[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the effects of abuse, and includes research articles on PACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs, PCEs and PACEs. Thank you, Harise!]
Human Trafficking
Andana C, Saldaña O, Rodríguez-Carballeira Á.
Understanding Child Sexual Exploitation Dynamics: Development and Validation of a Taxonomy of Recruitment and Domination Strategies. Sex Abuse. 2024:10790632241271091. PMID: 39122246
“Child sexual exploitation is a form of interpersonal violence which involves the use of manipulation, control, and coercion strategies to recruit and dominate minors. This study aimed to develop and validate a taxonomy that identifies, defines, and classifies these abusive strategies…also judged the frequency of each strategy's usage to recruit and dominate the victims in sex trade, sex trafficking, sex tourism, and online sexual exploitation. The taxonomy comprises 20 specific strategies, classified into five categories: isolation, control of personal life, emotional abuse, cognitive manipulation, and behavioral domination.”
Dunnigan AE, Fusco RA.
The relationship between commercial sexual exploitation and foster care placement in the U.S.: A scoping review. Child Abuse Negl. 2024;155:106950. PMID: 39089105
“Youth in foster care may be vulnerable to commercial and sexual exploitation of children in the US. Youth in care may show vulnerabilities such as running away, identifying as sexual/gender minorities, or exhibiting complex behavioral and mental health needs.” In this research review, authors note the lack of common definitions, lack of national databases, and lack of federal and state data sharing as obstacles to developing interventions.
Casassa K, England G, Karandikar S.
"It's Not Love, Baby Doll. It's Science": Experiences of Trauma Bonding Among Survivors of Sex Trafficking. Violence Vict. 2024 Aug 26:VV-2023-0005.R1. PMID: 39187293
“Trauma bonds between sex trafficking survivors and their traffickers or other perpetrators are one of the most complex and least understood concerns facing survivors.” From interviews with 19 female sex trafficking survivors, “survivors have experienced trauma bonds (a) as involuntary, (b) as having lingering power, and (c) as consisting of both love and hate. These findings contain significant implications for practice, policy, and future research.”
Helpingstine C, Kenny MC.
Working With Youth Who Have Experienced Commercial Sexual Exploitation: Voices From the Field. Violence Vict. 2024 Aug 12:VV-2022-0195.R1. PMID: 39134402
Twelve service providers shared their experiences working with youth who have experienced commercial sexual exploitation (CSE), including the challenges posed by working with this population, the breadth of necessary services and the type of support that is needed, the importance of being prepared to work with this population and learn from those with lived experience, the complexity of cases, and the difficulty engaging youth who had experienced CSE.
LGBTQ Concerns
Shirsat N, Finney N, Strutner S, et al.
Characterizing Chronic Pain and Adverse Childhood Experiences in the Lesbian, Gay, Bisexual, Transgender, or Queer Community. Anesth Analg. 2024 Oct 1;139(4):821-831. PMID: 38412111
From a survey of 136 LGBTQ individuals (average age of 29 years) reporting chronic pain, “47% had high ACE scores, and high ACE scores were significantly associated with higher average pain scores, and higher perceived current pain ratings…History of any sexual trauma was prevalent in 36.7% and was associated with chronic pain located in the pelvic region. Specific histories of forced sexual and touch encounters were associated with a specific diagnosis of fibromyalgia…indicates a need to explore trauma's role in perceived pain…type of trauma may also be crucial in understanding chronic pain development.”
Raney JH, Weinstein S, Testa A, et al.
Sexual identity is associated with adverse childhood experiences (ACEs) in US early adolescents. Acad Pediatr. 2024 Aug 10:S1876-2859(24)00290-0. PMID: 39134208
From a large national survey of adolescents aged 10-14 years, “LGB adolescents had higher risk of experiencing 2, 3, or ≥4 ACEs (2 ACEs Relative Risk Ratios [RRR] =1.57, 3 ACEs RRR=1.78, or ≥4 ACEs RRR=3.20), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR=2.17), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse ("yes" odds ratio =4.21, "maybe" OR=6.20) and parent mental illness ("yes" OR=1.95, "maybe" OR=1.63) compared to heterosexual adolescents…Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.”
Madzoska M, Lawrence D, Higgins DJ, et al.
