Associations between child maltreatment, PTSD, and internet addiction among Taiwanese students

AbstractThis study examines (1) the associations between multiple types of child maltreatment and Internet addiction, and (2) the mediating effects of post-traumatic stress disorder (PTSD) on these associations. We collected data from a national proportionately stratified random sample of 6233 fourth-grade students in Taiwan in 2014. We conducted bivariate correlations and sets of multiple regression analyses to examine the associations between multiple types of maltreatment (5 types in total) and Internet addiction, and to identify the mediating role of PTSD. The results reveal that being male and experiencing abuse (psychological neglect, physical neglect, paternal physical violence, sexual violence) were associated with increased risk among children of developing PTSD and Internet addiction. Moreover, PTSD mediated the associations between multiple types of maltreatment (except maternal physical violence) and Internet addiction. This study demonstrates (1) the effects of multiple types of maltreatment on the PTSD and Internet addiction of children and (2) the importance of early prevention and intervention in addressing related public-health concerns

Associations between child maltreatment, PTSD, and internet addiction among Taiwanese students

This study examines (1) the associations between multiple types of child maltreatment and Internet addiction, and (2) the mediating effects of post-traumatic stress disorder (PTSD) on these associations. We collected data from a national proportionately stratified random sample of 6233 fourth-grade students in Taiwan in 2014. We conducted bivariate correlations and sets of multiple regression analyses to examine the associations between multiple types of maltreatment (5 types in total) and Internet addiction, and to identify the mediating role of PTSD. The results reveal that being male and experiencing abuse (psychological neglect, physical neglect, paternal physical violence, sexual violence) were associated with increased risk among children of developing PTSD and Internet addiction. Moreover, PTSD mediated the associations between multiple types of maltreatment (except maternal physical violence) and Internet addiction. This study demonstrates (1) the effects of multiple types of maltreatment on the PTSD and Internet addiction of children and (2) the importance of early prevention and intervention in addressing related public-health concerns

Ecological Predictors and Trajectory of Internet Addiction from Childhood through Adolescence: A Nationally Representative Longitudinal Study

We examined multidimensional factors within four systems (individual, family, school, and community) that influence internet addiction across time among children through adolescence in Taiwan. We hypothesize that internet addiction increases from childhood to adolescence and that resilience, child neglect, positive school experiences, and community violence are significant predictors at baseline and of the rate of change across time. Based on stratified random sampling, a valid sample size of 6233 Taiwanese children participated in our study, which we began in 2014 and then followed this sample in 2016 and 2018 using repeated measures. We used hierarchical linear modeling to model changes in internet addiction across time (with equal two-year intervals between assessments) and the associations between the predictors and internet addiction over time. The results show that internet addiction increases from childhood to adolescence. After controlling for gender, we found that resilience and positive school experiences predict less internet addiction, whereas neglect and community violence predict greater internet addiction. Over time, greater resilience predicts a decreasing trajectory of internet addiction, whereas greater neglect and community violence predict a slower increasing trajectory and positive school experiences predict a faster-increasing trajectory. A holistic approach can help children cope with internet addiction

Ecological Predictors and Trajectory of Internet Addiction from Childhood through Adolescence: A Nationally Representative Longitudinal Study

We examined multidimensional factors within four systems (individual, family, school, and community) that influence internet addiction across time among children through adolescence in Taiwan. We hypothesize that internet addiction increases from childhood to adolescence and that resilience, child neglect, positive school experiences, and community violence are significant predictors at baseline and of the rate of change across time. Based on stratified random sampling, a valid sample size of 6233 Taiwanese children participated in our study, which we began in 2014 and then followed this sample in 2016 and 2018 using repeated measures. We used hierarchical linear modeling to model changes in internet addiction across time (with equal two-year intervals between assessments) and the associations between the predictors and internet addiction over time. The results show that internet addiction increases from childhood to adolescence. After controlling for gender, we found that resilience and positive school experiences predict less internet addiction, whereas neglect and community violence predict greater internet addiction. Over time, greater resilience predicts a decreasing trajectory of internet addiction, whereas greater neglect and community violence predict a slower increasing trajectory and positive school experiences predict a faster-increasing trajectory. A holistic approach can help children cope with internet addiction

