Background: Maltreatment by a primary caregiver is an important risk factor for the development of PTSD symptoms. Whereas meta-analyses indicate that parental emotional abuse is one of the most... Show moreBackground: Maltreatment by a primary caregiver is an important risk factor for the development of PTSD symptoms. Whereas meta-analyses indicate that parental emotional abuse is one of the most common forms of maltreatment, the impact of emotional abuse on PTSD symptoms and treatment effectiveness is still unclear, especially in children.Objective: We aimed to investigate the impact of parental emotional abuse on PTSD symptom severity and effectiveness of trauma treatment in children and adolescents.Method: In an outpatient sample (N = 287, mean age = 15.5 years), emotional abuse, index traumatic event, and PTSD symptoms were assessed at baseline. Thereafter, patients received evidence-based treatment for trauma-related symptoms embedded in a broader (systemic) treatment package. In a subsample (n = 130, mean age = 15.3 years) PTSD symptoms were assessed again 6 and 12 months after baseline.Results: Emotional abuse (rather than any other type of maltreatment) was associated with more severe PTSD symptoms in all symptom clusters. This was independent of whether emotional abuse was reported as index traumatic event or not. Moreover, PTSD symptoms were significantly reduced 6 months after the start of trauma-focused treatment, and emotional abuse was associated with more severe PTSD symptoms over the course of treatment.Conclusions: These findings underline the detrimental nature of emotional maltreatment in the context of PTSD symptomatology and treatment effectiveness. This calls for routine assessment of parental emotional abuse in the diagnostic phase, even when this is not the reason of referral. Show less
This study investigated the prevalence of child maltreatment in a cross-cultural perspective, the changes in prevalence estimates in Vietnam over time, child and family risk factors of maltreatment... Show moreThis study investigated the prevalence of child maltreatment in a cross-cultural perspective, the changes in prevalence estimates in Vietnam over time, child and family risk factors of maltreatment, and possible consequences of child maltreatment. We administered questionnaires and a working memory test to 1,851 secondary and high school students (12-17 years old) in four Northern provinces of Vietnam. We compared current Vietnamese prevalence estimates with those from the Dutch prevalence study on child maltreatment (NPM-2010) and from a prevalence study in Vietnam 10 years ago to achieve a cross-cultural and chronological comparison. We found that although there was a decrease in emotional and physical abuse over time, all types of child maltreatment were still highly prevalent, ranging from 2.6% for sexual abuse to 31.8% for emotional abuse. Most types were more common in Vietnam than in the Netherlands. Only the past year sexual abuse prevalence in Vietnam was lower. Single parenthood, being a boy, and older age were risk factors for child maltreatment. Child maltreatment was related to negative child well-being aspects with the largest effect on emotional functioning. Our study draws a clearer picture on child maltreatment in Vietnam. It highlights the importance of prompt responses to child maltreatment. Show less
Vahl, P.; Damme, L. van; Doreleijers, T.; Vermeiren, R.; Colins, O. 2016
The aim of this set of studies was to provide more insight in individual characteristics that influence care-giving abilities, in particular precursors of harsh and abusive parenting. We examined... Show moreThe aim of this set of studies was to provide more insight in individual characteristics that influence care-giving abilities, in particular precursors of harsh and abusive parenting. We examined how different subtypes of childhood abuse were related to child abuse potential in adulthood. Emotional neglect in childhood was related to child abuse potential, which is in line with earlier research showing the long-lasting effects of emotional maltreatment and neglect in childhood. With regard to the effects of oxytocin on the neural basis of parenting, we used fMRI to examine how oxytocin influenced emotion recognition using pictures of both adult and infant faces, taking experiences of maternal love withdrawal into account as potential moderator. Oxytocin enhanced neural activity in regions involved in emotion processing, such as the IFG, insula and STG. Our findings regarding the moderating role of experiences of maternal love withdrawal are inconsistent for emotion recognition in adult faces and in infant faces. Lastly, a new paradigm (LISSA) to observe sensitivity in response to standardized infant cues was developed and tested. Our results show that sensitivity can be reliably assessed using this procedure, making the LISSA a promising method for future research and clinical practice. Show less
Child maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment... Show moreChild maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment among university students in Kenya, Zambia, and The Netherlands. We also sought to compare the psychopathological sequelae of child maltreatment in the three samples. In addition, we sought to find out whether PTSS mediated the association between child maltreatment and the psychopathological symptoms. The results of our study showed that neglect in childhood was the most prevalent of all forms of child maltreatment across the three samples. Physical abuse and sexual abuse was most prevalent in Kenya and Zambia while witnessing interparental violence was the least prevalent in the two samples. Child maltreatment was differentially associated with psychopathological symptoms in the three samples of our study. Notably, neglect was the most predictive of psychopathology symptoms. The cross-validation results of our study showed that there were no significant differences in the predictive patterns of PTSS from child maltreatment in the three samples. PTSS mediated the association between child maltreatment and psychopathology symptoms albeit differentially. The results of our study show that there is need to mitigate the prevalence and sequelae of child maltreatment. Show less
Hoe hangt kindermishandeling met gehechtheid samen, en wat zijn de risicofactoren die de kans op kindermishandeling vergroten? Het proefschrift van Eveline Euser geeft antwoord op deze vragen, en... Show moreHoe hangt kindermishandeling met gehechtheid samen, en wat zijn de risicofactoren die de kans op kindermishandeling vergroten? Het proefschrift van Eveline Euser geeft antwoord op deze vragen, en presenteert de laatste stand van zaken met betrekking tot preventie van mishandeling. Kindermishandeling en gehechtheid Alle mishandelde kinderen zijn gehecht aan hun ouders, zelfs als die ouders de daders zijn. De meta-analyse in dit proefschrift laat echter zien dat mishandelde kinderen vaker onveilig en gedesorganiseerd gehecht zijn, in vergelijking tot kinderen die opgroeien in risicogezinnen (bv. in armoede of met een drugsverslaafde ouder) maar niet mishandeld worden. Kinderen met meer dan vier risicofactoren lopen echter wel evenveel gevaar gedesorganiseerde gehechtheid te ontwikkelen. Verrassend is dus dat de opeenstapeling van sociaal-economische risico’s en kindermishandeling beide een negatieve invloed hebben op de kwaliteit van de gehechtheidsrelatie. Preventie en interventie op het gebied van kindermishandeling. In Nederland zijn momenteel geen wetenschappelijk onderbouwde interventies beschikbaar die specifiek tot doel hebben om kindermishandeling te bestrijden. Evidence-based programma's zullen daarom ontwikkeld moeten worden en getoetst in gecontroleerde experimenten. De huidige praktijk in ons land is dat preventieve opvoedingsprogramma’s die eigenlijk ontworpen zijn voor andere problematiek of in andere landen zijn beproefd (bijv. Triple P, een programma gericht op gedragsproblemen) worden ingezet bij Nederlandse gezinnen met een hoog risico op mishandeling. Uit onderzoek zal nog moeten blijken of deze preventieprogramma’s ook effectief zijn in het voorkomen van kindermishandeling. Nu worden opvoedingsprogramma’s soms overhaast breed uitgerold zonder dat er grondige experimentele evaluaties van eigen bodem voorhanden zijn. De preventie van kindermishandeling is te belangrijk om aan het toeval te worden overgelaten. Show less