Child Maltreatment, Mental Health Disorders, and Health Risk Behaviors in People With Diverse Gender Identities. J Interpers Violence. 2024:8862605241270077. PMID: 39152737
From a national Australian study, people with diverse gender identities who experienced child maltreatment were significantly more likely to have generalized anxiety disorder (43.3% vs. cisgender men 13.8% and cisgender women 17.4%). Similarly, higher prevalence was found for PTSD (21.3%), self-harm (27.8%) and suicide attempt (7.2%) for people with diverse gender identities.
Race/Cultural Concerns
Schweiberger K, Patel M, Ragavan MI.
Promoting Equity in Pediatric Health Care Through Language Services Reimbursement. Pediatrics. 2024 May 1;153(5):e2023064214. PMID: 38567419
“An estimated 21.7% of the US population speaks a language other than English, and 8.2% identifies as LEP [limited English proficiency]…Compared with English-speaking families, LEP families report worse care quality, are less likely to have a pediatric medical home, are more likely to experience adverse medical events, and are less likely to receive adequate pain treatment. Children with LEP parents may also be asked to assist in situations that may not be developmentally appropriate, such as interpreting during a medical visit or translating medical documents. LEP families are also often excluded from pediatric health research…Currently, only 17 state Medicaid and State Children’s Health Insurance programs pay for interpreter services, whereas 33 states require clinicians to provide interpretation services without additional payment…Universal payment for interpretation and translation services is necessary to…ensure high-quality services are provided to LEP families.”
Qian J, Wolfson C, Kramer B, Creanga AA.
Insights from preventability assessments across 42 state and city maternal mortality reviews in the United States. Am J Obstet Gynecol. 2024 Aug 26:S0002-9378(24)00870-6. PMID: 39197563
Preventability was analyzed among all deaths during pregnancy or within 1 year postpartum from any cause (pregnancy-associated deaths) and deaths during pregnancy or within 1 year postpartum from causes related to pregnancy or its management, but not from accidental causes...Of deaths that occurred after 2010, between 53% to 93.8% of pregnancy-associated deaths and 45% to 100% of pregnancy-related deaths were deemed preventable across the 42 states and cities…While collectively patient-family and provider factors were most frequently noted as contributing to pregnancy-related deaths…racism or discrimination were noted in relation to 37.7% of pregnancy-related deaths.
Jones MN, Elliott K, Sherman SN, et al.
"Racism happens every day, all the time": Black families' outpatient experiences of racism across a large pediatric system. Acad Pediatr. 2024 Aug 25:S1876-2859(24)00329-2. PMID: 39191371
From focus groups with parents or guardians of Black children, recruited from academic primary care offices at a single pediatric institution, “Black families have had many poor pediatric experiences, perceive racism as affecting child health broadly across socioecological levels, and recommend a multidimensional antiracist approach to improvement. Our findings underscore the importance of elevating Black family voices in developing policies that prioritize antiracism.”
Perpetrators
Hunt GR, Mathews B, Higgins DJ, et al.
The prevalence of child sexual abuse perpetrated by leaders or other adults in religious organizations in Australia. Child Abuse Negl. 2024:106946. PMID: 39103255
From a national Australian survey, 1 in 250 people reported being sexually abused as a child by an adult in a religious organization (0.4 %). Men reported significantly higher rates of child sexual abuse by these perpetrators (0.8 %), compared to women (0.1 %). This type of sexual abuse was overwhelmingly perpetrated by men compared to women, and was substantially more often experienced in Catholic organizations (71.9 %) than other Christian denominations or other religions. Prevalence of child sexual abuse in religious organizations has declined over time (2.2 % of men 65 years and older, compared with 0.2 % of 16-24-year-old men).
Police and Court Systems
Summers A, Gatowski SI.
A Multimethod Exploration of the COVID-Era Transition to Virtual Hearings in Child Welfare Court Cases. Child Maltreat. 2024 Aug;29(3):440-450. PMID: 38319043
“From a four-state court observation study conducted pre and post emergence of the pandemic, as well as from a national survey of court professionals and a survey of parents, we reflect on the experiences of courts and court participants with virtual hearings in child welfare cases. Findings indicate that despite stakeholder perceptions, there is little difference in the quality of hearings with respect to judicial engagement and discussion. Differences were found however, in the attendance of fathers and relatives at hearings, with less fathers and relatives attending virtual hearings. Parents had mixed experiences with the virtual hearing process. Professionals noted challenges, as well as strategies for overcoming challenges, to engage parents and ensure their access to virtual hearings.”
