From adverse childhood experiences to harsh parenting: Psychological symptoms as a mediator.

BACKGROUND: Research evidence has demonstrated a direct link between ACEs and harsh parenting. However, the mechanisms linking paternal ACEs to harsh parenting have remained largely unexplored among Asian populations. OBJECTIVE: In the current study, we examined the relationships between parental ACEs and harsh parenting and explored the potential mediating effect of psychological symptoms on the relationship between parental ACEs and harsh parenting. PARTICIPANTS AND SETTING: A total of 6195 Taiwanese parents of children aged 6 to 12 were recruited from 58 primary schools in the Taiwanese cities of Taipei and New Taipei. METHOD: Using probability-proportional-to-size sampling and a self-report survey, we collected data relating to parental ACEs, psychological symptoms, and child-rearing behaviors. A hierarchical regression analysis was completed to examine the effects of parental ACEs and psychological symptoms on harsh parenting. In addition, we tested the potential mediating effects of psychological symptoms on the relationship between parental ACEs and harsh parenting by employing a simple mediation model (PROCESS) with a bootstrapping procedure. RESULTS: We found that both parental ACEs and psychological symptoms were significant predictors for mothers' and fathers' adoption of harsh parenting behaviors. Moreover, after adjusting for covariates, we discovered the unique finding that psychological symptoms mediated the relationship between parental ACEs and harsh parenting among Taiwanese parents. CONCLUSIONS: The study revealed a direct link between parental ACEs and harsh parenting, with psychological symptoms serving as a mediator. Our findings suggest that trauma-recovery programs should promote regular screening and interventions for parents with ACEs.

Peer Victimization Trajectory and Psychosocial Maladjustment in Early Taiwanese Adolescents: A Longitudinal Study.

This study examined the peer victimization trajectory and maladjustment outcomes among early Taiwanese adolescents. Data were extracted from a large-scale longitudinal study with a national representative sample. A total of 1691 school students in 4th, 6th, and 8th grade were analyzed. Using latent profile analysis, students were classified into four trajectories, chronic victims, late onset victims, desisters, and non-victims, based on their self-reported physical and verbal victimization at three time points. Maladjustment, including psychological distress, reduced school attachment, internet addiction, and suicidal ideation in 8th grade, were assessed. The results showed significant differences in adjustment among students in the four trajectories. Chronic victims had the poorest outcomes on most variables, followed by late onset victims and desisters, while non-victims had the least maladjustment. The findings highlight the need for future interventions that would consider students' victim status over time and pay particular attention to those who suffer constant bullying and abuse.

Patterns and trajectories of children's maltreatment experiences in Taiwan: Latent transition analysis of a nationally representative longitudinal study.

BACKGROUND: Little is known about the patterns of child maltreatment change over time and vary according to gender and child protective services (CPS) experience in Taiwan. OBJECTIVE: To examine the latent status and the trajectories of child maltreatment and to identify effects that gender and CPS have on these statuses and trajectories in Taiwan. PARTICIPANTS AND SETTING: A national proportionately stratified sample of 6233 4th-grade students were recruited from 314 elementary schools in Taiwan, and followed up at 6th and 8th graders. A total of 1908 students completed valid data at all three time points was analyzed. METHODS: Latent class analysis and latent transition analysis were used to identify the number of latent variables and the patterns of child maltreatment. Multiple-group model was used to test with gender difference. RESULTS: Four latent maltreatment statuses were identified: high all maltreatment, high psychological maltreatment, high neglect, and no/low maltreatment. A reduction in maltreatment severity occurred over time was found. The percentage of students in the "high all maltreatment" and "high neglect" groups decreased whereas those in the "high psychological maltreatment" and "no/low maltreatment" groups increased. Differences in the transition probabilities of latent maltreatment status by gender was revealed. The percentage of CPS recipients in the "high all maltreatment" decreased over time. CONCLUSIONS: This study highlighted the dynamic nature of child maltreatment and described the timing, continuity, and change that characterizes children's exposure to maltreatment in Taiwan. Policies and interventions geared toward early detection, mitigation, and prevention of child maltreatment are needed.

Profiles of Teen Dating Violence and Association With Depression Among Chinese Teens.

