 mental conditions, including suicidal ideation and suicide attempts. The specific research objectives were to estimate the prevalence of 3 types of physical abuse, sexual abuse and exposure to intimate partner violence; to examine the association of mental conditions with types of child abuse and number of child abuse types experienced; and to determine whether sex differences exist in the associations between child abuse and mental conditions.  相似文献   

17.

Background

HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women.

Methods

In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV.

Results

Over 93% (1817) disclosed the HIV results to their partners (96.5% HIV− vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.7–16.9), 35.2% among non-disclosers and 14.3% among disclosers. Overall 32.8% reported IPV (40.5% HIV+; 31.5% HIV− women, p = 0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.84–9.93).

Conclusion

The study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened.  相似文献   

18.
Socio-emotional dynamics were examined in 230 forensic interviews of 3- to -13-year-old Israeli children who disclosed chronic physical abuse that could be substantiated. Half of the children were interviewed using the Standard (SP) National Institute of Child Health and Human Development Protocol and the others using the Revised Protocol (RP) that emphasized emotional support from interviewers. When children disclosed physical abuse in the RP interviews, they did so in response to fewer prompts than children in the SP interviews. The number of turns in the transitional phase (during which the interviewer transitioned from rapport-building to exploring the possibility of abuse) was associated with increased directness and more specific utterance types. The younger children displayed reluctance more than older children. The RP interviews were characterized by more emotionally supportive statements throughout. These findings highlight various aspects of child forensic interviews that should be considered when seeking to understand children’s willingness to engage with interviewers.  相似文献   

19.

Background  

The evolutionary interests of males and females rarely coincide (sexual conflict), and these conflicting interests influence morphology, behavior and speciation in various organisms. We examined consequences of variation in sexual conflict in two closely-related passerine birds with contrasting breeding systems: the Eurasian penduline tit Remiz pendulinus (EPT) exhibiting a highly polygamous breeding system with sexually antagonistic interests over parental care, and the socially monogamous Cape penduline tit Anthoscopus minutus (CPT). We derived four a priori predictions from sexual conflict theory and tested these using data collected in Central Europe (EPT) and South Africa (CPT). Firstly, we predicted that EPTs exhibit more sexually dimorphic plumage than CPTs due to more intense sexual selection. Secondly, we expected brighter EPT males to provide less care than duller males. Thirdly, since song is a sexually selected trait in many birds, male EPTs were expected to exhibit more complex songs than CPT males. Finally, intense sexual conflict in EPT was expected to lead to low nest attendance as an indication of sexually antagonistic interests, whereas we expected more cooperation between parents in CPT consistent with their socially monogamous breeding system.  相似文献   

20.
The disclosure of incest is often difficult to accept. Denial or incredulity is common. Furthermore, attitudes to the consequences vary according to the period and the culture. The adverse effects of incest in children and young people could justify the prohibition of incest the world over. In this article, the authors report a case of a young student who consulted several health practitioners. Finally, he made a connection between his memories of incest with his grandmother and his failures in life. Recognition and long-term treatment of this sexual abuse within the family seem to be essential for the re-establishment of psychological development and social integration of this young man.  相似文献   

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