Providers
Quas JA.
Improving Outcomes for Vulnerable Children and Families: Applying what We Learned About the COVID-19 Pandemic and Child Maltreatment. Child Maltreat. 2024;29(3):516-8. PMID: 38715368
“One theme that emerged across these studies concerned challenges faced by professionals as they attempted to evaluate families and provide service and support. Organizational leadership was crucial in helping these professionals navigate challenges in a positive and productive manner. A second theme concerned remote service delivery. Findings suggested that remote maltreatment assessments, treatment, and court procedures all worked to some degree. Thus, despite the massive social disruption caused by the pandemic and lockdowns, parents, professionals, and systems were able to adapt and address core needs of children and families. In future work, it may be important to consider how these findings and their implications vary depending on the type of maltreatment children experienced.”
Stover CS, Holland ML, Martin E, et al.
Comparing in Person to Telehealth Delivery of a Family Violence Intervention. Clin Psychol Psychother. 2024;31(4):e3034. PMID: 39089327
Evaluating a Fathers for Change (F4C) intervention which was delivered in person pre-pandemic and then via telehealth, “There were few differences in completion rates or outcomes based on in-person compared to telehealth delivery. Fathers were slightly more likely to complete treatment and attended a significantly higher percentage of their sessions when it was delivered by telehealth during COVID. Fathers reported significantly lower stress scores posttreatment when they received COVID telehealth delivery compared to prior to COVID in-person delivery of F4C. These findings suggest that telehealth may be an appropriate and viable option for the delivery of IPV interventions for families.”
Goslin MC, Epstein C.
Telehealth Delivery of the Child and Family Traumatic Stress Intervention is Associated With Reduced Posttraumatic Stress in Children and Caregivers. Child Maltreat. 2024 Aug;29(3):430-439. PMID: 38379207
“The Child and Family Traumatic Stress Intervention is a brief (5-8 session), evidence-based, trauma-focused mental health treatment developed for implementation with children and caregivers in the early phase of the trauma response…9 agencies that provided CFTSI via telehealth in 2020 and 2021…revealed significant reductions in child and caregiver posttraumatic stress symptoms. Effect sizes were large and consistent with or stronger than prior studies of CFTSI implemented in person. Preliminary findings also indicated high levels of caregiver satisfaction.”
Baker M, Berens KA, Giesbrecht CJ, et al.
"Locked in a Jail Cell in Your Own Home": Child Maltreatment Investigators' Perspectives of COVID-19's Effects on Maltreated Children. Child Maltreat. 2024 Aug;29(3):415-429. PMID: 38086535
Focus groups with 16 Canadian child maltreatment investigators, “resulted in five primary themes regarding maltreatment investigators' perceptions of the pandemic's effects on children, including child maltreatment during the COVID-19 pandemic, increased exposure to violent and traumatic events, stress and challenges faced by families, reduced access to services, and challenges and delays with maltreatment investigations. Child maltreatment investigators perceived that the pandemic profoundly impacted maltreated children and their families. It is critical to ensure children and parents have access to services during future emergencies.”
Prevention
Volkow ND, Gordon JA, Bianchi DW, et al.
The HEALthy Brain and Child Development Study (HBCD): NIH collaboration to understand the impacts of prenatal and early life experiences on brain development. Developmental cognitive neuroscience. 2024;69:101423. PMID: 39098249
“Several NIH Institutes, Centers, and Offices collaborated to support and launch the HEALthy Brain and Child Development (HBCD) Study…that will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood… Knowledge gained from the HBCD Study will help identify targets for early interventions and inform policies.”
Edwards KM, Waterman EA, Wheeler LA, et al.
Preventing Adverse Childhood Experiences in a Sample of Largely Indigenous Children. Pediatrics. 2024 Sep 1;154(3):e2023065412. PMID: 39136077
“The Tiwahe Wicagwicayapi program (TWP) is a 7-session program that teaches skills to prevent ACEs and is rooted in Lakota culture, language, and history…compared with control participants, there were reductions in the incidence of child ACEs, bullying victimization, depression, and externalizing behaviors; and increased parent-child communication and child help-seeking behaviors. For caregivers, the program prevented IPV victimization and perpetration, harsh parenting, and depression; and increased emotion regulation, social support, and cultural connection.”