Teen dating violence (TDV) is a major global public health concern. Few studies, however, have examined profiles of TDV in Chinese societies and how these profiles might be associated with teens' mental health. The current study analyzed a sample of 891 middle and high school students with dating experience in Taiwan, Hong Kong, and Shanghai. Latent class analysis (LCA) and multinomial logit regression analysis were performed in an attempt to identify profiles of TDV and then investigate possible associations between class membership and self-reported depression. The results of LCA suggested that a four-class model was the best fit for the data: Severe/Multi-Type TDV (5.51%), Controlling Behavior (13.08%), Non/Low TDV (64.50%), and Physical Violence (16.91%). The best-fit model suggested bidirectionality, meaning among teen partners in an abusive relationship, both tended to participate in violent acts and controlling behaviors. The results of the multinomial regression showed that, compared with the Non/Low TDV class, teens in the Severe/Multi-Type TDV class or Controlling Behavior class had greater odds of screening positive for depression. There was no significant difference in the risk of depression between the Physical Violence class and the Non/Low TDV class. Implications for future research and practice are also discussed herein.

Ecological Predictors and Trajectory of Internet Addiction from Childhood through Adolescence: A Nationally Representative Longitudinal Study.

We examined multidimensional factors within four systems (individual, family, school, and community) that influence internet addiction across time among children through adolescence in Taiwan. We hypothesize that internet addiction increases from childhood to adolescence and that resilience, child neglect, positive school experiences, and community violence are significant predictors at baseline and of the rate of change across time. Based on stratified random sampling, a valid sample size of 6233 Taiwanese children participated in our study, which we began in 2014 and then followed this sample in 2016 and 2018 using repeated measures. We used hierarchical linear modeling to model changes in internet addiction across time (with equal two-year intervals between assessments) and the associations between the predictors and internet addiction over time. The results show that internet addiction increases from childhood to adolescence. After controlling for gender, we found that resilience and positive school experiences predict less internet addiction, whereas neglect and community violence predict greater internet addiction. Over time, greater resilience predicts a decreasing trajectory of internet addiction, whereas greater neglect and community violence predict a slower increasing trajectory and positive school experiences predict a faster-increasing trajectory. A holistic approach can help children cope with internet addiction.

How to Safely Reopen Colleges and Universities During COVID-19: Experiences From Taiwan.

Reopening colleges and universities during the coronavirus disease 2019 (COVID-19) pandemic poses a special challenge worldwide. Taiwan is one of the few countries where schools are functioning normally. To secure the safety of students and staff, the Ministry of Education in Taiwan established general guidelines for college campuses. The guidelines delineated creation of a task force at each university; school-based risk screening based on travel history, occupation, contacts, and clusters; measures on self-management of health and quarantine; general hygiene measures (including wearing masks indoors); principles on ventilation and sanitization; regulations on school assemblies; a process for reporting suspected cases; and policies on school closing and make-up classes. It also announced that a class should be suspended if 1 student or staff member in it tested positive and that a school should be closed for 14 days if it had 2 or more confirmed cases. As of 18 June 2020, there have been 7 confirmed cases in 6 Taiwanese universities since the start of the pandemic. One university was temporarily closed, adopted virtual classes, and quickly reopened after 14 days of contact tracing and quarantine of possible contacts. Taiwan's experience suggests that, under certain circumstances, safely reopening colleges and universities this fall may be feasible with a combination of strategies that include containment (access control with contact tracing and quarantine) and mitigation (hygiene, sanitation, ventilation, and social distancing) practices.

Childhood poly-victimization and children's health: A nationally representative study.

BACKGROUND: Although research on the negative effects of childhood poly-victimization is substantial, few studies have examined the relationship between poly-victimization and younger children's physical health and diseases. OBJECTIVE: This study examines the associations between poly-victimization and children's health problems requiring medical attention. METHODS: A national stratified cluster random sampling was used to select and approach 25% of the total primary schools in Taiwan, and 49% of the approached schools agreed to participate in this study. We collected data with a self-report questionnaire from 6233 (4th-grade) students aged 10-11, covering every city and county in Taiwan. RESULTS: Logistic regression analyses demonstrate a significant dose-response relationship between children's poly-victimization exposure and their health problems including hospitalization, serious injury, surgery, daily-medication requirements, heart murmurs, asthma, dizziness or fainting, allergies, kidney disease, therapies for special needs, smoking, and alcohol use. The results indicate that children's risk of having a health problem grew significantly with each increase in the number of victimization types that children experienced. CONCLUSIONS: These research findings underscore the effect of poly-victimization on children's health problems requiring medical attention, and stress the need for both proper screening methods for children's exposure to poly-victimization and stronger awareness of poly-victimization's effects on health conditions in healthcare clinics.

Relationships between Parent-Reported Parenting, Child-Perceived Parenting, and Children's Mental Health in Taiwanese Children.

