The interplay between borderline personality disorder and oxytocin: a systematic narrative review on possible contribution and treatment options.

Background: Borderline personality disorder (BPD) is a complex mental health condition marked by instability in mood, relationships, self-image, and behavior. Individuals with BPD often struggle with intense emotions, impulsivity, and maintaining stable relationships. Oxytocin, known as the "love hormone" or "bonding hormone," plays a crucial role in social bonding, trust, empathy, and emotional regulation and its dysregulation may contribute to BPD difficulties. This systematic review aims to analyze existing literature, examining the intricate interplay and encouraging future research and treatment strategies. Methods: A systematic search of Literature in PubMed, Embase and Psychinfo, without any language or time restriction, was performed until March 2024 combining thesaurus and free-search indexing terms related to "borderline personality disorder" and "oxytocin", producing 310 results (77 in PubMed, 166 in Embase and 67 in Psychinfo). Ninety-four full texts were analyzed, and 70 articles were included in qualitative analysis. Results: Oxytocin may influence attachment styles, parental behaviors, and stress responses, particularly in individuals with a history of childhood trauma. The interaction between oxytocin, genetics, early life experiences, and environmental factors contributes to the complexity of BPD. Genetic variations in the oxytocin receptor gene may influence social and emotional abilities and contribute to the development of psychopathology. Additionally, early adverse experiences, such as childhood maltreatment, can alter oxytocin functioning, impacting social cognition and emotional regulation.However, oxytocin's role in BPD treatment remains uncertain, with some studies suggesting potential benefits for specific symptoms like social threat avoidance, while others indicate adverse effects on nonverbal behavior and mentalizing. Conclusion: Understanding oxytocin's role in BPD offers insights into potential therapeutic interventions. While oxytocin-based treatments may hold promise for addressing specific symptoms, further research is needed.

Impact of childhood maltreatment on aging: a comprehensive Mendelian randomization analysis of multiple age-related biomarkers.

BACKGROUND: Childhood maltreatment (CM) is linked to long-term adverse health outcomes, including accelerated biological aging and cognitive decline. This study investigates the relationship between CM and various aging biomarkers: telomere length, facial aging, intrinsic epigenetic age acceleration (IEAA), GrimAge, HannumAge, PhenoAge, frailty index, and cognitive performance. METHODS: We conducted a Mendelian randomization (MR) study using published GWAS summary statistics. Aging biomarkers included telomere length (qPCR), facial aging (subjective evaluation), and epigenetic age markers (HannumAge, IEAA, GrimAge, PhenoAge). The frailty index was calculated from clinical assessments, and cognitive performance was evaluated with standardized tests. Analyses included Inverse-Variance Weighted (IVW), MR Egger, and Weighted Median (WM) methods, adjusted for multiple comparisons. RESULTS: CM was significantly associated with shorter telomere length (IVW: ß = - 0.1, 95% CI - 0.18 to - 0.02, pFDR = 0.032) and increased HannumAge (IVW: ß = 1.33, 95% CI 0.36 to 2.3, pFDR = 0.028), GrimAge (IVW: ß = 1.19, 95% CI 0.19 to 2.2, pFDR = 0.040), and PhenoAge (IVW: ß = 1.4, 95% CI 0.12 to 2.68, pFDR = 0.053). A significant association was also found with the frailty index (IVW: ß = 0.31, 95% CI 0.13 to 0.49, pFDR = 0.006). No significant associations were found with facial aging, IEAA, or cognitive performance. CONCLUSIONS: CM is linked to accelerated biological aging, shown by shorter telomere length and increased epigenetic aging markers. CM was also associated with increased frailty, highlighting the need for early interventions to mitigate long-term effects. Further research should explore mechanisms and prevention strategies.

Good parent-child relationship protects against alcohol use in maltreated adolescent females carrying the MAOA-uVNTR susceptibility allele.