Ayano G, Rooney R, Pollard CM, et al.
Risk and protective factors of youth crime. Clin Psychol Rev. 2024;113:102479. PMID: 39178756
From a research review of risk and protective factors of youth crime, “11 factors were supported…Evidence of association was highly suggestive (class II) for substance use (odds ratio [OR] = 2·29), previous history of crime (OR = 2·03), moral development (OR = 3·98), psychopathology (OR = 2·22), adverse childhood experiences (OR = 1·37), poor parental supervision (OR = 1·85), maltreatment or neglect (OR = 1·34), attachment (OR = 1·94), and school bullying (OR = 2·50); and suggestive (class III) for peer pressure (OR = 2·11) and supportive school environments (OR = 0·56).”
Wortham W, Sullivan KS, Ancharski K, et al.
Reducing risk factors for child maltreatment: The Parenting-STAIR open pilot study. Child Abuse Negl. 2024;154:106942. PMID: 39079321
The novel intervention, Parenting-STAIR (P-STAIR), seeks to address maternal mental health and parenting skills in order to reduce punitive parenting behaviors…P-STAIR was administered to 112 child welfare-involved mothers in New York City …Among the 71 mothers who completed treatment, “significant improvements…were observed for nonviolent disciple, psychological aggression, expectations, empathy, and parent-child family roles.”
Platt C, Hunsley J, Platt B, Morrison H, Pace T, Gephart S.
Effects of a behavioral intervention with foster families. Child Abuse Negl. 2024;155:106984. PMID: 39126881
“95 currently fostering families across the US, participated in a 4-week, online, self-paced, behavioral intervention with an emphasis on the relationship between children residing in the home…Providing families the sibling-inclusive intervention caused an increase in positive indicators of sibling relationship and overall family hardiness. Researchers should consider the implications of supporting foster siblings and the affects their inclusion may have on outcomes for children in foster care.”
Newman EF, Efthymiadou E, Quayle E, et al.
The Impact of a Public Health Campaign to Deter Viewing of Child Sexual Abuse Images Online: A Case Study of the UK Stop It Now! Campaign. Sex Abuse. 2024;36(6):635-61. PMID: 37837444
“This paper explores the impact of The Lucy Faithfull Foundation's 'Stop It Now!' campaign in the UK (2015-2018) on help-seeking…there were more visitors to the help website during active campaigning periods, and helpline callers and website visitors were more likely to seek help after viewing campaign materials…Help-seekers were predominantly men concerned about their own behavior…their awareness of the law (75.5%), and legal and personal consequences (67.9%) had changed after hearing about the campaign, and 66% reported a change in behavior. Public health campaigns may be an effective way to promote help-seeking and prevent abuse.”
Researchers
Remmers MCC, Reijs RP, Hoebe C.
Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load. Scand J Public Health. 2024:14034948241260105. PMID: 39087715
“Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research…Conclusions: ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.”
Lemons J, Saravanan M, Tumin D, Anyigbo C. Caregiver Report of Adverse Childhood Events: Comparison of Self-Administered and Telephone Questionnaires. Children and youth services review. 2024;163. PMID: 39157649
“This study compares data on the prevalence of ACEs from two publicly available surveys conducted on the same population of children's caregivers…We find higher disclosure of caregiver-reported child exposure to ACEs in the telephone interview survey [vs. a mailed/web survey], highlighting the importance of the role of verbal communication in developing a safe and trusting relationship in the disclosure of trauma.”
Elklit A, Petterson M, Petersen AS, Nielsen T. Is there consensus on child violence exposure measures? A study of six recommended instruments. European journal of psychotraumatology. 2024;15(1):2392414. PMID: 39195629
“A systematic review published in 2023 recommended six child and adolescent self-report violence against children (VAC) measures [the Adverse Childhood Experiences (ACE), Childhood Trauma Questionnaire – Short Form (CTQ-SF), Parent–Child Conflict Tactics Scale (CTS-PC), Childhood Experiences of Care and Abuse Questionnaire (CECA.Q), ISPCAN Child Abuse Screening Tool (ICAST), and Juvenile Victimization Questionnaire (JVQ)]…The overall overlap between the six measures was 25%...The lack of overlap among measures reflects a heterogeneity of definitions and purposes. It also impedes progress in research, as comparisons between various studies are difficult to make in a valid and reliable way.”