The current study examines the relationship between parents' and children's reports of parenting and their effects on children's mental health symptoms. Six hundred and sixty-six parent-child dyads in Taiwan participated in this study. The parents and the children filled out the parenting questionnaires, and the children also reported their general mental health. The results demonstrated that parental-reported and child-perceived parenting were positively correlated, but parents tended to report lower scores on authoritarian parenting and higher scores on Chinese parenting than did their children. There were also significant gender differences: The mothers reported higher authoritative parenting than did the fathers; and the boys perceived higher authoritarian and Chinese-culture specific parenting than did the girls. Moreover, the Chinese parenting had a negative effect on children's mental health outcomes. Finally, our results showed that children's perception of parenting had a stronger effect on children's mental health symptoms than did parental reports on parenting, urging future research to include the children's report when investigating the effects of parenting on children's mental health outcomes.

Who Gets Protection? A National Study of Multiple Victimization and Child Protection Among Taiwanese Children.

This study aims to examine the prevalence of multiple types of child victimization and the effects of multiple types of victimization on children's mental health and behavior in Taiwan. The study also examines the child-protection rate and its correlates among children experiencing various types of victimization. This study collected data with a self-report questionnaire from a national proportionately stratified sample of 6,233 fourth-grade students covering every city and county in Taiwan in 2014. After calculating the 1-year prevalence of child victimization, the study found that bullying was the most prevalent (71%), followed by physical neglect (66%), psychological violence (43%), inter-parental violence (28%), community violence (22%), physical abuse (21%), and sexual violence (9%). As the number of victimization types increased, children were more likely to report greater posttraumatic symptoms, psychiatric symptoms, suicide ideation, self-harm thoughts, and violent behaviors. Gender, neonatal status, parental marital status, and other family risks were significantly associated with elevated incidences of the victimization types. Only 20.6% of the children who had experienced all seven types of victimization had received child protective services. A child was more likely to receive child protective services if he or she had experienced sexual violence, community violence, inter-parental violence exposure, higher family risks, higher suicidal ideation, or living in a single-parent or separated family. In conclusion, this study demonstrates the cumulative effects and the harmful effects that children's experience of multiple types of victimization can have on the children's mental health and behavior. The present findings also raise alarms regarding the severity of under-serving in child-victimization cases. These results underscore the importance of assessing, identifying, and helping children with multiple victimization experiences.

Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan.

Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.

Beliefs About Wife Beating Among Social Work Students in Taiwan.

Based on an integrative framework, this study addresses the beliefs that a group of social work students from Taiwan had about wife beating. A self-administered questionnaire was filled out by 790 students (76.5% female, 23.5% male) spanning all 4 years of undergraduate studies. The results show that male students exhibited a greater tendency than their female counterparts to justify wife beating and to hold battered women responsible for violence against them. This tendency was also found among students who held traditional attitudes toward women, students who held patriarchal expectations of marriage, and students who had witnessed interparental violence in childhood. In addition, male students and students with traditional attitudes toward women exhibited the strongest tendency to believe that wives benefit from beating. Conversely, female students expressed more willingness than their male counterparts to help battered women, as did students who held liberal attitudes toward women and students who held egalitarian expectations of marriage. Furthermore, female students and those with liberal attitudes toward women tended to hold violent husbands responsible for their behavior, and to express support for punishing violent husbands. This article concludes with a discussion of the study's limitations and the results' implications for future research on the topic.

Dating violence and posttraumatic stress disorder symptoms in Taiwanese college students: the roles of cultural beliefs.

This study has examined the effects that young adults' experience of dating-violence victimization can have on their manifestation of posttraumatic stress disorder (PTSD) symptoms. This study has also examined the possible roles that cultural beliefs can play in dating-violence experience, coping choices, and PTSD symptoms. This study has used self-reporting measures to collect data from a nationally stratified random sample of 1,018 college students in Taiwan. Results demonstrate that college students who had experienced dating-violence victimization reported higher levels of PTSD symptoms than those who had not. The results reveal that psychological-violence victimization and cultural beliefs have direct and indirect effects on PTSD symptoms via the mediation of young adults' use of emotion-focused coping strategies. Greater frequencies of psychological-violence victimization were associated with a greater use of emotion-focused coping, which was in turn associated with increases in PTSD symptoms. This study illustrates that traditional Chinese beliefs have played significant roles in exacerbating the risk for dating violence and PTSD, and in shaping victims' coping choices with dating violence.

Predictors of dating violence among Chinese adolescents: the role of gender-role beliefs and justification of violence.

