Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering a treatment program for CSA survivors and their non-offending family members. The review organizes barriers around factors related to individual characteristics of children and caregivers, perceptions and beliefs commonly held following CSA, and challenging family interactions in the context of individual and group treatment for CSA. Finally, barriers related to systemic and societal factors are examined given the importance of understanding the legal and cultural context in which families seek and engage in treatment. Recommendations for further research, suggestions for clinicians, and considerations for policy change to decrease the identified treatment barriers for families impacted by CSA are provided

Adverse Childhood Experiences and Visual-Spatial Deficits: Relationships with Emotional and Behavioral Problems in Adolescent Girls at a Residential Treatment Program

Adverse Childhood Experiences (ACEs) have many deleterious consequences for children’s cognitive, emotional, and behavioral wellbeing (e.g., Hughes et al., 2017). Girls experience more ACEs than boys and have different psychological and behavioral responses (Leban, 2021). However, outcomes following trauma are heterogenous. Some girls are resilient to ACE exposure, but many have serious emotional and behavioral challenges (Chaplin & Aldao, 2013). A minority of these girls may be placed in a residential treatment program (RTP) as a result. Adolescent girls in RTPs are an understudied, highly trauma-exposed population who typically report significant academic struggles, anxiety, depression, and PTSD symptoms, along with behavior problems (Baker et al., 2007). While previous literature has established person- and abuse-specific factors that help explain this variability in outcomes, visual-spatial skills have not been explored as a mediator between ACEs and negative outcomes. Visual-spatial skills are a set of cognitive functions that play a role in social functioning and have been found to be lower in women after experiencing trauma. Visual-spatial skill deficits are clinically meaningful when they are significantly lower than a person’s verbal abilities (Broitman, et al., 2020). This study aimed to (a) establish the prevalence of visual-spatial deficits relative to verbal comprehension (RVSA), (b) identify relationships between ACEs, RVSA, and emotional/behavioral problems, and (c) determine whether RVSA moderates the relationship between ACEs and negative outcomes in adolescent girls living in a RTP. Results revealed fewer RVSA deficits in this population compared to a normed sample. Instead, there was a higher proportion of girls who showed strengths in RVSA. Additionally, findings indicated that ACEs were associated with depression, anxiety, and PTSD symptoms. A threshold effect was found for ACEs on behavioral problems (ACE scores \u3e4 predicted increased negative behaviors). Lastly, RVSA deficits did not interact with the relationship between ACEs and negative emotional and behavioral outcomes. Findings provide valuable information regarding young women’s functioning following ACE exposure, especially for those living in RTPs

Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering a treatment program for CSA survivors and their non-offending family members. The review organizes barriers around factors related to individual characteristics of children and caregivers, perceptions and beliefs commonly held following CSA, and challenging family interactions in the context of individual and group treatment for CSA. Finally, barriers related to systemic and societal factors are examined given the importance of understanding the legal and cultural context in which families seek and engage in treatment. Recommendations for further research, suggestions for clinicians, and considerations for policy change to decrease the identified treatment barriers for families impacted by CSA are provided

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele