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  • 1.
    Annerback, Eva-Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i D län (CKFD).
    Sahlqvist, Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i D län (CKFD).
    Svedin, C. G.
    Wingren, G.
    Gustafsson, P. A.
    Child physical abuse and concurrence of other types of child abuse in Sweden: Associations with health and risk behaviors2012In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 36, no 7-8, p. 585-595Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the associations between child physical abuse executed by a parent or caretaker and self-rated health problems/risk-taking behaviors among teenagers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking behaviors.

    Methods: A population-based survey was carried out in 2008 among all the pupils in 2 different grades (15 respectively 17 years old) in Sodermanland County, Sweden (n = 7,262). The response rate was 81.8%. The pupils were asked among other things about their exposure to child physical abuse, exposure to parental intimate violence, bullying, and exposure to being forced to engage in sexual acts. Adjusted analyses were conducted to estimate associations between exposure and ill-health/risk-taking behaviors.

    Results: Child physical abuse was associated with poor health and risk-taking behaviors with adjusted odds ratios (OR) ranging from 1.6 to 6.2. The associations were stronger when the pupils reported repeated abuse with OR ranging from 2.0 to 13.2. Also experiencing parental intimate partner violence, bullying and being forced to engage in sexual acts was associated with poor health and risk-taking behaviors with the same graded relationship to repeated abuse. Finally there was a cumulative effect of multiple abuse in the form of being exposed to child physical abuse plus other types of abuse and the associations increased with the number of concurrent abuse.

    Conclusions: This study provides strong indications that child abuse is a serious public health problem based on the clear links seen between abuse and poor health and behavioral problems. Consistent with other studies showing a graded relationship between experiences of abuse and poor health/risk-taking behaviors our study shows poorer outcomes for repeated and multiple abuse. Thus, our study calls for improvement of methods of comprehensive assessments, interventions and treatment in all settings where professionals meet young people.

  • 2.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Sahlqvist, L.
    Research and Development Centre, Sörmlands County Council, S-631 88 Eskilstuna, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Child Physical Abuse and concurrence of other types of Child Abuse: associations with health and risk behaviors2012In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 36, no 7-8, p. 585-595Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the associations between child physical abuse and health problems/risk-taking behaviors among teen-agers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking behaviors.

    Methods: A population-based survey was carried out in 2008 among all the pupils in two different grades (15 respectively 17 years old) in Södermanland County, Sweden (N=7 262). The response rate was 81.8 %. The pupils were asked among other things about their exposure to child physical abuse, exposure to parental intimate violence, bullying and exposure to being forced to engage in sexual acts. Adjusted analyses were conducted to estimate associations between exposure and illhealth/risk-taking behaviors.

    Results: Child physical abuse was associated with poor health and risk-taking behaviors with adjusted Odds Ratios (OR) ranging from 1.6 to 6.2. The associations were stronger when the pupils reported repeated abuse with OR ranging from 2.0 to 13.2. Also experiencing parental intimate partner violence, bullying and being forced to engage in sexual acts was associated with poor health and risk-taking behaviors with the same graded relationship to repeated abuse. Finally there was a cumulative effect of multiple abuse in the form of being exposed to child physical abuse plus other types of abuse and the associations increase with the number of concurrent abuse.

    Conclusions: This study provides strong indications that child abuse is a serious public health problem based on the clear links seen between abuse and poor health and behavioral problems. Consistent with other studies showing a graded relationship between experiences of abuse and poor health/risk-taking behaviors our study shows poorer outcomes for repeated and multiple abuse. Thus, our study calls for improvement of methods of comprehensive assessments, interventions and treatment in all settings where professionals meet young people.

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  • 3.
    Back, Kristina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Larsson, IngBeth
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Managing the legal proceedings: An interpretative phenomenological analysis of sexually abused children's experience with the legal process2011In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 35, no 1, p. 50-57Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe how sexually abused children experience the legal process, a process that includes being questioned by the police during the preliminary investigation and by lawyers and the prosecutor in the courtroom, and meeting other professionals from various agencies.

    METHOD: Face-to-face in-depth interviews were conducted with 10 children-9 girls and 1 boy between 9 and 15 years old-who had experienced child sexual abuse (CSA). The interviews were semi structured and carried out and analyzed by interpretative phenomenological analysis (IPA). The aim of IPA is to explore the participants' views of the world and to adopt as far as possible an "insider perspective." IPA draws on a tradition of phenomenology and symbolic interactionism in attempting to understand how people make sense of their experiences.

    RESULTS: Five major themes emerged through the analysis: not being believed, making CSA visible, need for support, sanctions for offenders, and lack of respect for the child's integrity. Almost all the children had a feeling of not being believed. They described feelings ranging from anxiety to dread and even terror when they had to describe the CSA they had experienced. Even though the importance of support for such children is already well understood, the children stated that the support they were given was not sufficient. The children said that they wanted support from a single professional who was well informed about both the legal process and CSA. When the children were asked to reflect on sanctions against the abusers, they said that it was important that the perpetrator got treatment/therapy but they also said that imprisonment was desirable. Financial compensation was not as important to them; the damage had been done and money could not compensate for that damage. The children also said that both the lawyers and the media had treated them with disrespect.

    CONCLUSIONS: It is valuable for children who have been exposed to CSA to learn that they can take part in the legal process as equal partners with the other participants, and it is evident that the quality of psychological care and support needs to be improved. The children want to be participants in the legal process rather than passive objects of that process.

  • 4.
    Brunnberg, Elinor
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Linden Boström, Margaretha
    Örebro City Council, Dept Community Med & Publ Hlth, Örebro.
    Berglund, Mats
    Lunds Universitet.
    Sexual Force at Sexual Debut: Swedish Adolescents with Disabilities at Higher Risk than Adolescents without Disabilities2012In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 36, no 4, p. 285-295Article in journal (Refereed)
    Abstract [en]

    The aims of this study are first to compare the incidence of force on the first occasion of sexual intercourse reported by participants with disabilities to that of students without disabilities; second to determine whether there are significant differences in mental health, substance abuse, and school performance as reported by participants forced into their sexual debut as opposed to those who were not forced, analysed by gender; and finally to identify the significant variables that predict girls reporting force at sexual debut as opposed to girls not reporting force, as well as to identify similar variables within the male group. There were no data on sexual abuse prior to the first occasion of full sexual intercourse. Method:This cross-sectional study is based on 2 surveys: Life and Health—Young People 2005 and 2007. All 17/18-year-old adolescents in upper-secondary schools in a county in Sweden were asked the same questions both years. A total of 2,254 students completed the survey in 2005 and 2,641 in 2007. Results: The main finding is that force at sexual debut (intercourse) is more common among adolescents with a disability (4.0%) than those not reporting any disability (1.6%), and is most common among those reporting multiple disabilities (10.4%). This was found both for girls and boys, even if the rates for girls were several times higher. Other findings are that girls and boys reporting force at sexual debut (disability and non-disability groups taken together) reported different profiles. For girls, their country of origin and who they live with are significant. This background data is not significant for boys. Boys report a strong psychosomatic reaction.Conclusion: Culture-, functionality-, and gender-sensitive studies of adolescents’ reactions to sexual abuse are needed to help determine relevant and effective interventions

  • 5.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Forsman, Hilma
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The truly disadvantaged? Midlife outcome dynamics of individuals with experiences of out-of-home care2017In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 67, p. 408-418Article in journal (Refereed)
    Abstract [en]

    Little is known about developmental outcomes in midlife of persons who were placed in out-of-home care (OHC) in childhood. Utilizing longitudinal Swedish data from a cohort of more than 14,000 individuals who we can follow from birth (1953) to the age of 55 (2008), this study examines midlife trajectories of social, economic, and health-related disadvantages with a specific focus on the complexity, timing, and duration of disadvantage in individuals with and without childhood experience of OHC. Roughly half of the OHC alumni did not have disadvantaged outcomes in midlife. However, experience of OHC was associated with a two-fold risk for various forms of permanent disadvantage, net of confounding factors. Implications for research, policy, and practice are discussed.

  • 6.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström Almquist, Ylva
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Intergenerational transmission of placement in out-of-home care: Mediation and interaction by educational attainment2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 123, article id 105436Article in journal (Refereed)
    Abstract [en]

    Background: Persons with childhood experiences of out-of-home care (OHC) have elevated risks of having their own children taken into societal care. High educational attainment has been linked to favorable long-term outcomes in a host of previous studies on OHC alumni. This could be indicative of resilience, which may also have protective potential against intergenerational continuity of OHC placements.

    Objective: The present study examined the processes of mediation and interaction by educational attainment, here conceptualized as having completed upper secondary school, regarding the intergenerational transmission of placement in OHC.

    Participants and setting: Longitudinal data came from a Swedish cohort of parents (and their children) born in 1953 (n = 11,338).

    Methods: Associations between parental experience of OHC and their children's placement in OHC were analyzed by means of binary logistic regression. Four-way decomposition was used to explore mediation and interaction by parental educational attainment.

