Accidents & Violence, Author Interviews, Pediatrics / 28.06.2019 Interview with:

Amanda Fingarson, DO Attending Physician, Child Abuse Pediatrics Ann and Robert H. Lurie Children’s Hospital of Chicago Assistant Professor of Pediatrics Feinberg Northwestern School of Medicine  What is the background for this study?  What are the main findings?

Response: Child physical abuse is a substantial pediatric public health issue, with significant morbidity and mortality. Studies have found that men, particularly children’s fathers and mothers’ boyfriends are common perpetrators of physical abuse. There is still a lack of knowledge, however, about the specific caregiver features that increase a child’s risk for physical abuse.

Our study design was unique, in that it was a multi-center study that compared young children with abusive and accidental injuries. Our primary finding was that abuse was much more likely when a male caregiver was present, and the resulting injuries were more likely to be severe or fatal. The presence of the mother’s boyfriend was the riskiest scenario, with the highest likelihood of abuse. Similarly, we found that caregiver relationships of less than 1 year increased the odds of abuse. Overall, the likelihood of abuse with female caregivers was much lower, with the exception of female babysitters.  A final important finding of our study was that caregiving arrangements that were different than usual at the time of injury were at increased risk of abuse, suggesting that a stable and consistent caregiver is also important.  (more…)

Author Interviews, Cost of Health Care, Pediatrics, Sexual Health / 02.04.2018 Interview with: Dr. Xiangming Fang, PhD Associate professor of Health Management and Policy School of Public Health Georgia State University What is the background for this study? Response: Child sexual abuse is a serious public health problem in the United States. The estimated prevalence rates of exposure to child sexual abuse by 18 years old are 26.6 percent for U.S. girls and 5.1 percent for U.S. boys. The effects of child sexual abuse include increased risk for development of severe mental, physical and behavioral health disorders; sexually transmitted diseases; self-inflicted injury, substance abuse and violence; and subsequent victimization and criminal offending. (more…)
Abuse and Neglect, Author Interviews, Pediatrics, University of Pennsylvania / 16.12.2016 Interview with: Joanne N. Wood, MD, MSHP Assistant Professor of Pediatrics Perelman School of Medicine at the University of Pennsylvania Research Director, SafePlace Faculty, PolicyLab The Children’s Hospital of Philadelphia What is the background for this study? Response: Each year the U.S. Army Family Advocacy program (FAP) investigates between 6000 to 9000 reports of alleged abuse or neglect involving children of Army service members.   In approximately 48% of reported cases FAP determines a child was a victim of maltreatment, substantiates the report, and collaborates with local civilian child protection service (CPS) agencies in providing services and ensuring safety. Thus, FAP plays a key role in supporting Army families and protecting children.  But FAP can only investigate and respond to cases of child abuse and neglect about which they are aware. (more…)
Abuse and Neglect, Accidents & Violence, Author Interviews, JAMA, Mental Health Research / 29.01.2016 Interview with: Tracie O. Afifi, PhD Associate Professor of Epidemiology CIHR New Investigator (2013-2018) Departments of Community Health Sciences and Psychiatry College of Medicine, Faculty of Health Sciences University of Manitoba  Medical Research: What is the background for this study? Dr. Afifi: Recent studies in the US have examined predictors and correlates of suicide among solider, but none of these studies have investigated the potential role that child abuse exposure may play in suicide-related outcomes. In addition no representative military and civilian comparisons from any country have examined possible differences in the prevalence of child abuse exposure and the potential differences in the relationships between child abuse exposure and suicide-related outcomes in these populations. This study uses nationally representative military and civilian samples from Canada. Medical Research: What are the main findings? Dr. Afifi: Child abuse was more prevalent among Regular Forces personnel (47.7%) and Reserve Forces personnel (49.4%) compared to the Canadian general population (33.1%). Child abuse exposure was associated with an increased likelihood of suicidal thoughts, plans, and attempts in military and civilian populations, with associations weaker for many outcomes in military personnel relative to civilians. Deployment-related trauma was associated with past-year suicidal thoughts and suicide plans. However, relative to deployment-related trauma, child abuse exposure had a more robust association with suicide-related outcomes. (more…)
Accidents & Violence, JAMA, Pediatrics, Yale / 03.06.2014

Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale Interview with Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University. What are the main findings of the study? Dr. Wildeman: There are four key findings in the study. First, the cumulative risk of having a confirmed maltreatment report any time between birth and age 18 is much higher than most people would have thought. Fully 1 in 8 American children will experience this event at some point. Second, the risk of experiencing this event is highly unequally distributed, with Black and Hispanic experiencing it much more than Hispanic, White, and (especially) Asian children. Between 1 in 4 and 1 in 5 Black children will have a confirmed maltreatment report at any time in their childhood. For Native American, the risk is about 1 in 7. Third, the risk of maltreatment is quite similar for boys and girls. Finally, the highest risks of child maltreatment are in the first few years of life, suggesting that interventions aiming to diminish maltreatment should focus on parents with very young children. (more…)
Accidents & Violence, Author Interviews, Endocrinology, Pediatrics, Weight Research / 23.03.2014 Interview with: Christos S. Mantzoros, MD, DSc, PhD Beth Israel Deaconess Medical Center and the VA Boston HealthcareChristos S. Mantzoros, MD, DSc, PhD Beth Israel Deaconess Medical Center and the VA Boston Healthcare Cynthia R. Davis PhD Judge Baker Children’s Center in Boston, MA.Cynthia R. Davis PhD Judge Baker Children’s Center in Boston, MA. What are the main findings of this study? Answer: These results highlight that chronic stressors in childhood, like child abuse and family violence, parental substance abuse, divorce and separation from a parental figure, can potentially have a long standing impact on brain structures and functioning, such as the hypothalamic-pituitary-adrenal axis.  Our work supports the notion of allostatic load, and is the first of its kind to demonstrate links between childhood adversity and central obesity later in life which leads to increased cardio metabolic risk. This study describes the role of these novel molecules in mediating metabolic dysregulation highlighting them as a novel mechanism linking childhood adversity to obesity. We have also used more sensitive assessments of childhood adversity, not typically employed in biomedical research, that incorporate the severity of adversities and their chronicity across childhood.  Assessments of this nature are better able to detect severe and chronic adversity, and are critical in the measurement of stress, its role in allostatic load and its impact on the brain.  Furthermore, the current study and others from our lab show that severe and chronic adversity in childhood is associated with metabolic dysregulation and obesity in adulthood, regardless of lifestyle factors such as diet and exercise and psychosocial factors like depression and social support. Clinicians and patients need to be aware of the fact that subjects exposed to early life adversity are at increase risk for central obesity and cardio metabolic risk. (more…)