In Chinese societies, violence among adolescent dating partners remains a largely ignored and invisible phenomenon. The goal of this study is to examine the relationships among gender-role beliefs, attitudes justifying dating violence, and the experiences of dating-violence perpetration and victimization among Chinese adolescents. This study has used self-reporting measures to collect data from a probability sample of 976 adolescents (mean age = 15.9) in three Chinese societies: Taiwan, Hong Kong, and Shanghai. Research results reveal a high prevalence of dating violence (including physical violence, sexual violence, and controlling behavior) among Chinese adolescents with dating experience: the perpetration rate is 27.3% and the victimization rate is 39%. Study results demonstrate that adolescents who endorse traditional gender-role beliefs tend to view dating violence as acceptable behavior. Boys' endorsement of traditional gender roles, boys' attitudes justifying boy-on-girl violence, and boys' attitudes against girl-on-boy violence predict boys' actual sexual-violence behavior. Moreover, boys' attitudes justifying boy-on-girl dating violence is the strongest predictor of boys' perpetration of physical and sexual dating violence. This study also shows that boys' hostility is a significant predictor of boys' controlling behavior. Programs for preventing dating violence should include components designed to challenge traditional gender-role beliefs and attitudes justifying dating violence.

Cultural barriers to help-seeking among Taiwanese female victims of dating violence.

This article presents a qualitative analysis regarding the help-seeking behaviors of female dating-violence victims from a cultural perspective. A semistructured, in-depth interview was used to collect data from 10 female victims (aged 20-28). Findings indicate that Taiwanese dating-violence victims tend to seek informal help rather than formal help. Culturally structured help-seeking experiences center around six primary themes: (a) self-reliant culture, (b) personal and family shame, (c) secretive and sexual dating relationships, (d) fear of negative reactions from others, (e) unfamiliarity with available resources, and (f) revictimization in seeking help. Understanding cultural meanings and barriers encountered in help-seeking behaviors is an important step in effectively assisting victims of dating violence.

Long-term effects of interparental violence and child physical maltreatment experiences on PTSD and behavior problems: a national survey of Taiwanese college students.

OBJECTIVES: This study investigated the joint long-term impact of witnessing interparental violence and experiencing child physical maltreatment on young adults' trauma symptoms and behavior problems. It also explored Chinese traditional beliefs as a possible contributor to young adults' trauma and behavior. METHODS: This study used self-reporting measures to collect data from a national proportionate stratified sample of 1,924 college students in Taiwan. The sample was divided into four groups: no violence; interparental violence only; child physical maltreatment only and dual violence, to compare the combined effect of dual violence on long-term outcome with the no violence group and the one type of violence group. RESULTS: The results indicated a significant association of interparental violence and child physical maltreatment, and 11.3% of participants reported witnessing partner violence between parents and experiencing physical maltreatment during childhood. Participants experiencing dual violence reported more trauma symptoms and behavior problems than did those experiencing only one form of violence or none at all. Exposure to both interparental violence and child physical maltreatment during childhood is a significant predictor of young adults' trauma symptoms and behavior problems, after controlling for other potentially confounding risk factors. Cultural factors also play a significant role in predicting young adults' trauma symptoms and internalizing behavior problems, after accounting for control variables and violence-related variables. Moreover, cultural factors interact significantly with dual violence experiences in predicting young adults' externalizing behavior problems. CONCLUSIONS: This study extended Western co-occurrence study findings with large Taiwanese community samples. The results demonstrated that dual violence experiences during childhood have long-term detrimental impact on young adults' trauma symptoms and behavior problems. Cultural beliefs and their interaction with dual violence experiences play a significant role in young adults' trauma symptoms and behavior problems as well. PRACTICE IMPLICATIONS: The present findings underscore the need for interventions for young adults exposed to childhood dual violence. Moreover, the findings highlight the need for culturally sensitive interventions to address the cultural factor impact on young adults' trauma symptoms and behavior problems.

Self-esteem of young adults experiencing interparental violence and child physical maltreatment: parental and peer relationships as mediators.

This study examined the joint impact of experiencing both interparental violence and child physical maltreatment on young adults' self-esteem. It also tested the hypothesis of parental and peer relationship qualities as mediators in the relationship between childhood histories of family violence and adult self-esteem. Data were collected from a national probability sample of 1,924 college students in Taiwan. Research results demonstrated that experiencing both interparental violence and physical maltreatment during childhood have long-term and detrimental impact on adult self-esteem. This impact was statistically independent of other potential confounding factors. Moreover, participants experiencing dual violence during childhood reported lower self-esteem than those experiencing only one type of family violence or none at all. Male participants who experienced dual violence reported lower self-esteem than female participants who experienced dual violence. Further analyses revealed that parental and peer relationship qualities mediated the joint impact of interparental violence and physical maltreatment on adult self-esteem.