    Results: The odds of having at least one child being placed in OHC was more than six-fold (OR = 6.67, 95% CI = 5.28; 8.06) in the OHC group compared to majority population peers. Mediation and/or interaction by educational attainment accounted for a substantial proportion of the overall association (53%). Interaction effects appeared to be more important for the outcome than mediation.

    Conclusions: Having completed upper secondary school seems to reflect processes of resilience with the potential to break the intergenerational transmission of placement in OHC. These findings suggest that the impact of enhanced educational attainment of OHC populations may have potential of extending into the fate of the next generation.

  • 7.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Long-term outcomes of Sweden's Contact Family Program for children2013In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 37, no 6, p. 404-414Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the long-term impacts of Sweden's Contact Family Program (CFP) for children on participants' future outcome profiles, here conceptualized as combinations of outcomes related to mental health problems, public welfare receipt, illicit drug use, placement in out-of-home care, educational achievement, and offending. Methods: We analyzed longitudinal register data on more than 950,000 children born 1980-90, including 6693 children who entered CFP at 2-5 years of age, with a follow-up until 2008. Children's outcome profiles were identified by latent class analysis. The average program impact was estimated by means of propensity score matching. Results: Long-term outcomes for those who had received the intervention were not better than for matched peers who did not receive the intervention. Simulation-based sensitivity analyses indicate that some of our estimated negative treatment effects may be affected by unobserved factors related to program participation and outcomes. However, both selection and outcome effects must be extremely strong in order to generate notable positive effects of CFP participation. Conclusions: The results did not find support for CFP effectiveness in reducing risks of compromised long-term development in children. Since the intervention reaches a high-risk group of children and is popular among users, volunteer families and professionals, the program should be reinforced with knowledge-based components that target known risk factors for child welfare recipients.

  • 8. Buisman, Renate S. M.
    et al.
    Compier-de Block, Laura H. C. G.
    Bakermans-Kranenburg, Marian
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology. University Institute of Psychological, Social and Life Sciences, Portugal.
    Pittner, Katharina
    van den Berg, Lisa J. M.
    Tollenaar, Marieke S.
    Elzinga, Bernet M.
    Voorthuis, Alexandra
    Linting, Mariëlle
    Alink, Lenneke R. A.
    The role of emotion recognition in the intergenerational transmission of child maltreatment: A multigenerational family study2024In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 149, p. 106699-, article id 106699Article in journal (Refereed)
    Abstract [en]

    Background

    Understanding how child maltreatment is passed down from one generation to the next is crucial for the development of intervention and prevention strategies that may break the cycle of child maltreatment. Changes in emotion recognition due to childhood maltreatment have repeatedly been found, and may underly the intergenerational transmission of child maltreatment.

    Objective

    In this study we, therefore, examined whether the ability to recognize emotions plays a role in the intergenerational transmission of child abuse and neglect.

    Participants and setting

    A total of 250 parents (104 males, 146 females) were included that participated in a three-generation family study.

    Method

    Participants completed an emotion recognition task in which they were presented with series of photographs that depicted the unfolding of facial expressions from neutrality to the peak emotions anger, fear, happiness, and sadness. Multi-informant measures were used to examine experienced and perpetrated child maltreatment.

    Results

    A history of abuse, but not neglect, predicted a shorter reaction time to identify fear and anger. In addition, parents who showed higher levels of neglectful behavior made more errors in identifying fear, whereas parents who showed higher levels of abusive behavior made more errors in identifying anger. Emotion recognition did not mediate the association between experienced and perpetrated child maltreatment.

    Conclusions

    Findings highlight the importance of distinguishing between abuse and neglect when investigating the precursors and sequalae of child maltreatment. In addition, the effectiveness of interventions that aim to break the cycle of abuse and neglect could be improved by better addressing the specific problems with emotion processing of abusive and neglectful parents.

  • 9.
    Cater, Åsa
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Andershed, Henrik
    Örebro University, School of Law, Psychology and Social Work.
    Andershed, Anna-Karin
    Örebro University, School of Law, Psychology and Social Work.
    Youth victimization in Sweden: prevalence, characteristics and relation to mental health and behavioral problems in young adulthood2014In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 38, no 8, p. 1290-1302Article in journal (Refereed)
    Abstract [en]

    The present study examines multiple types of victimization simultaneously, their preva-lence and characteristics in childhood and adolescence, and it examines the associationsbetween victimization and poly-victimization on the one hand and single and multiplemental health and behavioral problems on the other. The sample consisted of 2,500 Swedishyoung adults (20–24 years) who provided detailed report of multiple types of lifetime vic-timization and current health and behaviors via an interview and a questionnaire. Resultsshowed that it was more common to be victimized in adolescence than in childhood andmore common to be victimized repeatedly rather than a single time, among both malesand females. Males and females were victimized in noticeably different ways and par-tially at different places and by different perpetrators. With regard to mental health andbehavioral problems, anxiety, post-traumatic stress, self-harm, and criminality were clearlyoverrepresented among both males and females who had experienced any type of victim-ization. Poly-victimization was related to single and multiple mental health and behavioralproblems among both males and females. We conclude that professionals need to conductthorough evaluations of victimization when completing mental health assessments amongtroubled youths, and that youth might benefit from the development of interventions forpoly-victimized youth.

  • 10.
    Cederborg, Ann-Christin
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Cognition, Development and Disability.
    Lamb, M.E
    How does the legal system respond when children with learning difficulties are victimized?2006In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 30, no 5, p. 537-547Article in journal (Refereed)
    Abstract [en]

    Objective: To understand how the Swedish legal system perceives and handles mentally handicapped children who may have been victimized. Method: Twenty-two judicial districts in Sweden provided complete files on 39 District Court cases (including the Appeals Court files on 17 of these cases) involving children with learning difficulties or other handicaps as alleged victims of abuse, threat and neglect. The children (25 girls and 14 boys) averaged 11.8 years of age when first allegedly victimized. Sexual abuse was the most frequently alleged crime (33 cases). Court transcripts, court files and expert assessments of the alleged victims' handicaps and their possible consequences were examined to elucidate the ways in which courts evaluated the credibility of the alleged victims. Results: The children's reports of their victimization were expected to have the characteristics emphasized by proponents of Statement Reality Analysis (SRA) and Criterion Based Content Analysis (CBCA) in order to be deemed credible. Expert reports were seldom available or adequate. Because many reports were poorly written or prepared by experts who lacked the necessary skills, courts were left to rely on their own assumptions and knowledge when evaluating children's capacities and credibility. Conclusions: Children with learning difficulties or other handicaps were expected to provide the same sort of reports as other children. To minimize the risk that judgments may be based on inaccurate assumptions courts need to require more thorough assessments of children's limitations and their implications. Assessments by competent mental health professionals could inform and strengthen legal decision-making. A standardized procedure that included psycho-diagnostic instruments would allow courts to understand better the abilities, capacities, and behavior of specific handicapped children. © 2006 Elsevier Ltd. All rights reserved.

  • 11.
    Cederborg, Ann-Christin
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability.
    Orbach, Y.
    Natl. Inst. Child Hlth. Hum. Devmt., Bethesda, MD, United States.
    Sternberg, K.J.
    Natl. Inst. Child Hlth. Hum. Devmt., Bethesda, MD, United States.
    Lamb, M.E.
    Natl. Inst. Child Hlth. Hum. Devmt., Bethesda, MD, United States.
    Investigative interviews of child witnesses in Sweden2000In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 24, no 10, p. 1355-1361Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the structure and informativeness of interviews with 4- to 13-year-old alleged victims of sexual abuse in Sweden. Method: Seventy-two alleged victims of sexual abuse were interviewed by six experienced officers from one police district in Sweden. Our evaluation focused on the structure of the interviews, the distribution and timing of the investigators' utterance types, and the quantity and quality of the information provided by the children. Results: Content analysis revealed that the interviewers relied primarily on option-posing and suggestive questions-together, these comprised 53% of their utterances-when interviewing the alleged victims. As a result, most of the details (57%) obtained from the children were elicited by option-posing and suggestive utterances. Only 6% of the interviewers' utterances were open-ended invitations, and these elicited only 8% of the information obtained. Conclusion: The reliance on option-posing and suggestive prompts may have reduced the accuracy of the information obtained, thereby interfering with the investigations, and reducing the forensic admissibility of the children's statements. This suggests a continuing need in Sweden, as in other countries, for interview practices that enhance the quality of information provided by young victims. Copyright (C) 2000 Elsevier Science Inc.

