The long-term effects of childhood neglect or abuse. Implications for child and family services in the UK

Childhood neglect or abuse is damaging, with lifelong impacts on functioning, clinical and physical health. It can also transmit risk to the next generation. Child abuse is related to social deprivation, a source of family breakup, common in families under stress and is associated with other social ills such as domestic violence, and parental mental health problems. It is therefore costly to society financially, emotionally and in terms of family wellbeing. It is increasingly seen as a major public health issue given its wide prevalence. Contemporary issues in the UK concern not only ongoing neglect or abuse of children, but also the impact of historical abuse, a psychological burden to a significant number of adults. Often untreated, and occurring before adequate child protection policies were in place, the impacts of historical abuse is an ongoing concern both for health and social care services. This paper will describe the Childhood Experience of Care and Abuse (CECA) interview research findings and application in child and family services. It enables an accurate assessment of historical abuse, and its scoring system can be used on ongoing case files for children for better classification. A social and attachment model are described as explaining how damage from neglect and abuse can extend into later life

Family history and searching for hidden trauma—a personal commentary [Commentary]

Background: Searching family history is now popular through increased internet access coinciding with a need for understanding identity. Prior unresolved war trauma can help explain impacts on subsequent generations and the need to search for family narrative, particularly in refugee families. This paper explores the search for trauma narratives through personal family history research, with links to community groups. Method: The author’s own Polish family history research provides examples of trauma and loss from World War II in Poland. This is supplemented by quotes from an existing interview study of second-generation Poles to amplify themes and indicate their wider community relevance

Assessing child abuse: "We need to talk!"

This discussion paper adds to the recent critical debate concerning retrospective measurement of childhood abuse and adverse experiences. A series of recent articles found only modest overlap of prospective informant-based records with retrospective self-report questionnaires, with biases evident in the latter. However, this literature has omitted the use of investigator-based interviews as an alternative retrospective tool for triangulation of measurement. Validated interview approaches can ascertain accurate data using expert scoring that can be used to test both dose-effect and specificity analyses for further research and treatment purposes. Arguments for the retention and further promotion of intensive interview measures for retrospective assessment of childhood neglect and abuse in relation to lifetime clinical outcomes are presented, with illustrative analyses. A network analytic approach is outlined, with six types of childhood abuse or neglect experiences scored via a well-validated interview (the Childhood Experiences of Care and Abuse). This indicates distinct pathways between types of neglect and abuse, but also from more common emotional abuse (antipathy, critical parenting) through to more pernicious psychological abuse (coercive, sadistic control) involving physical abuse or sexual abuse pathways. This is supplemented by a case vignette to illustrate the different pathways indicated. The interview approach gives victims a voice with their narrative (chance to talk) needed for better understanding of the specific dynamics of child abuse and neglect and for an entry into psychotherapeutic work. We need to ensure that such methods are retained in the research and practitioner portfolio of measurement tools. [Abstract copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Social, family and trauma risk factors for common disorders in Israeli youth

Trauma exposure needs to be differentiated from trauma impacts in models of psychological disorder. Early life trauma experience is well established as a risk for psychological disorder in teenage and adult years. However, trauma experience is a broad category including personal (e.g. familial abuse, peer violence) and non-personal such as social deprivation and political violence related trauma. These factors are examined together in the Israeli context to gain understanding of their impact on emotional and behavioural disorders

Shared practice, learning, and goals between police and young people: a qualitative analysis of the National Volunteer Police Cadets

Engaging all members of the public is of paramount importance to British policing. This assists with demystifying the role of police in society, and also providing a shared vision and partnership between communities and the criminal justice system. The National VPC programme provides the opportunity to achieve this, recruiting diverse young people into a structured programme led by a range of police officers and staff. A series of focus groups were conducted across the country with both cadets and adult leaders to explore the benefits of the cadet programme for both groups—those relevant to policing but also more widely for community cohesion and individual development. Although the benefits to policing were clearly articulated, a range of strengths to the programme were also identified

Exploring disorganized attachment style among Malay mothers in Malaysia: a study using the Attachment Style Interview