Posttraumatic stress disorder symptoms and peer problems in children and adolescents exposed to maltreatment

Objectives: This study aimed to analyze the associations between posttraumatic stress disorder (PTSD) and peer problems, and to examine the moderating effect of sex on that association in maltreated children and adolescents. Methods: A survey was conducted in Portugal as part of a wider study about the effects of early adversity on child cognitive and socioemotional development. The sample included 121 maltreated children and adolescents, aged 7 to 17 years. The caregivers reported on child maltreatment (domestic violence, emotional abuse, neglect, physical abuse, and sexual abuse), PTSD symptoms, and peer problems. Results: Maltreatment-derived PTSD symptoms predicted more peer problems. Child sex did not influence the relationship between total PTSD scores and peer problems, although it did moderate the effect of PTSD intrusion symptoms on peer problems, with only boys showing a statistically significant association between the two variables. Conclusions: This study extended North American research findings with a Portuguese community sample. The results demonstrated that maltreatment-derived trauma symptoms during childhood have an impact on social problems with peers. Implications: The findings highlight the need to assess the impact of biological, cultural, and gender normative factors on child and adolescent trauma symptoms and on social development and on the quality of relationships in children and adolescents exposed to maltreatment.Objetivos: Este estudo teve como objetivo analisar as associações entre a perturbação de stress pós-traumático (PSPT) e problemas com os pares, e examinar o efeito moderador do sexo naquela associação em crianças e adolescentes expostos a mau trato. Métodos: Foi realizado um inquérito em Portugal no âmbito de um estudo mais amplo sobre os efeitos das adversidades precoces no desenvolvimento cognitivo e socio-emocional da criança. A amostra incluiu 121 crianças e adolescentes, entre 7 e 17 anos, expostos a mau trato. Os cuidadores das crianças e adolescentes preencheram um conjunto de questionários acerca dos mesmos, designadamente acerca da exposição a experiências adversas (violência doméstica, abuso emocional, negligência, abuso físico e abuso sexual), presença de sintomas de PSPT e problemas com os pares. Resultados: Sintomas de PSPT revelaram estar associados a mais problemas com os pares. O sexo da criança emergiu como um moderador da associação entre os sintomas de intrusão e problemas com os pares. Em particular, aquela associação revelou ser estatisticamente significativa, mas apenas para os rapazes. Conclusões: O presente estudo veio alargar os resultados da investigação existente sobre a temática, dominada por estudos norte-americanos, para o contexto português. Os resultados demonstraram que sintomas de PSPT em crianças e adolescentes expostos a mau-trato têm um impacto na qualidade da relação com os pares, em particular nos rapazes. Implicações: Os achados deste estudo destacam a necessidade de avaliar o impacto de fatores biológicos, culturais e de género nos sintomas de trauma e no desenvolvimento social e qualidade das relações em crianças e adolescentes

Childhood poly-victimization and children's health: A nationally representative study

Background Although research on the negative effects of childhood poly-victimization is substantial, few studies have examined the relationship between poly-victimization and younger children’s physical health and diseases. Objective This study examines the associations between poly-victimization and children’s health problems requiring medical attention. Methods A national stratified cluster random sampling was used to select and approach 25% of the total primary schools in Taiwan, and 49% of the approached schools agreed to participate in this study. We collected data with a self-report questionnaire from 6233 (4th-grade) students aged 10–11, covering every city and county in Taiwan. Results Logistic regression analyses demonstrate a significant dose-response relationship between children’s poly-victimization exposure and their health problems including hospitalization, serious injury, surgery, daily-medication requirements, heart murmurs, asthma, dizziness or fainting, allergies, kidney disease, therapies for special needs, smoking, and alcohol use. The results indicate that children’s risk of having a health problem grew significantly with each increase in the number of victimization types that children experienced. Conclusions These research findings underscore the effect of poly-victimization on children’s health problems requiring medical attention, and stress the need for both proper screening methods for children’s exposure to poly-victimization and stronger awareness of poly-victimization’s effects on health conditions in healthcare clinics

a school-based cross-sectional research

학위논문(박사)--서울대학교 대학원 :의과대학 의학과,2020. 2. 김붕년.한국 청소년을 대상으로, 아동기 역경(childhood adversity, 이하 CA)이 청소년의 정신장애와 전반적 정신건강 문제에 미치는 영향을 조사하기 위한 학교기반 단면조사 연구를 시행하였다. 2017년 4월부터 12월까지, 10-19세 청소년 927명이 모집되었으며, 참가자들과 부모는 CA을 평가하기 위한 Early Trauma Inventory Self-Report–Short Form (ETISR-SF), Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) 정신장애 선별을 위한 Diagnostic interview schedule for children Predictive Scales (DPS), 내면화/외현화 문제 평가를 위한 한국판 아동·청소년 행동평가척도 (CBCL/YSR) 우울 평가를 위한 Center for Epidemiological Studies-Depression Scale Children (CES-DC), 불안 평가를 위한 Screen for Child Anxiety Related Emotional Disorders (SCARED), 인터넷 중독 평가를 위한, 인터넷 중독 자가진단척도 (K-scale), 그리고 자살 평가를 위한 설문을 시행하였다. 또한 보호자 추가 설문을 통해, 인구학적 정보와, 임신, 주산기 및 초기 발달에 대한 정보를 얻었다. 전체 청소년의 약 40%가 한가지 이상의 CA 경험을 보고하였다. CA는 틱장애를 제외한 전반적인 정신장애 발생 위험을 높였으며(OR=1.34-1.50), CA의 하위유형 중에는 정서적 학대가 위험도가 가장 높고(OR=1.92-2.98), 이어 신체적 학대(OR=1.36-2.05), 일반 외상 경험(OR=1.43-1.79) 순서의 위험도를 보였다. 전체 CA 경험은 내면화/외현화 문제 수준을 증가시켰으며(β=0.13–0.35), CA 하위유형 중 정서 학대(β=0.18–0.30)와, 신체 학대(β=0.12–0.38)가 내면화/외현화 문제 수준과 유의한 상관관계를 보였다. 또한 CA는 우울 및 불안 수준을 증가시켰는데, 특히 정서 학대가 우울(β=0.16), 불안(β=0.13)과 유의한 상관관계가 있었다. CA는 남아의 인터넷 중독 위험을 높였고(β=0.20), 정서적 학대는 여아의 자살 문제(사고: OR=1.74, 계획: OR=1.76, 비자살적 자해행동: OR=1.95)의 발생 위험을 높였다. 본 연구는 CA가 국내 청소년의 정신장애 발병 및 정신건강 문제에 미치는 영향을 통합적으로 분석한 최초의 연구이다. 이를 통해 CA가 청소년의 정신건강 전반에 미치는 영향 분석하고 그 패턴을 확인하였다는데 의미가 있다.This school-based cross-sectional study aimed to investigate the effects of childhood adversity (CA) on adolescents' Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) mental disorders and overall psychopathologies in Korean adolescents. A total of 927 adolescents aged 10 to 19 years were recruited from April to December 2017. Adolescents and their parents completed the Early Trauma Inventory Self-Report–Short Form (ETISR-SF) for CA, the Diagnostic Interview Schedule for Children predictive scales (DPS) for mental disorders, the Child Behavior Checklist (CBCL) and Youth Self Report (YSR) for internalizing and externalization problems, the Center for Epidemiological Studies Depression Scale for Children (CES-DC) for depression, the Screen for Child Anxiety Related Emotional Disorders (SCARED) for anxiety, Korean Internet Addiction Proneness Scale (K-scale) for internet addiction, and suicide questionnaire for suicidality. Parental surveys also provided demographic, pregnancy, perinatal and early developmental data. Approximately 40% of all adolescents reported one or more CA experiences (odds ratio (OR) = 1.34 - 1.50). CA increased the overall risk of developing DSM-IV mental disorders, except for tic disorders (OR = 1.34 - 1.50), and among the CA subtypes, emotional abuse was the highest risk factor (OR = 1.92 - 2.98), followed by physical abuse (OR = 1.36 - 2.05), and general traumatic experience (OR = 1.43 - 1.79). CA increased adolescents' internalizing/externalizing problems (β = 0.13 – 0.35), and among CA subtypes, emotional abuse (β = 0.18 – 0.30), and physical abuse (β = 0.12 – 0.38) were significantly correlated. CA increased depression and anxiety, and among CA subtypes, emotional abuse was significantly correlated with depression (β = 0.16) and anxiety (β = 0.13). CA increased the risk of internet addiction among boys (β = 0.20), whilst emotional abuse increased the risk of suicide ideation (OR = 1.74), plan (OR = 1.76), and non-suicidal self-injury (OR = 1.95) among girls. This study is the first comprehensive analysis of the effects of CA on DSM-IV mental disorders and psychopathologies in Korean adolescents. This study is valuable in identifying the overall pattern of the effects of CA on mental health.Introduction 1 Methods 5 1. Study design 5 2. Participants 5 3. Measure 6 4. Statistical analyses 11 Results 14 1. Demographic and clinical characteristics 14 2. Association of CA with adolescent mental disorders 15 3. Association of CA with adolescent psychopathologies 16 4. Subgroup analyses 19 Discussion 21 1. Summary of results 21 2. Association of CA with adolescent mental disorders 21 3. Association of CA with adolescent psychopathologies 23 4. Differential association by gender and age 24 5. Limitations and strengths of this study 25 References 27 Abstract in Korean 58Docto

Internet Addiction: A Closer Look at Multidimensional Parenting Practices and Child Mental Health

This study aimed to examine how both psychosocial variables (authoritative, authoritarian, and shaming, and parent-child relationships) and psychological symptoms were associated with Internet addiction, while controlling for the sociodemographic variable (child gender). A national proportionately stratified random sample of 6,233 fourth-grade primary school students in Taiwan participated in the study. Hierarchical regression models were performed to test the research hypotheses. The results show that psychological symptoms, authoritarian parenting, and shaming were positively associated with Internet addiction, whereas authoritative parenting and positive parent-child relationship were negatively associated with Internet addiction. Girls had lower levels of Internet addiction than boys. In conclusion, this study demonstrates the direct effects of child mental health status, multidimensional parenting practices, and family relationship on Internet addiction in children, and the importance of early individual- and family-based prevention and intervention in addressing related public health concerns of Internet addiction in children. The cultural perspectives of parenting and implications of these findings are discussed

Childhood emotional abuse and problematic social networking sites use in a sample of Italian adolescents: The mediating role of deficiencies in self-other differentiation and uncertain reflective functioning.

Childhood emotional abuse (CEA) is associated with various negative mental health outcomes. This study aimed to investigate the association between CEA and problematic social networking site (SNS) use in a sample of Italian adolescents. Using structural equation modeling, the study examined whether the relationship between CEA and problematic SNS use was sequentially mediated by self-other differentiation and uncertain reflective functioning in 1308 Italian adolescents (628 males, age range 13-19 years). A history of CEA was positively associated with problematic SNS use. Furthermore, deficiencies in self-other differentiation and uncertain reflective functioning partially mediated the relationship between CEA and problematic SNS use. The present study provides additional insight into the psychological dynamics underpinning problematic SNS use among adolescents. The clinical implications of these findings are discussed