  • 12.
    Engström, Maria
    et al.
    Uppsala University.
    Randell, Eva
    Dalarna University, School of Health and Welfare, Social Work.
    Lucas, Steven
    Uppsala University.
    Child health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children – A mixed-methods study2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 132, article id 105820Article in journal (Refereed)
    Abstract [en]

    Background: Child maltreatment (CM) is often hidden, and the youngest children are often thosemost exposed. CM can be prevented through programs that address risk factors, but few primaryprevention strategies have been evaluated.Objective: To examine the experiences of nurses using the Safe Environment for Every Kid (SEEK)model compared to nurses using current standard practice in the Swedish child health services(CHS) to address psychosocial risk factors in the family environment.Participants and setting: Nurses at 27 child health centers in the CHS in the county of Dalarna,Sweden participated in the study. A survey was answered by 55 nurses and 18 nurses participatedin focus-group interviews.Methods: A convergent mixed methods research design with focus-group interviews and surveydata was used. Qualitative Content Analysis was used to analyze the interview data and MannWhitney U test was used to analyze the survey data.Results: The qualitative analysis identified four categories – “Framing the prerequisites for suc-cessful practice”; “Managing the mission of the CHS”; “Meeting the family as a professional”; and“Working with psychosocial risk factors can be emotional” – under the overarching theme“Universal application of a structured method adds value to experience-based knowledge whenaddressing psychosocial risk factors”. Survey data showed that SEEK nurses rated to a greaterdegree that they possessed adequate knowledge, competence and sense of security to addresspsychosocial risk factors in their work.Conclusions: This study indicates that using SEEK can strengthen the nurses in identifying andresponding to families in need of psychosocial support.

  • 13.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research.
    Randell, Eva
    Högskolan Dalarna, Socialt arbete.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research.
    Child health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children – A mixed-methods study2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 132, article id 105820Article in journal (Refereed)
    Abstract [en]

    Background: Child maltreatment (CM) is often hidden, and the youngest children are often thosemost exposed. CM can be prevented through programs that address risk factors, but few primaryprevention strategies have been evaluated.Objective: To examine the experiences of nurses using the Safe Environment for Every Kid (SEEK)model compared to nurses using current standard practice in the Swedish child health services(CHS) to address psychosocial risk factors in the family environment.Participants and setting: Nurses at 27 child health centers in the CHS in the county of Dalarna,Sweden participated in the study. A survey was answered by 55 nurses and 18 nurses participatedin focus-group interviews.Methods: A convergent mixed methods research design with focus-group interviews and surveydata was used. Qualitative Content Analysis was used to analyze the interview data and MannWhitney U test was used to analyze the survey data.Results: The qualitative analysis identified four categories – “Framing the prerequisites for suc-cessful practice”; “Managing the mission of the CHS”; “Meeting the family as a professional”; and“Working with psychosocial risk factors can be emotional” – under the overarching theme“Universal application of a structured method adds value to experience-based knowledge whenaddressing psychosocial risk factors”. Survey data showed that SEEK nurses rated to a greaterdegree that they possessed adequate knowledge, competence and sense of security to addresspsychosocial risk factors in their work.Conclusions: This study indicates that using SEEK can strengthen the nurses in identifying andresponding to families in need of psychosocial support.

  • 14.
    Ernberg, Emelie
    et al.
    Univ Gothenburg, Sweden.
    Magnusson, Mikaela
    Linköping University, Department of Biomedical and Clinical Sciences, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Univ Gothenburg, Sweden.
    Koponen, Linnea
    Univ Gothenburg, Sweden.
    Landström, Sara
    Univ Gothenburg, Sweden.
    "It doesn't work at all, that's my experience": Swedish forensic interviewers' views on interpreter-mediated child interviews2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 127, article id 105540Article in journal (Refereed)
    Abstract [en]

    Background: Legal practitioners have expressed concerns regarding the quality of interpreter mediated forensic interviews with child witnesses. Objective: This mixed-methods study aimed to examine Swedish forensic interviewers experiences of conducting child interviews via a language interpreter. Participants and setting: Forty-one forensic interviewers from the Swedish Police Authority with experience conducting interpreter-mediated child interviews participated in a digital survey. Methods: Their responses were analyzed using both qualitative (thematic and content analyses) and quantitative (descriptive and inferential statistics) approaches. Results: The forensic interviewers general experiences of conducting interpreter-mediated child interviews were negative. Limited access to authorized legal interpreters and doubts regarding the accuracy of interpretation were described as major obstacles in these investigations. The presence of an interpreter could negatively impact childrens disclosure process and limit their chances of expressing their views during legal proceedings. Conclusions: According to Swedish forensic interviewers, the quality of interpreter-mediated child interviews urgently needs to be addressed. Our results are consistent with previous surveys from Australia and the United States, highlighting the international relevance of these topics. Future improvements are vital to ensure that all children are provided an equal right to be heard during criminal investigations, regardless of the native language.

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  • 15.
    Forsman, Hilma
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Criminal outcomes among infants placed in out-of-home care: A longitudinal nationwide cohort study2024In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 154, article id 106857Article in journal (Refereed)
    Abstract [en]

    Background: Infant placements into out-of-home care have garnered increased research and societal attention, yet the long-term outcomes of this vulnerable group are virtually unknown.

    Objective: This study aims to examine the association between infant placement and criminal offences across the life course, contrasting with general population peers and children placed at later developmental periods.

    Participants and setting: The study includes 622,940 individuals born in Sweden between 1975 and 1981, among whom around 0.2 % (n = 1524) were taken into care during infancy (<12 months).

    Methods: Utilizing Swedish longitudinal population-based register data, sex-stratified hurdle regression analyses, adjusted for individual and family background characteristics, were conducted to investigate the risk and rates of criminal offences ages 15–38.

    Results: Infants placed in care exhibited higher risks of any criminal offence compared to the general population (men: RR = 1.32, p < 0.001, women RR = 1.47, p < 0.001), but lower risks compared to children placed at later ages. Incidence-adjusted rates of offences were also higher among infants compared to their general population peers (men: IRR = 2.54, p < 0.001, women: IRR = 2.77, p < 0.001), with differences to other care groups being less pronounced.

    Conclusions: Infant placement in care is associated with an increased risk of criminal activity over the life course.

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  • 16.
    Forsman, Hilma
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Does poor school performance cause later psychosocial problems among children in foster care? Evidence from national longitudinal registry data2016In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 57, p. 61-71Article in journal (Refereed)
    Abstract [en]

    Research has shown that children in foster care are a high-risk group for adverse economic, social and health related outcomes in young adulthood. Children's poor school performance has been identified as a major risk factor for these poor later life outcomes. Aiming to support the design of effective intervention strategies, this study examines the hypothesized causal effect of foster children's poor school performance on subsequent psychosocial problems, here conceptualized as economic hardship, illicit drug use, and mental health problems, in young adulthood. Using the potential outcomes approach, longitudinal register data on more than 7500 Swedish foster children born 1973–1978 were analyzed by means of doubly robust treatment-effect estimators. The results show that poor school performance has a negative impact on later psychosocial problems net of observed background attributes and potential selection on unobservables, suggesting that the estimated effects allow for causal interpretations. Promotion of school performance may thus be a viable intervention path for policymakers and practitioners interested in improving foster children's overall life chances.

  • 17.
    Fredlund, Cecilia
    et al.
    Linköpings universitet.
    Dahlstrom, Orjan
    Linköpings universitet.
    Svedin, Carl Goran
    Linköpings universitet.
    Wadsby, Marie
    Linköpings universitet.
    Jonsson, Linda S.
    Linköpings universitet.
    Priebe, Gisela
    Linköpings universitet.
    Adolescents' motives for selling sex in a welfare state - A Swedish national study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 81, p. 286-295Article in journal (Refereed)
    Abstract [en]

    In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents' motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.

  • 18.
    Fredlund, Cecilia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Pribe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden.
    Adolescents motives for selling sex in a welfare state - A Swedish national study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 81, p. 286-295Article in journal (Refereed)
    Abstract [en]

    In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.

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  • 19. He, Amy S.
    et al.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Sedivy, Jennifer A.
    Lundgren, Lena
    Umeå University, Faculty of Social Sciences, Department of Social Work. Graduate School of Social Work, University of Denver, Denver, CO, USA.
    A Swedish national study: Immigrant-country of birth status and child welfare compulsory care among a sample of parents with risky substance use2020In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 101, article id 104316Article in journal (Refereed)
    Abstract [en]

    Background: Sweden has a high percentage of foreign-born residents (18.5 %) and one of the highest overdose death rates in Europe. For immigrant parents with risky substance use (RSU), risk factors associated with immigration status (e.g., economic strain and psychological stress) potentially heightening the risk of involvement with the child welfare system (CWS). Using Swedish registry national data, this study explored the relationship between immigration-country of birth status, psychosocial risk factors, and child compulsory care for parents with RSU.

    Methods: Study sample consisted of 5932 parents from 65 Swedish municipalities assessed for psychosocial problems (including alcohol and drug use) using the Addiction Severity Index (2007–2017). Stepwise multinomial logistic regression models examined the relationship between immigration-country of birth status (Swedish born, Nordic-born, and non-Nordic born), psychosocial problems, and compulsory care in the CWS.

    Results: Compared to Swedish-born parents, parents not born in Sweden, Norway, Denmark or Finland (non-Nordic born parents) had a lower probability of children living in compulsory care (family homes or institutions). However, after accounting for psychosocial problems, immigration status was no longer significantly associated with children’s living arrangements.

