Trauma,Violence,& Abuse

The aim of the systematic review described in this article was to determine the outcome of child maltreatment in long-term childcare and the scope of the evidence base in this area. Searches of 10 databases were conducted. Forty-nine documents describing 21 primary studies and 25 secondary studies were selected for review. Searches, study selection, data extraction, and study quality assessments were independently conducted by two researchers, with a high degree of interrater reliability. Participants in the 21 primary studies included 3,856 abuse survivors and 1,577 nonabused controls. In six primary studies, survivors were under 18 years, and participants in the remaining primary studies were adults with a mean age of 54 years. Reviewed studies were conducted in the United Kingdom, the United States, Finland, Romania, Tanzania, Canada, Ireland, Australia, the Netherlands, Germany, Austria, and Switzerland. Participants were abused in religious and nonreligious residential care centers and foster care. There were significant associations between the experience of child abuse in long-term care and adjustment across the life span in the domains of mental health, physical health, and psychosocial adjustment. Evidence-based trauma-focused treatment should be offered to child abuse survivors. Future research in this area should prioritize longitudinal studies.

Sexual assault is a public health issue, with college-age students reporting high levels of victimization. Following an increase in national attention and federal initiatives, college and universities’ sexual assault response efforts are being examined. The practice of community sexual assault response teams (SARTs) may provide campuses with a model strategy to coordinate campus and community service delivery and planning, still underdeveloped or missing at many institutions. This literature review summarizes in side-by-side fashion the most current empirical literature about community SARTs and campus team approaches (CTAs) in four domains: (1) defined purpose, (2) activities to achieve purpose, (3) membership, and (4) challenges to functioning. Two searches were conducted. The community SART inclusion criteria were (a) an empirical study focusing on community SARTs as the level of analysis, (b) located in the United States, (c) published between 2010 and 2017, and (d) written in English. The inclusion criteria for the CTA were (a) an empirical study on CTAs to sexual assault and/or intimate partner violence as the level of analysis and (b) written in English. Eight articles met the criteria for community SARTs, and six articles met the criteria for CTAs. Differences between community SARTs and CTAs included community SARTs shared and more discretely defined purpose and subsequent activities. Further directions offered for the conceptual and practical development of a CTA to address sexual assault include the need for clearer definition of a team’s purpose leading to response-focused coordination of activities.

Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive–behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and “dysfunctional” thinking (CBT). Considering the mental, physical, and economic toll of IPV on families and the limited effectiveness of current intervention approaches, an assessment of the strengths and weaknesses of current modalities and an incorporation of the latest science addressing violence prevention and cessation are paramount. This article draws upon existing theories of trauma and the etiologies of violence perpetration and proposes an alternative model of care for men with IPV histories. Experiences of childhood adversity and trauma have well-established associations with a range of negative sequelae, including neurological, cognitive, behavioral, physical, and emotional outcomes. Childhood trauma is also associated with later violence and IPV perpetration. Thus, incorporating trauma-informed care principles and trauma interventions into programming for IPV perpetrators warrants further investigation. Practice and policy implications of a trauma interventions for men with IPV histories, as well as areas for future research, are discussed.

Behavioral parenting interventions can enhance positive parenting practice, which is crucial in preventing maltreatment and promoting child well-being. Primary care has been increasingly recognized as an underutilized platform to widely disseminate evidence-based parenting interventions, given parents’ ongoing access to primary care without stigma and the perceptions toward health-care providers as a trustworthy source of information about positive parenting. This study sought to explore the effects of primary care–based parenting interventions on parenting practice and child behavioral outcomes while examining the types of and the theories of change underlying these interventions. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Randomized controlled trials or quasi-experimental studies of interventions targeting caregivers of children aged between 1 and 17 were included in the review. Information sources included electronic databases, relevant government and private organizational websites, and expert consultations. The final sample included 17 studies focusing on 10 interventions. Positive results were found in knowledge gain, locus of control, monitoring, parent–child interactions, and negative discipline. Child behavior outcomes were inconsistent as most studies reported nonsignificant changes while one study reported significant intervention effects on various externalizing behaviors. A limited number of studies described the process of adapting, installing, and implementing the interventions in primary care. Future studies should examine the types, dosages, and delivery formats that are most suitable and sustainable in the context of primary care to maximize its utility in promoting child well-being while preventing maltreatment through integrated behavioral parenting interventions.

Enthusiasm for trauma-informed practice has increased dramatically. Organizational interventions that train staff about trauma-informed practice are frequently used to promote trauma-informed systems change, but evidence about these interventions’ effects has not been integrated. A systematic review was conducted of studies that evaluated the effects of organizational interventions that included a “trauma-informed” staff training component. A search was conducted in July 2017 and studies were identified in PubMed, PsycINFO, and the Published International Literature on Traumatic Stress database, limited to articles published in English after 2000. Six hundred and thirty-two articles were screened and 23 met inclusion criteria. Seventeen studies used a single group pretest/posttest design, five used a randomized controlled design, and one used a quasi-experimental design with a nonrandomized control group. The duration of trauma-informed trainings ranged from 1 hr to multiple days. Staff knowledge, attitudes, and behaviors related to trauma-informed practice improved significantly pre-/posttraining in 12 studies and 7 studies found that these improvements were retained at ≥1month follow-up. Eight studies assessed the effects of a trauma-informed organizational intervention on client outcomes, five of which found statistically significantly improvements. The strength of evidence about trauma-informed organization intervention effects is limited by an abundance of single group, pretest/posttest designs with short follow-up periods, unsophisticated analytic approaches, and inconsistent use of assessment instruments. In addition to addressing these methodological limitations, priorities for future research include understanding intervention effects on clients’ perceptions of care and the mechanisms through which changes in staff knowledge and attitudes about trauma-informed practice influence client outcomes.

The risk of violence following childhood maltreatment is uncertain. This meta-analytic review identified prospective studies that have examined this association. We systematically searched three electronic databases (PsycINFO, EMBASE, and MEDLINE) and completed a targeted search on Google Scholar. These were supplemented with scanning reference lists and correspondence with authors. We considered non-English-language and unpublished studies. Studies were included if childhood maltreatment was measured before age 18 years and occurred before violent outcomes. We identified 18 eligible studies with data on 39,271 participants. We conducted meta-analysis to calculate odds ratios (ORs) using random-effects models. Heterogeneity was explored through subgroup analyses and meta-regression. The overall OR of violent outcomes in childhood maltreatment was 1.8 (95% confidence interval [1.4, 2.3]) with substantial heterogeneity (I² = 92%). Meta-regression suggested that risk of violence following childhood maltreatment was more elevated in samples with higher percentage of females, in higher quality investigations, in studies with case-linkage methods compared to that followed-up participants over time using a prospective cohort design, when general population or matched controls were used rather than selected population controls, and when violent outcomes were ascertained in older individuals. In conclusion, the risk of later violence perpetration was modestly increased in individuals with a history of childhood maltreatment. Preventative strategies and interventions for childhood maltreatment may have an important role in violence reduction. Methodological issues and recommendations for future research are discussed.

Intimate partner violence (IPV) is a major, global public health concern with significant impacts, particularly for women, worldwide. There is an immediate need to develop comprehensive understandings of the complex drivers of this multifaceted issue in diverse cultural and social contexts. This scoping review used a systematic approach to gather a broad scope of peer-reviewed, publisher-controlled, and gray literature investigating IPV in Polynesia, a region of the Pacific experiencing high rates of IPV. A total of 181 articles were identified through a comprehensive search that included five cross-disciplinary databases; government, intergovernmental, and nongovernment websites; and consultation with community organizations. Thirty-three articles met the inclusion criteria related to IPV in a Polynesian country or community abroad and were included in this review. Narrative synthesis, which included summarizing and sorting key findings into common themes, was conducted to provide an overview of what is currently known about IPV in Polynesia and Polynesian communities living aboard. Key themes, which arose from the data analysis included: high prevalence of IPV, attitudes supporting IPV, urbanization and migration, traditional protective factors, and formal leadership and laws. The paucity of rigorous literature highlights an immediate need for IPV prevention research and intervention within Polynesian communities. This review includes a discussion of the limitations of this small body of literature and makes recommendations for future research, policy, and program development to include intersectionality in order to deepen understandings and enhance inclusive and meaningful intervention and policy implementation.

The goal of this study is to provide a systematic review of empirically based journal articles published between 2006 and 2016 that address intimate partner violence (IPV) among Asian communities in the United States. We analyzed 57 peer-reviewed journal articles published in English. Most studies employed quantitative research designs that were cross-sectional in nature and focused on examining the statistical relationships between variables. Sociodemographic variables were the most frequently used variables to predict IPV, while health outcome variables were the most frequently used variables caused by IPV. Theoretical frameworks, methodology, and policy implications used in other studied were discussed in depth. Based on the findings of our study, we recommended future research avenues that can fill the gap in scholarly journal articles investigating the Asian communities.

Canada relies on newcomers for population growth, labor supply, and cultural diversity. Newcomers, in turn, see Canada as a haven of economic opportunities. However, the extent to which these mutual benefits can be realized depends on how well newcomers fare in Canada. Intimate partner violence (IPV) significantly undermines immigrants’ capacity to rebuild their lives in host societies. As in other Western democracies, recent immigrants and refugees to Canada are highly vulnerable to IPV; they arrive with limited support systems, wrestle with changing family dynamics, and may have to adapt to new gender roles. IPV often occurs in the private domain of the family and poses serious risks to women, children, families, and the broader society. Our scoping review of 30 articles on IPV within Canadian immigrant groups identifies crucial differences in perceptions and experiences of, responses to, and coping mechanisms among female survivors, and a tendency to place the blame for IPV on the cultural values and practices that immigrants bring to Canada. The majority of existing services and policies, our review shows, are not well suited to immigrant women’s needs and may undermine women’s capacity to find satisfying solutions. Our review is limited by a dearth of literature; it is based mainly on the experiences of South East Asian immigrant women in the Greater Toronto Area. Our findings suggest that future research should address women’s and men’s experiences of IPV, include nonheterosexual couples, extend to the broader immigrant population, and incorporate the voices of stakeholders other than survivors.

Sexual assault prevention on college campuses often includes programming directed at men, women, and all students as potential bystanders. Problematically, specific types of sexual assault prevention are often implemented on campuses in isolation, and sexual assault risk reduction and resistance education programs for women are rarely integrated with other approaches. With increasing focus on the problem of sexual assault on college campuses, it is timely to envision a comprehensive and interconnected prevention approach. Implementing comprehensive prevention packages that draw upon the strengths of existing approaches is necessary to move toward the common goal of making college campuses safer for all students. Toward this goal, this commentary unpacks the models and mechanisms on which current college sexual assault prevention strategies are based with the goal of examining the ways that they can better intersect. The authors conclude with suggestions for envisioning a more synthesized approach to campus sexual assault prevention, which includes integrated administration of programs for women, men, and all students as potential bystanders on college campuses.

The aim of the systematic review described in this article was to synthesize available high-quality evidence on the outcomes of noninstitutional child maltreatment across the life span. A systematic review of previous systematic reviews and meta-analyses was conducted. Ten databases were searched. One hundred eleven papers which met stringent inclusion and exclusion criteria were selected for review. Papers were included if they reported systematic reviews and meta-analyses of longitudinal or cross-sectional controlled studies, or single-group cohort primary studies of the outcomes of child maltreatment in the domains of physical and mental health and psychosocial adjustment of individuals who were children lived mainly with their families. Using AMSTAR criteria, selected systematic reviews and meta-analyses were found to be of moderate or high quality. Searches, study selection, data extraction, and study quality assessments were independently conducted by two researchers, with a high degree of interrater reliability. The 111 systematic reviews and meta-analyses reviewed in this article covered 2,534 independent primary studies involving 30,375,962 participants, of whom more than 518,022 had been maltreated. The magnitude and quality of this evidence base allow considerable confidence to be placed in obtained results. Significant associations were found between a history of child maltreatment and adjustment in the domains of physical health, mental health, and psychosocial adjustment in a very wide range of areas. The many adverse outcomes associated with child maltreatment documented in this review highlight the importance of implementing evidence-based child protection policies and practices to prevent maltreatment and treat child abuse survivors.