McGuire A, Singh M, Jackson Y.
Let it go, let it go: Stop measuring child maltreatment as a binary yes/no. Child Abuse Negl. 2024;155:106994. PMID: 39154601
“The current paper sought to progress the field of CM [child maltreatment] and trauma research forward by reviewing several lines of research demonstrating why the use of a binary yes/no CM measurement approach is problematic…The ethical and clinical implications of a CM binary measurement approach are also discussed. Several recommendations for the field are provided on how researchers can improve the measurement of CM and ensure that accurate and replicable studies are being published.”
Rajan S, Buttar N, Ladhani Z, et al.
School Violence Exposure as an Adverse Childhood Experience: Protocol for a Nationwide Study of Secondary Public Schools. JMIR research protocols. 2024;13:e56249. PMID: 39196631
“Exposure to school violence, specifically intentional gun violence, is an increasingly prevalent ACE. The anticipation of school shootings has led to the implementation of school safety and security interventions that may increase anxiety, depression, and other indicators of poor mental well-being among students and staff alike…Data collection is currently ongoing and the expected completion date is January 2025…Analyses will be used to evaluate the role of ACEs on the relationships among exposure to an intentional school shooting, exposure to school safety strategies, and student outcomes (ie, mental health and well-being, perceptions of school safety, and educational outcomes).”
Other of Interest
Mathersul DC, Zeitzer JM, Schulz-Heik RJ, Avery TJ, Bayley PJ.
Emotion regulation and heart rate variability may identify the optimal posttraumatic stress disorder treatment: analyses from a randomized controlled trial. Front Psychiatry. 2024 Feb 8;15:1331569. PMID: 38389985
For 85 US veterans with clinically significant PTSD symptoms, “Veterans with poorer autonomic regulation [regulation of the autonomic nervous system in charge of heart rate, breathing, etc.] prior to treatment had better PTSD outcome with a yoga-based intervention, whereas those with better autonomic regulation did better with a trauma-focused psychological therapy. Findings show potential for the use of heart rate variability in clinical practice to personalize PTSD treatment.”
Lennon T, Kemal S, Heffernan ME, et al.
Childhood Exposure to Firearm Violence in Chicago and Its Impact on Mental Health. Acad Pediatr. 2024;24(6):982-6. PMID: 38101617
Data were collected in May-July 2022 from 989 parents with children aged 2-17 years from all 77 Chicago neighborhoods. “Firearm violence exposure was characterized as indirect (hearing gunshots or knowing someone who was shot) or direct (witnessing a shooting, being threatened with a firearm, being shot at but not injured, or being shot and injured)…More than one third (37%) of children were exposed to firearm violence with an indirect exposure prevalence of 32% and a direct exposure prevalence of 10%. Mental health symptoms associated with firearm violence exposure were reported for 20% of children…7% of children without firearm violence exposure compared to 31% with indirect exposure (adjusted odds ratio 6.2) and 68% with direct exposure (aOR 36.1)…Trauma informed care approaches to mitigate the negative mental health effects of both direct and indirect firearm violence exposure are critical.”
Testa A, Fu K, Jackson DB, Semenza DC, McKay S.
Adverse Childhood Experiences and Adult Household Firearm Ownership. JAMA network open. 2024;7(8):e2428027. PMID: 39145981
From a Nevada random digit phone survey with a 40.2% response rate, among the 1709 adults (50.9% males, mean age 48.5 years), 42.4% reported household firearm ownership. Household firearm ownership was lowest among respondents with 0 ACEs (30.8%) and highest among those with 4 or more ACEs (49.8%). “The relationship may be due to a heightened sense of vulnerability to physical violence and greater perceived threats to personal safety associated with a traumatic childhood, which lead individuals to seek self-protection. Furthermore, exposure to violence and instability in childhood may normalize the presence and use of weapons, making firearm ownership a more acceptable and familiar choice later in life. Still, having a firearm in the home is a known risk factor for suicide, homicide, and unintentional injury.”
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