    Conclusions: Study findings indicate that parental immigrant status (even among parents dealing with RSU) in itself is not a risk factor for compulsory care in the CWS. Moreover, parental employment and health problems posed greater risk for children being in compulsory care. Receipt of targeted services for employment and health problems may help to maintain stable child living arrangements for immigrant parents dealing with RSU.

  • 20.
    Joleby, Malin
    et al.
    Göteborgs universitet.
    Lunde, Carolina
    Göteborgs universitet.
    Landström, Sara
    Göteborgs universitet.
    Jonsson, Linda
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Offender strategies for engaging children in online sexual activity2021In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 120, article id 105214Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Following technological developments, there has been increasing interest in online offenders' use of digital communication technology to sexually groom and abuse children. However, research has thus far primarily explored offenders' interactions with decoys instead of actual children, and initial evidence indicates that conversations with actual children may include more overt persuasion and extortion than conversations with decoys.

    OBJECTIVE: This study aims to describe online offenders' interactions with actual children when inciting them to engage in online sexual activity.

    PARTICIPANTS AND SETTING: Swedish court judgements including 50 offenders (aged 16-69, median = 28.9) and 122 child victims (aged 7-17, median = 13.0) were analyzed.

    METHODS: By using an explorative mixed-methods approach, we thematically analyzed what strategies the children were exposed to, and looked for patterns between the strategy used and the characteristics of the abuse, victim, or offender.

    RESULTS: We identified two types of strategies that the children were exposed to: pressure (threats, bribes, or nagging, N = 56), and sweet-talk (flattery, acting as a friend, or expressing love, N = 25). Overall, the offenders who used pressure were younger and targeted older children than the offenders who used sweet-talk.

    CONCLUSIONS: This study expands the existing knowledge about the variety of manipulative strategies used by online offenders and adds support to the initial literature showing substantially more pressure and coercion in online offenders' interactions with actual children. The study also identifies some patterns between the strategy used and the age of the offender and victim that warrant further investigation in future studies.

  • 21.
    Kalin, Torbjörn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Ahlgren, Thorbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Persdotter, B.
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Gender disparities in child welfare services' assessments of referrals. Findings from Sweden2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 134, article id 105918Article in journal (Refereed)
    Abstract [en]

    Background: Many children referred to the child welfare services are not screened in for further investigation. Factors related to intake decisions have been found on several levels. Many studies, however, lack information about the children's own experiences of child maltreatment and/or behavioral problems. Objective: To examine case factors relating to decision to investigate referrals to the child welfare services in Sweden. Participants and setting: Data are used from a prospective longitudinal multisource program (LoRDYA) in Sweden studying two cohorts of adolescent children in four municipalities (n = 1884). Methods: By linking annual self-rating data with registry data from the child welfare services, data are analyzed through latent-class analysis and Poisson regression. Results: Most children who are self-rated severely exposed to maltreatment and/or behavioral problems are never investigated by the child welfare services (74.2 %). Referrals concerning girls are more likely to be investigated than referrals concerning boys (crudeAME = 0.09 p = ***). For girls, prior referrals (adjAME = 0.16, p = ***), household poverty (adjAME = 0.09, p = *) and any form of self-rated severe exposure to maltreatment and/or behavioral problems (adjAME = 0.14, p = ***) increased the chance of a decision to investigate. For boys, prior referrals (adjAME = 0.24, p = ***) increased the chance of a decision to investigate, while achieved age (adjAME = −0.03, p = *), and being referred on suspicions of neglect and behavioral problems (adjAME = −0.15, p = **) decreased the chance of a decision to investigate. Conclusions: Child welfare services assess referrals on boys and girls differently, which may explain why boys have in crude numbers a decreased chance of decisions to investigate.

  • 22.
    Kalin, Torbjörn
    et al.
    Jönköping University.
    Ahlgren, Thorbjörn
    Jönköping University.
    Persdotter, Birgitta
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Gender disparities in child welfare services' assessments of referrals. Findings from Sweden2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 134, p. 1-10, article id 105918Article in journal (Refereed)
    Abstract [en]

    Background: Many children referred to the child welfare services are not screened in for further investigation. Factors related to intake decisions have been found on several levels. Many studies, however, lack information about the children's own experiences of child maltreatment and/or behavioral problems. Objective: To examine case factors relating to decision to investigate referrals to the child welfare services in Sweden. Participants and setting: Data are used from a prospective longitudinal multisource program (LoRDYA) in Sweden studying two cohorts of adolescent children in four municipalities (n = 1884). Methods: By linking annual self-rating data with registry data from the child welfare services, data are analyzed through latent-class analysis and Poisson regression. Results: Most children who are self-rated severely exposed to maltreatment and/or behavioral problems are never investigated by the child welfare services (74.2 %). Referrals concerning girls are more likely to be investigated than referrals concerning boys (crudeAME = 0.09 p = ***). For girls, prior referrals (adjAME = 0.16, p = ***), household poverty (adjAME = 0.09, p = *) and any form of self-rated severe exposure to maltreatment and/or behavioral problems (adjAME = 0.14, p = ***) increased the chance of a decision to investigate. For boys, prior referrals (adjAME = 0.24, p = ***) increased the chance of a decision to investigate, while achieved age (adjAME = −0.03, p = *), and being referred on suspicions of neglect and behavioral problems (adjAME = −0.15, p = **) decreased the chance of a decision to investigate. Conclusions: Child welfare services assess referrals on boys and girls differently, which may explain why boys have in crude numbers a decreased chance of decisions to investigate.

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  • 23.
    Kassman, Anders
    et al.
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion, Centre for Civil Society Research.
    Wollter, Filip
    Marie Cederschiöld University, Department of Social Sciences.
    Eriksson, Maria
    Marie Cederschiöld University, Department of Social Sciences.
    The selective child welfare funnel: Children's exposure to violence and CWS investigations in Sweden2023In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 144, article id 106356Article in journal (Refereed)
    Abstract [en]

    Background Research indicates that child welfare services reach out to children exposed to violence unequally depending on the child's social background, living conditions and violence type.

    Objective Based on the notion of selective recognition of vulnerability and risk, this study explores which children CWS pursue to a complete child welfare investigation.

    Participants and setting A register was set up including all children (n = 1764) between 7 and 12 years that were investigated for suspected exposure to violence by CWS in the municipality of the City of Stockholm, Sweden, in 2019.

    Methods This cohort was systematically compared to demographic data and national self-report prevalence studies to explore possible biases regarding which children CWS investigates. Descriptive analysis, cluster analysis and logistic regressions were used.

    Results The results confirm previous research that children exposed to violence have reduced access to material resources and inferior living conditions compared to non-exposed children. Physical abuse is more prevalent among boys of foreign backgrounds in stable, two-parent families residing in higher-status suburbs. Conversely, neglect is more common among children of Swedish backgrounds in low-income, single-parent households living in low-status suburbs. In comparison with self-reported prevalence studies, sexual and psychological abuse seem underrepresented in the study group, while neglect and violence in the family are relatively more frequently investigated compared to self-reported prevalence studies.

    Conclusions The results indicate that CWS should develop its methods to reach certain vulnerable groups that are underrepresented for safeguarding and support, for example, girls exposed to sexual abuse.

  • 24.
    Kvist, T.
    et al.
    Karolinska Inst, Sweden.
    Annerbäck, Eva-Maria
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Uppsala Univ, Sweden.
    Dahllöf, G.
    Karolinska Inst, Sweden.
    Oral health in children investigated by Social services on suspicion of child abuse and neglect2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 76, p. 515-523Article in journal (Refereed)
    Abstract [en]

    Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.

  • 25.
    Kvist, Therese
    et al.
    Karolinska Institutet, Huddinge, Sweden.
    Annerbäck, Eva-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Dahllöf, Göran
    Karolinska Institutet, Huddinge, Sweden.
    Oral health in children investigated by Social services on suspicion of child abuse and neglect2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 76, p. 515-523, article id S0145-2134(17)30443-XArticle in journal (Refereed)
    Abstract [en]

    Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.

  • 26.
    Laajasalo, Taina
    et al.
    Finnish Inst Hlth & Welf, Finland; Univ Helsinki, Finland.
    Cowley, Laura Elizabeth
    Swansea Univ, Wales.
    Otterman, Gabriel
    Linköping University, Department of Biomedical and Clinical Sciences, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences.
    Lamela, Diogo
    Lusophone Univ Humanities & Technol, Portugal.
    Rodrigues, Leonor Bettencourt
    ProChild CoLAB, Portugal.
    Jud, Andreas
    Univ Clin Ulm, Germany.
    Kemp, Alison
    Cardiff Univ, Wales.
    Naughton, Aideen
    Natl Safeguarding Team NHS Wales, Wales.
    Hurt, Lisa
    Cardiff Univ, Wales.
    Soldino, Virginia
    Univ Valencia, Spain.
    Ntinapogias, Athanasios
    Inst Child Hlth, Greece.
    Nurmatov, Ulugbek
    Cardiff Univ, Wales.
    Current issues and challenges in the definition and operationalization of child maltreatment: A scoping review2023In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 140, article id 106187Article, review/survey (Refereed)
    Abstract [en]

    Background: Studies show considerable variability in the definitions and operationalization of child maltreatment (CM), which limits research, policy formation, surveillance, and cross-country and cross-sector comparisons.Objective: To review the recent literature (2011-2021) to understand current issues and chal-lenges in defining CM, to assist in the planning, testing and implementing of CM conceptualizations.Methods: We searched eight international databases. Articles were included if the substantive content was related to issues, challenges, and debates in defining CM, and the article was an original study, review, commentary, report, or guideline. The review followed methodological guidance for the conduct of scoping reviews and was reported in accordance with the PRISMA-ScR checklist. Four experts in CM conducted a thematic analysis to summarize findings. Meth-odological rigor of the included studies was not formally assessed. Results: We identified 7372 potentially relevant articles; 55 full-text studies were assessed for eligibility, 25 satisfied the inclusion criteria. We identified three themes: 1) strategies to define CM, including the integration of child and victim perspectives; 2) difficulties in defining specific CM types; and 3) real-world implications for research, prevention and policy.Conclusions: Despite longstanding concerns, challenges regarding the definitions of CM persist. A small minority of studies have tested and implemented CM definitions and operationalizations inpractice. The findings will inform international multi-sectoral processes to develop uniform definitions of CM, for example by highlighting the need to acknowledge challenges in defining some CM types and emphasizing the importance of considering the perspectives of children and CM survivors.

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  • 27.
    Lagerberg, Dagmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    A descriptive survey of swedish child health nurses´ awareness of abuse and neglect. I: Characteristics of the nurses2001In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 25, no 12, p. 1583-1601Article in journal (Refereed)
    Abstract [en]

    Objective:

    The objectives were to assess: (1) child health nurses’ identification of abuse/neglect of children of preschool age in their districts; (2) overall prevalence of abuse/neglect according to the nurses; (3) determinants of nurse identification; (4) determinants of nurse-reported district prevalences; and (5) determinants of reporting to the child protection services (CPS).

    Method:

    Questionnaires were mailed to about 3000 child health centers.

    Results:

    Fifty-five percent responded. Of these, 22% identified no case and 33% at least one (mostly five or fewer). The overall prevalence was 1.4%. Identification correlated with general participation rate in the county. Other determinants of identification were acquaintance with the district, large district populations, and three variables assumed to reflect a personal interest. Determinants of prevalences were small district populations, regular contacts with the social services, and two personal interest variables. With large district populations, identification increased, whereas prevalences decreased. Only 30.3% had made a report to the CPS. Regular contacts with the social services correlated with reporting. Personal interest was a determinant of the decision to report, and acquaintance with the district a determinant of reporting rate.

    Conclusions:

    Abuse and neglect did not appear as priorities for the Child Health Services. The method probably led to an underestimation of the true prevalence. Personal interest and social services contacts emerged as important determinants. However, the assumed criteria of “interest” were not validated. For effective identification, no nurse should be responsible for more than 400 to 500 children. Implications for practice and research are discussed.

  • 28.
    Landberg, Åsa
    et al.
    Marie Cederschiöld University, Department of Social Sciences.
    Svedin, Carl Göran
    Marie Cederschiöld University, Department of Social Sciences.
    Jonsson, Linda Sofia
    Marie Cederschiöld University, Department of Social Sciences.
    Patterns of disclosure and perceived societal responses after child sexual abuse2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 134, article id 105914Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Disclosure of child sexual abuse (CSA) is key for abused children to access help and to protect them and other children.

    OBJECTIVE: The aim of this study was to investigate patterns of disclosure of child sexual abuse and how children perceived responses from people they disclosed to.

    PARTICIPANTS AND SETTING: Data were collected online in classrooms and during home studies in a national probability-based sample of 3282 third-year students in Swedish high schools in 2020-2021 (the age of the students varied between 16 and 23 years (M = 18,2)).

    METHODS: Results are presented with frequencies (n) and percentages (%). Pearson's chi-squared test was used for comparisons between groups.

    RESULTS: First, a substantial share of abused girls and most abused boys had not yet told anyone about the abuse, leaving them unable to access protection or rehabilitation. Second, participants who had disclosed sexual abuse had most often turned to a peer, more rarely to an adult, and seldom to a professional or volunteer. Third, although the societal responses that the participants perceived were mixed, more severe abuse was associated with more negative societal responses. Fourth, most participants stated that they did not need any professional support. Fifth, among the minority who had sought help, half were satisfied and a third dissatisfied.

    CONCLUSIONS: Results showed that most children with experience of CSA did not have access to the protection, support, and rehabilitation that they have a right to. Preventive measures need to target children and young people, while societal responses after CSA, especially severe CSA, need to be improved.

  • 29.
    Larsson, Ingbeth
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Teachers’ and parents’ reports on 3- to 6-year-old children’s sexual behavior: a comparison2002In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 26, no 3, p. 247-266Article in journal (Refereed)
    Abstract [en]

    Objectives: The main purpose of the study was to compare observed range and frequency of sexual behavior in 3- to 6-year-olds in two different environments: the home and the daycare center. The study also aimed to investigate parental and staff opinions on child sexual behavior.

    Methods: Parents and daycare teachers of 185 preschool children, from different socio-economic housing areas, answered extensive questionnaires about each child’s sexual and general behavior. They were also asked about their own opinions on child sexual behavior.

    Results: Parents observed significantly more sexual behavior in their children at home compared to teachers’ observations at the daycare centers in all age groups, while teachers reported more general behavior problems. Significant gender differences on sexual behavior were displayed at the daycare centers but not at home. Rare behaviors at home were also very unusual at the daycare center. Parental and staff attitudes toward child sexuality were quite open, although 67% of the parents and 41% of the teachers never spoke to the children on sexual matters. One fifth of the adults used no term for genitals at all, and even fewer had a name for girls’ genitals.

    Conclusions: The findings indicate that young children explore their sexuality more at home than in settings with groups of children where the daily activities may be more structured and monitored. It enhances the importance of looking at the context in which the sexual behavior is taking place when investigating problematic sexual behavior.

  • 30.
    Leander, Lina
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Police interviews with child sexual abuse victims: Patterns of reporting, avoidance and denial2010In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 34, no 3, p. 192-205Article in journal (Refereed)
    Abstract [en]

    Objective: The present study investigated 27 sexually abused children's reports about abuse given in the context of police interviews. All abuse cases had been verified (with, e.g., photographs or video films), proving that abuse had occurred. Method: The interviews with the children were analyzed regarding amount and type of information reported, and the frequency of denial and avoidance. Furthermore, children's reporting on different interview occasions was investigated. Results: Children reported significantly more neutral information from the abusive acts per se than sexual information. The children were also highly avoidant and, on several occasions, denied that (documented) sexual acts had occurred. Furthermore, the second and third interviews generated twice as many (new) sexual details as the first interview. The children also produced more denials and avoidances at the first interview compared to subsequent interviews. Conclusions: The present study indicates that sexually abused children may be highly resistant to reporting about the abuse in police interviews, and that two or three interviews may be needed to enable children to give complete and informative reports. It is of vital importance that professionals within the legal system be aware of this problem when conducting child interviews and when evaluating the reliability of child sexual abuse reports.

  • 31.
    Lindblad, Frank
    et al.
    Department of Child and Adolescent Psychiatry, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Gustavsson, Per A.
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Larsson, IngBeth
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Lundin, Björn
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Preschoolers' sexual behavior at daycare centers: An epidemiological study1995In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 19, no 5, p. 569-577Article in journal (Refereed)
    Abstract [en]

    The frequency of sexual behaviors in a population of preschoolers (n = 251) attending Swedish daycare centers was studied using a questionnaire given to the staff. Some behaviors turned out to be frequently occurring, like searching for body contact and responding to such contact. However, several behaviors were very uncommon (1% or fewer): touching an adult's genitals; attempting to make the adult touch the child's genitals; using objects against own or other childs genitals/anus; to masturbate obsessively, without pleasure or in a way that caused pain. Other behaviors occurred more frequently but were still uncommon (less than 2% of the children displayed such a behavior “sometimes” or “often/daily”): exhibiting own genitals; playing sexually explorative games; initiating games with a similarity to adult sexual activity; using sexual words; attempting to touch a woman's breast. Only masturbation and clinging body contact were positively correlated with behavioral disturbance. The correlations between age and single behaviors may be summarized as manifestations of the process of socialization. The results offer an incipient frame of reference for statistically normal expected sexual behaviors in preschoolers at daycare centers. The rarity of certain behaviors implies that their occurrence in an individual case may necessitate special clinical attention.

  • 32.
    Maul, Kayleigh M.
    et al.
    Whiston Hosp, Warrington Rd, Liverpool L35 5DR, Merseyside, England;Waikato DHB, Obstet & Gynaecol, Pembroke St, Hamilton 3204, New Zealand.
    Naeem, Rubaba
    Aga Khan Univ, Dept Emergency Med, POB 3500,Stadium Rd, Karachi, Pakistan.
    Khan, Uzma Rahim
    Aga Khan Univ, Dept Emergency Med, POB 3500,Stadium Rd, Karachi, Pakistan.
    Mian, Asad I.
    Aga Khan Univ Hosp, Dept Emergency Med, CCIT, Karachi, Pakistan.
    Yousafzai, Aisha K.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA 02115 USA.
    Brown, Nick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Lanssjukhuset Gavle Sandviken, Dept Paediat, S-80187 Gavle, Sweden;Aga Khan Univ, Dept Child Hlth, Stadium Rd, Karachi 74800, Pakistan.
    Child abuse in Pakistan: A qualitative study of knowledge, attitudes and practice amongst health professionals2019In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 88, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Child abuse is a global problem and pervades all cultures and socio-economic strata. The effects can be profound and life altering for victims. There is substantial literature from high income countries about signs of abuse, but a dearth of data from low and middle income countries like Pakistan. Healthcare professionals (HCP) are ideally placed to detect abuse, but, to inform interventions, an understanding of their experiences, training needs and cultural beliefs is needed. This study aimed to: (1) Explore the challenges that HCP face when managing cases of abuse; (2) Explore cultural beliefs and understand how these shape practice and (3) Identify training needs. A qualitative study using a phenomenological design was conducted. In-depth interviews were conducted with doctors, nurses and security staff in the emergency department of a large private hospital in Pakistan (n = 15). Interviews were undertaken in Urdu, translated into English and analysed using an inductive thematic approach. Multiple challenges were identified. The process of referral to legal services was poorly understood and further training and guidelines was suggested by participants. As the legal system in Pakistan does not allow HCP to keep potentially abused patients in their custody, they felt restricted in their ability to advocate and concerned about the safety of both the identified children and themselves. HCP have potential to detect abuse early; however, in Pakistan there are numerous challenges. HCP require support through training, as well as clear institutional frameworks and legal support to undertake this role.

  • 33.
    Miller, Laura E.
    et al.
    Department of Psychology and Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, USA.
    Cater, Åsa
    Örebro University, School of Law, Psychology and Social Work.
    Howell, Kathryn H.
    Department of Psychology, University of Memphis, Memphis, USA.
    Graham-Bermann, Sandra A.
    Psychology and Psychiatry, Department of Psychology, University of Michigan, Ann Arbor, USA.
    Perpetration patterns and environmental contexts of IPV in Sweden: relationships with adult mental health2014In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 38, no 1, p. 147-158Article in journal (Refereed)
    Abstract [en]

    Although excellent data exist on the overall prevalence of childhood exposure to intimatepartner violence (IPV), there is less information available on the specific patterns of IPVexposure in childhood and how they influence adult mental health. The current study exa-mines 703 Swedish adults who reported exposure to IPV in childhood. Participants werepart of a large national study on violence exposure. They provided an extensive history of their exposure to IPV and maltreatment experiences during childhood via electronically administered questionnaires. Mean comparison and multivariate regression methods were employed to assess differences in violence severity by reported perpetration pattern(mother-only, father-only, bidirectional or other), the association between violence severity and environmental context, and the contribution of these characteristics to adult mental health outcomes. Overall, violence perpetrated in public and by fathers was more severe and was related to poorer mental health outcomes in adulthood for child witnesses. These findings provide important insight into possible clinical "flags" for identifying children at high risk for exposure to IPV and abuse in the home.

  • 34.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Nordås, Elvira
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Priebe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Department of Psychology, Lund University, Lund, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Child physical abuse: High school students’ mental health and parental relations depending on who perpetrated the abuse2017In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 70, p. 28-38Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to contribute to the research of child physical abuse (CPA) by examining if there were any differences in high school students’ mental health (in this study symptoms of depression and anxiety, self-esteem and sense of coherence) and/or, in how they perceive their parents, depending on whether or not they had been subjected to CPA during childhood. In addition, if high school students reported different mental health and/or, relationships with their parents, depending on if their mother, father or both parents were the perpetrators of CPA.

    A representative national sample of high school students (N = 3288, data collected 2009) participated in the study. Participants completed the following: questions about CPA and alleged perpetrators, the Hopkins Symptom Checklist, Rosenberg Self-Esteem Scale, the Sense of Coherence Scale and Parental Bonding Instrument.

    The results showed students who reported experiences of CPA were more likely to report symptoms of mental illness and negative perceptions of their parents’ parenting. However, there were no mental health differences depending on whether their mother, father or both parents were the perpetrators of CPA. Still, there were differences in perceived parenting indicating that mothers’ parenting was perceived as more negative when mothers only or both parents were perpetrators of the abuse than when only fathers were perpetrators.

  • 35.
    Nilsson, Doris
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Wadsby, Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Svedin, Carl Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    The psychometric properties of the Trauma Symptom Checklist For Children (TSCC) in a sample of Swedish children2008In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 32, no 6, p. 627-636Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the psychometric properties of the Swedish version of the Trauma Symptom Checklist for Children (TSCC) and to study traumatic symptoms in a normative group of Swedish children and adolescents. Method: A normative group of 728 children and adolescents age 10-17 and a clinical group of 91 children and adolescents known to have experienced sexual abuse participated in the study. A test-retest procedure was conducted with 79 participants from the normative group. Results: Good reliability such as internal consistency (Cronbach's alpha) for the total scale .94 (ranging in the clinical scales .78-.83) and test-retest for the total scale r = .81 (ranging in the clinical scales .67-.81) were found. The confirmatory 6-factor analysis explained 50.7% of the variance. Other validity measures such as concurrent validity and criterion related validity were also shown to be satisfactory. The normative sample of Swedish children and adolescents showed lower means on the subscales than has been reported in previous studies from a number of other countries. Conclusion: The Swedish version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable to identify trauma symptoms among children and adolescents who have themselves self-reported experiencing trauma or for whom clinicians have identified traumatic experiences. © 2008 Elsevier Ltd. All rights reserved.

  • 36. Peltonen, Kirsi
    et al.
    Ellonen, Noora
    Poso, Tarja
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, National Centre for Knowledge on Men.
    Mothers' self-reported violence toward their children: A multifaceted risk analysis2014In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 38, no 12, p. 1923-1933Article in journal (Refereed)
    Abstract [en]

    The universal aim of decreasing parental violence against children requires the detection of risk factors associated with violent behavior among parents. Although research has identified a number of such risk factors, these findings are scattered and a comprehensive picture is lacking. In the present study, 20 child-, parent- and family-related factors have been included in a combined analysis to assess which of these may pose as risk factors for mothers' severe violent behavior toward their children. The study is based on a representative sample of 2,716 Finnish mothers with 0-12-year-old children and was conducted as an anonymous survey. Analyses were carried out using logistic regression models. 6% of the mothers had committed severe violent acts, i.e. slapped, hit, punched (with a fist), kicked, bit, hit/try to hit the child with an object or shook (under 2 year old) child at least once during the 12 months preceding the survey. Corporal punishment experienced by the mother as a child (OR 2.45, CI 1.55-3.88) or used by the mother as a method of discipline (OR 11.14, Cl 5.95-20.87), strongly increased the likelihood of severe violent acts. Additionally, workor family-related stress (OR 1.83, Cl 1.24-2.73) and lack of help in dealing with parenting problems (OR 2.55, Cl 1.66-3.90) were detected as risk factors for severe violent acts toward one's own child. The findings suggest that prevention of corporal punishment may be an important hinder to the transmission of experiences of violence from one generation to another, and that contextual and situational factors may overlap the influence of individual-related risk factors.

  • 37.
    Pernebo, K.
    et al.
    Växjö universitet.
    Fridell, M.
    Lund universitet.
    Almqvist, Kjerstin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 79, p. 213-223Article in journal (Refereed)
    Abstract [en]

    Witnessing violence toward a caregiver during childhood is associated with negative impact on children's health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children—24 girls and 26 boys—aged 4–13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children's mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children's symptoms after interventions.

  • 38.
    Pernebo, K.
    et al.
    Linnaeus University, Växjö, Sweden.
    Fridell, M.
    Lunds universitet.
    Almqvist, Kjerstin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Reduced psychiatric symptoms at 6 and 12 months’ follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence2019In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 93, p. 228-238Article in journal (Refereed)
    Abstract [en]

    Background: Long-term follow-up studies of interventions for children exposed to intimate partner violence are few, and the sustainability of their outcomes often remains unexplored and uncertain. Current research including follow-up assessment suggests that treatment gains may be maintained or continue post termination. In addition some children may show increased levels of symptoms. Objective: The present effectiveness study investigated the long-term outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. Participants and Setting: The study included 50 children, 24 girls and 26 boys, aged 4 to 13 years attending a psychotherapeutic child and adolescent mental health service intervention and a psychoeducative community-based intervention. Methods: Background information, child and parental mental health problems, trauma symptoms, and exposure to violence were assessed pre- and post treatment and at 6 and 12 months’ follow-up. Results: Sustained treatment gains and late improvements in children's internalizing and externalizing symptoms and in symptoms of traumatic stress were recorded from post treatment to the follow-up assessments (p =.004–.044; d = 0.29–0.67). No significant increase in symptoms was reported. Additionally, very little continued or renewed child exposure to violence was reported. Conclusions: The results of the study indicate that the children did benefit from the two interventions studied and that the outcomes of reduced child symptoms and protection from exposure to violence were sustainable. Children with severe trauma symptoms benefited the most, though maternal psychological problems may for some have hindered recovery. Clinical implications are discussed.

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    Pernebo2019
  • 39.
    Pernebo, Karin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Region Kronoberg, Sweden.
    Fridell, Mats
    Lund university, Sweden.
    Almqvist, Kjerstin
    Karlstad university, Sweden.
    Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence.2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 79, p. 213-223Article in journal (Refereed)
    Abstract [en]

    Witnessing violence toward a caregiver during childhood is associated with negative impact on children's health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children-24 girls and 26 boys-aged 4-13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children's mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children's symptoms after interventions.

  • 40.
    Priebe, Gisela
    et al.
    Lund University.
    Backstrom, Martin
    Lund University.
    Ainsaar, Mare
    University Tartu, EST.
    Vulnerable adolescent participants' experience in surveys on sexuality and sexual abuse: Ethical aspects2010In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 34, no 6, p. 438-447Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this research was to study the discomfort experienced by adolescents when answering questions in a survey about sexuality and sexual abuse and to investigate factors that may determine possible experience of discomfort. The research focused particularly on vulnerable adolescents sexually abused and sexually inexperienced. Method: Adolescents in their final year of high school in Estonia (n = 1,334) and Sweden (n = 3,401) who had completed a survey about experiences of sexuality and sexual abuse answered additional questions about experiences of discomfort related to the survey questions. Results: A majority of the participants did not feel discomfort when completing the survey. This was also the case for the two vulnerable groups. Experience of penetrating sexual abuse, sexual inexperience, mental health problems, rape myth acceptance, gender, immigrant background, and country were included in a structural equation model. Experience of penetrating sexual abuse was not significantly related to discomfort in the final model, while sexual inexperience was associated with increased discomfort (standardized coefficient .20) and rape myth acceptance was the strongest indicator of discomfort (.27). The total amount of explained variance was 17%. Conclusions: Our data do not support the view that adolescents in general or vulnerable subgroups such as sexually abused or sexually inexperienced adolescents experience discomfort when answering a survey about sexuality and sexual abuse. As discomfort ratings were not highly related to any of the predictors further research is needed that includes other factors. It is important to follow existing ethical guidelines since there may always be some individuals who feel discomfort. (C) 2010 Elsevier Ltd. All rights reserved.

  • 41.
    Priebe, Gisela
    et al.
    Lunds universitet.
    Bäckström, Martin
    Lunds universitet.
    Ainsaar, Mare
    Tartu universitet, Estland.
    Vulnerable adolescent participants’ experience in surveys on sexuality and sexual abuse: Ethical aspects2010In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 34, no 6, p. 438-447Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this research was to study the discomfort experienced by adolescents when answering questions in a survey about sexuality and sexual abuse and to investigate factors that may determine possible experience of discomfort. The research focused particularly on vulnerable adolescents—sexually abused and sexually inexperienced.

    Method

    Adolescents in their final year of high school in Estonia (n = 1,334) and Sweden (n = 3,401) who had completed a survey about experiences of sexuality and sexual abuse answered additional questions about experiences of discomfort related to the survey questions.

    Results

    A majority of the participants did not feel discomfort when completing the survey. This was also the case for the two vulnerable groups. Experience of penetrating sexual abuse, sexual inexperience, mental health problems, rape myth acceptance, gender, immigrant background, and country were included in a structural equation model. Experience of penetrating sexual abuse was not significantly related to discomfort in the final model, while sexual inexperience was associated with increased discomfort (standardized coefficient .20) and rape myth acceptance was the strongest indicator of discomfort (.27). The total amount of explained variance was 17%.

    Conclusions

    Our data do not support the view that adolescents in general or vulnerable subgroups such as sexually abused or sexually inexperienced adolescents experience discomfort when answering a survey about sexuality and sexual abuse. As discomfort ratings were not highly related to any of the predictors further research is needed that includes other factors. It is important to follow existing ethical guidelines since there may always be some individuals who feel discomfort.

  • 42.
    Priebe, Gisela
    et al.
    Lunds universitet.
    Svedin, Carl Goran
    Linköping University.
    Child sexual abuse is largely hidden from the adult society An epidemiological study of adolescents' disclosures: An epidemiological study of adolescents' disclosures2008In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 32, no 12, p. 1095-1108Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse. Method: A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning sexual experiences in this study with a focus on disclosure of sexual abuse (non-contact, contact or penetrating abuse, and including peer abuse). Results: Of the sample, 1,505 girls (65%) and 457 boys (23%) reported experience of sexual abuse. The disclosure rate was 81% (girls) and 69% (boys). Girls and boys disclosed most often to a friend of their own age. Few had disclosed to professionals. Even fewer said that the incident had been reported to the authorities. Logistic regression showed that it was less likely for girls to disclose if they had experienced contact sexual abuse with or without penetration, abuse by a family member, only a single abuse occasion or if they had perceived their parents as non-caring. Boys were less likely to disclose if they studied a vocational program, lived with both parents or had perceived their parents as either caring and overprotective or non-caring and not overprotective. Conclusions: Disclosing sexual abuse is a complex process. Much is hidden from the adult society, especially from professionals and the legal system. Since peers are the most common receivers of abuse information, programs for supporting peers ought to be developed. Differences in disclosure patterns for girls and boys indicate that a gender perspective is helpful when developing guidelines for professionals. Practice implications: Professionals, especially in the school system, need to be more aware of the finding that few sexually abused children seek help from professionals or other adults and that support offers should be directly addressed not only to the vulnerable young persons themselves but also to peers who wish to help a friend. (C) 2008 Elsevier Ltd. All rights reserved.

  • 43.
    Priebe, Gisela
    et al.
    Lunds universitet.
    Svedin, Carl Göran
    Linköping University.
    Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents’ disclosures2008In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 32, no 12, p. 1095-1108Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse.

    Method

    A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning sexual experiences in this study with a focus on disclosure of sexual abuse (non-contact, contact or penetrating abuse, and including peer abuse).

    Results

    Of the sample, 1,505 girls (65%) and 457 boys (23%) reported experience of sexual abuse. The disclosure rate was 81% (girls) and 69% (boys). Girls and boys disclosed most often to a friend of their own age. Few had disclosed to professionals. Even fewer said that the incident had been reported to the authorities. Logistic regression showed that it was less likely for girls to disclose if they had experienced contact sexual abuse with or without penetration, abuse by a family member, only a single abuse occasion or if they had perceived their parents as non-caring. Boys were less likely to disclose if they studied a vocational program, lived with both parents or had perceived their parents as either caring and overprotective or non-caring and not overprotective.

    Conclusions

    Disclosing sexual abuse is a complex process. Much is hidden from the adult society, especially from professionals and the legal system. Since peers are the most common receivers of abuse information, programs for supporting peers ought to be developed. Differences in disclosure patterns for girls and boys indicate that a gender perspective is helpful when developing guidelines for professionals.

    Practice implications

    Professionals, especially in the school system, need to be more aware of the finding that few sexually abused children seek help from professionals or other adults and that support offers should be directly addressed not only to the vulnerable young persons themselves but also to peers who wish to help a friend.

  • 44.
    Pålsson, David
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Leviner, Pernilla
    Stockholm University, Faculty of Law, Department of Law, Stockholm Centre for the Rights of the Child.
    Wiklund, Stefan
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Children's right to participation in Swedish child welfare: The extent, nature and determinants of child interviews during investigations2024In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757Article in journal (Refereed)
    Abstract [en]

    Background: Children's right to participation in child welfare decision-making is highlighted in law and research. However, there is a lack of comprehensive empirical research on how such participation is actually fulfilled.

    Objective: This article aims to describe and analyse the extent, nature and determinants of children's participation in child welfare investigations in Sweden as well as to discuss barriers to participation.Participants and settingThe dataset comprises a cohort of 2123 children investigated during 2022 across eight municipalities in Stockholm County, Sweden.

    Methods: The study is based on cross-sectional data where the responsible child welfare workers served as informant in a survey focusing child and case factors concerning 2123 children subject to child welfare investigations. The data is analysed by using descriptive and binary logistic regression analyses.

    Results: In approximately 75 % of the child welfare investigations, child welfare workers held interviews with the child (with or without parental presence) while individual child interviews were carried out in about 50 % of the cases. Multiple interviews (≥3) occurred in 14 % of the cases. Reasons for not interviewing children included finding interviews to be unnecessary, perceiving the child as too young, and reluctance by the child as to participation. Investigations involving older children and referrals related to abuse increased the odds for participation.

    Conclusions: The study suggests that more children are interviewed by child welfare authorities than found in previous studies, but that there still is a gap between the legislative intention to facilitate child participation and the actual state of child welfare practice.

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  • 45. Quarles van Ufford, Sara
    et al.
    Heimer, Maria
    Schön, Ulla-Karin
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Dalarna University, Sweden.
    Linell, Hanna
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    The Swedish social services' police reporting and children's access to protection and support in child abuse cases: A quantitative content analysis2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 133, article id 105828Article in journal (Refereed)
    Abstract [en]

    Background: The UN Convention on the Rights of the Child prohibits all forms of violence against children. Sweden was early in introducing a ban on disciplinary violence; however, difficulties have been noted in identifying children in need of protection and providing help for children exposed to violence.

    Objectives: The purpose of this study was to explore the social services' police reporting and children's access to protection and support in cases of physical and sexual child abuse.

    Methods: The sample consisted of 291 child welfare reports from three Swedish municipalities. Data were collected from child welfare reports, investigations, and child social records and analyzed using quantitative content analysis.

    Results: A majority of the cases, including cases with a high indication for police reporting, were not reported to the police by the social services. Although the child in 60.1 % of cases provided information about violence, 70.7 % of all child welfare investigations were completed without support measures, and only 8.2 % led to protection or support linked to violence. Children's participation was limited, suggesting inadequate conditions for children's access to protection and support.

    Conclusions: Children's right to protection against violence requires the recognition of children as active participants with access to safe participation. Failure to report suspected crimes against children risks minimizing acts of violence or making violence invisible. Difficulties in handling conflicts of interest between children and parents risk neither protection nor support being provided for the child.

  • 46.
    Quarles van Ufford, Sara
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Social Work.
    Heimer, Maria
    Uppsala University, Uppsala.
    Schön, Ulla-Karin
    Dalarna University, School of Health and Welfare, Social Work.
    Linell, Hanna
    Stockholm University, Stockholm.
    The Swedish social services' police reporting and children's access to protection and support in child abuse cases: A quantitative content analysis.2022In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 133, article id 105828Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The UN Convention on the Rights of the Child prohibits all forms of violence against children. Sweden was early in introducing a ban on disciplinary violence; however, difficulties have been noted in identifying children in need of protection and providing help for children exposed to violence.

    OBJECTIVES: The purpose of this study was to explore the social services' police reporting and children's access to protection and support in cases of physical and sexual child abuse.

    METHODS: The sample consisted of 291 child welfare reports from three Swedish municipalities. Data were collected from child welfare reports, investigations, and child social records and analyzed using quantitative content analysis.

    RESULTS: A majority of the cases, including cases with a high indication for police reporting, were not reported to the police by the social services. Although the child in 60.1 % of cases provided information about violence, 70.7 % of all child welfare investigations were completed without support measures, and only 8.2 % led to protection or support linked to violence. Children's participation was limited, suggesting inadequate conditions for children's access to protection and support.

    CONCLUSIONS: Children's right to protection against violence requires the recognition of children as active participants with access to safe participation. Failure to report suspected crimes against children risks minimizing acts of violence or making violence invisible. Difficulties in handling conflicts of interest between children and parents risk neither protection nor support being provided for the child.

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  • 47.
    Rajesh, Tanishta
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Jonsson, Kenisha Russell
    Jackisch, Josephine
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Schultz Straatmann, Viviane
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Changes in parents' mental health related to child out-of-home care placements: A Swedish national register study2023In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 140, article id 106149Article in journal (Refereed)
    Abstract [en]

    Background: Literature on outcomes of children in out-of-home care (OHC) is extensive. However, less is known regarding associations of such placements with parental mental health disorders (MHD).

    Objective: This study investigated changes in hospitalization rates due to MHD among parents, four years before and after placement of their child in OHC.Participants and settingWe used data on 4067 members (Generation 1) of the RELINK53 cohort (individuals born and living in Sweden in 1953) and their 5373 children (Generation 2) in OHC.

    Methods: Using random effects regression models, associations between OHC and MHD were examined separately for fathers and mothers. Nested models were tested exploring associations with parent and child/placement-related factors. Marginal effects were computed to assess mean rates of hospitalization annually.

    Results: Overall, mothers had higher mean hospitalization rates than fathers. Compared to the year of placement, hospitalization rates were significantly lower in the four years before placement for mothers (9.9 %, 9.5 %, 10.5 %, 12.1 %, respectively) and fathers (5.9 %, 7.6 %, 8 %, 9.8 %, respectively). Mothers showed highest hospitalization rates at the year of placement (26.6 %), while fathers, one year after placement (13.4 %). Hospitalization rates declined significantly directly after placement among mothers, but an unclear and non-significant pattern of results was found among fathers.

    Conclusions: Most parents have higher hospitalization rates at and directly after placement. Potential hypotheses underlying these findings are discussed, including psychosocial gender differences and opportunities to seek care as means of reunification. There is an urgency to develop strategies to better support these parents throughout the process.

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  • 48.
    Regber, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Dahlgren, Jovanna
    Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Janson, Staffan
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
    Neglected children with severe obesity have a right to health: Is foster home an alternative?—A qualitative study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, no 83, p. 106-119Article in journal (Refereed)
    Abstract [en]

    Objective: To explore key person’s perspectives of foster home placement or notification of risk of harm to Social Services of children with severe obesity.

    Methods: This case study research was performed in the southwest of Sweden and based on interviews with nine informants: a foster home youth, two foster parents, a social worker, two hospital social workers, a pediatric physician, a pediatric nurse, and a psychologist. Content analysis was used for narrative evaluations, within- and cross case analyses and displays.

    Results: Positive health outcomes of the foster home placement were described as a healthy and normalized weight status, a physically and socially active life, and an optimistic outlook on the future. The foster parents made no major changes in their family routines, but applied an authoritative parenting style regarding limit setting about sweets and food portions and supporting physical activity. The professionals described children with severe obesity as having suffered parental as well as societal neglect. Their biological parents lacked the ability to undertake necessary lifestyle changes. Neglected investigations into learning disabilities and neuropsychiatric disorders were seen in the school and healthcare sector, and better collaboration with the Social Services after a report of harm might be a potential for future improvements. Rival discourses were underlying the (in) decision regarding foster home placement.

    Conclusion: A child’s right to health was a strong discourse for acting when a child was at risk for harm, but parental rights are strong when relocation to a foster home is judged to be necessary. © 2018 Elsevier Ltd

  • 49.
    Regber, Susann
    et al.
    Halmstad Univ, Sch Hlth & Welf, Halmstad, Sweden.
    Dahlgren, Jovanna
    Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Janson, Staffan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Neglected children with severe obesity have a right to health: Is foster home an alternative?-A qualitative study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 83, p. 106-119Article in journal (Refereed)
    Abstract [en]

    Objective: To explore key person's perspectives of foster home placement or notification of risk of harm to Social Services of children with severe obesity.

    Methods: This case study research was performed in the southwest of Sweden and based on interviews with nine informants: a foster home youth, two foster parents, a social worker, two hospital social workers, a pediatric physician, a pediatric nurse, and a psychologist. Content analysis was used for narrative evaluations, within- and cross case analyses and displays.

    Results: Positive health outcomes of the foster home placement were described as a healthy and normalized weight status, a physically and socially active life, and an optimistic outlook on the future. The foster parents made no major changes in their family routines, but applied an authoritative parenting style regarding limit setting about sweets and food portions and supporting physical activity. The professionals described children with severe obesity as having suffered parental as well as societal neglect. Their biological parents lacked the ability to undertake necessary lifestyle changes. Neglected investigations into learning disabilities and neuropsychiatric disorders were seen in the school and healthcare sector, and better collaboration with the Social Services after a report of harm might be a potential for future improvements. Rival discourses were underlying the (in) decision regarding foster home placement.

    Conclusion: A child's right to health was a strong discourse for acting when a child was at risk for harm, but parental rights are strong when relocation to a foster home is judged to be necessary.

  • 50. Ruchkin, V V
    et al.
    Eisemann, M
    Hägglöf, B
    Juvenile male rape victims: is the level of post-traumatic stress related to personality and parenting?1998In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 22, no 9, p. 889-99Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to assess the level of post-traumatic stress in juvenile male rape victims and to test for its relationships with perceived parental rearing and personality dimensions.

    METHOD: Fifteen subjects (mean age of 16 years) were recruited from a correctional camp for juvenile criminals in Arkhangelsk, Russia. They were investigated by means of the "Revised Impact of Event Scale," the "Child Self-Report Post-Traumatic Stress Reaction Index," the "Hospital Anxiety and Depression Scale," the "EMBU" (perceived parental rearing) and the "Temperament and Character Inventory" (TCI).

    RESULTS: The level of post-traumatic stress, in most cases moderate to high, correlated with the temperament dimensions of harm avoidance and reward dependence. As concerns parental rearing, the total level of post-traumatic stress reaction was negatively correlated with paternal emotional warmth and positively with paternal rejection.

    CONCLUSIONS: The experience of post-traumatic stress is influenced by temperamental characteristics as well as by perceived parental rearing practices. Assumingly, these factors also play a role in becoming a rape victim, which deserves further investigation.

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