This article explores emerging themes involving disorganized attachment style among Malay Muslim mothers using the Attachment Style Interview (ASI). Analysis of the 18 mothers with disorganized attachment style (those with combined anxious and avoidant styles) utilized themes deemed important from the attachment research literature and selected based on a careful reading of the narrative cases. These include more extreme negative interpersonal experiences than found in other insecure attachment style descriptors, and included partner violence and related isolation/social exclusion. It also indicated more complex cognitive-affective disturbance including mixed or contradictory dependency patterns and both angry and fearful attitudes to others. We discuss the concept of disorganized attachment style in relation to abuse, social exclusion, and its implication for psychopathology, intervention, and treatment

Attachment style, loneliness and depression in older age women

This study explores whether attachment, especially avoidant styles, might be a predictor of social support, loneliness and depression in old age

A contextual approach to trauma experience: lessons from life events research

There has been much debate over what constitutes trauma experience and how this is differentiated from other very negative life events in the diagnosis of PTSD. We believe the DSM implication that trauma events are uniquely different from other types of negative life events and are limited to a few specific types of predetermined event identified categorically hinders the utility of current trauma definitions in research and practice. Whilst we do not take issue with the standard definition of trauma events, a binary checklist-style approach to identifying such events has a potential for missing relevant experience. Instead, we argue that trauma events should be considered to be at one end of a continuum of threat/severity, with potential for more or less ‘threat to life’ in a range of domains. Furthermore, a wider assessment of events could elucidate a greater range of co-existing trauma events, those sub-threshold experiences related to phasing of trauma, and other unrelated negative life events which may contribute to context and impact. In this critique of definitions of trauma events we argue that the current definition of PTSD criterion-A events limits their utility in both research and clinical practice. Following intensive life event assessments such as the LEDS (Life Events and Difficulties Schedule) the application of dimensions underlying a cross spectrum of events includes loss (of person, role, plan or ideas about the self), danger (future loss/threat to security), humiliation (devaluation of self/rejection) and entrapment (sense of imprisonment) can be used to further categorise events or trauma, and specify their likely impact. Data is provided of the overlap of ‘markedly’ threatening negative events (using the LEDS) and those constituting trauma using a commonly used checklist in a high-risk community sample of women. This yielded high specificity (97%; CI = 95.60-97.71) but low sensitivity (41%; (95% CI = 27.57-54.97) with around a third rated on both. Most of the trauma events involved loss and danger categorisation and only in one instance humiliation. Other markedly threatening, non-trauma events, involved not only loss and danger but also humiliation and entrapment. We discuss how a more in-depth assessment of trauma events utilising these dimensions and with the new Computerised Life Events Assessment Record (CLEAR), could aid us in our understanding of trauma events and lead to more personalised treatment possibilities

2D-3D registration of CT vertebra volume to fluoroscopy projection: A calibration model assessment (doi:10.1155/2010/806094)

This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume) and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1?mm for displacements parallel to the fluoroscopic plane, and of order of 10?mm for the orthogonal displacement.<br/

The child attachment style interview (Child-ASI) and depression: preliminary findings

Background: Childhood familial trauma is a major contributor to psychological disorder. One of its key impacts is insecure attachment style, which impedes the development of close relationships. Trauma-related vulnerability is important to assess in primary school but there is a gap in age-appropriate measurement tools. This paper outlines the development of the Child Attachment Style Interview (Child-ASI) suitable for 6 to 11-year olds. This can be utilised on-site to identify damaging effects of trauma experience at an early stage. Method: The Child-ASI was developed from an existing adolescent/adult measure and tested on a sample of children in primary school (N=42) together with a subsample of those in care (N=20). A checklist of life events and the Mood and Feeling Questionnaire (MFQ) for depression was also administered. Results: Acceptable inter-rater reliability was found ([kappa]=0.84 for overall attachment style). A factor analysis of subscales produced the expected five factors for classification. Rates of insecure styles (38 per cent in school and 90 per cent in care) were consistent with other studies and related to separation from parent and depression. Logistic regression showed insecure attachment style and negative life events provided the best model for depression. Conclusion: Preliminary findings indicate the Child-ASI provides an effective way of assessing attachment style in children. Its use is for more intensive investigation of trauma-related interpersonal problems, administered by trained teachers. It is less intrusive than direct trauma assessments and fits with the policy need to identify vulnerability for mental health issues in schools