Introduction: Risk-allele carriers of a Monoamine oxidase A (MAOA) gene, short-allele (MAOA-S) in males and long-allele (MAOA-L) in females, in the presence of a negative environment, are associated with alcohol misuse. Whether MAOA-S/L alleles also present susceptibility to a positive environment to mitigate the risk of alcohol misuse is unknown. Thus, we assessed the association of the three-way interaction of MAOA, maltreatment, and positive parent-child relationship with alcohol consumption among adolescents. Methods: This prospective study included 1416 adolescents (females: 59.88%) aged 16 - 19 years from Sweden, enrolled in the "Survey of Adolescent Life in Västmanland" in 2012. Adolescents self-reported alcohol consumption, maltreatment by a family (FM) or non-family member (NFM), parent-child relationship, and left saliva for MAOA genotyping. Results and discussion: We observed sex-dependent results. Females carrying MAOA-L with FM or NFM and a good parent-child relationship reported lower alcohol consumption than those with an average or poor parent-child relationship. In males, the interactions were not significant. Results suggest MAOA-L in females, conventionally regarded as a "risk", is a "plasticity" allele as it is differentially susceptible to negative and positive environments. Results highlight the importance of a good parent-child relationship in mitigating the risk of alcohol misuse in maltreated individuals carrying genetic risk. However, the interactions were not significant after adjusting to several environmental and behavioural covariates, especially parent's alcohol use, negative parent-child relationship, and nicotine use (smoking and/or snus), suggesting predictor and outcome intersection. Future studies and frameworks for preventive strategies should consider these covariates together with alcohol consumption. More studies with larger sample sizes are needed to replicate the findings.

Characteristics of Transition-Age Youth Engaging in Suicidal Behavior.

PURPOSE: Suicide rates are markedly high among children with foster care involvement. Transition-age youth (TAY) who age-out of the foster care system are at particularly high risk. METHODS: Analyzing data from the California Youth Transitions to Adulthood Study (n=727), this paper explores the descriptive characteristics of TAY who engage in suicidal behavior with the goals of better identifying, understanding, and supporting those at risk. We report rates of suicidal ideation and suicide attempt at four interview waves (ages 17, 19, 21, 23) and examine differences in rates by sociodemographic characteristics, past maltreatment, and behavioral health disorders. RESULTS: At age 17, 42% of California Youth Transitions to Adulthood Study participants had thought of committing suicide and 24% had attempted suicide. Across ages, sexual minority youth reported significantly higher rates of suicidal ideation and behavior than their heterosexual peers. We also found that youth with (1) maltreatment experiences (both before and during foster care); (2) major depressive disorder, anxiety disorder or post-traumatic stress disorder; and (3) alcohol/substance abuse disorders were significantly more likely than their peers without these characteristics/diagnoses to engage in suicidal behavior at certain ages. Youth with comorbid psychiatric and substance use disorders were consistently at elevated risk. DISCUSSION: Routine screening for suicidal behavior among TAY is important for child welfare service providers to consider. Youth at risk may benefit from more consistent assessment, mental health care, and targeted mental health intervention. Future research is needed to shed light on mechanisms linking certain sociodemographic, experiential, and behavioral health characteristics with suicidal behavior in TAY.

Online Child Sexual Exploitation and the Role of Computer-Mediated Communication: A Scoping Review.

The online landscape has shifted since the rise of smartphones and social media in the 2010s and altered the way children use technologies. Along with a reliance on computer-mediated communication (CMC) is the concern of online child sexual exploitation (OCSE). This scoping review provided an updated examination of the prevalence, risk factors, outcomes, and disclosures of OCSE since 2010. Systematic searches were conducted using three databases for studies published between January 2010 and January 2023. Results indicated an alarming prevalence of, and a wide range of risk factors and consequences associated with OCSE worldwide. Many young victims struggled to recognize OCSE as a serious form of abuse. The need to monitor the ever-changing Internet landscape for young users is highlighted.

History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study.

BACKGROUND: Childhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association. METHODS: We included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes. RESULTS: The mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31-1.81]), particularly after physical neglect (2.04 [1.57-2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01-1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13-1.29]). CONCLUSIONS: Our results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.

Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response.

OBJECTIVE: Patients who have experienced child abuse often have complex clinical presentations; whether a history of child abuse (HCA) affects psychotherapy outcomes is unclear. The authors examined relationships between HCA, clinical baseline variables, and change in these variables after three different psychotherapies for panic disorder (PD). METHODS: Two hundred adults with PD (with or without agoraphobia) were randomly assigned to one of three treatments across two sites: panic-focused psychodynamic psychotherapy (PFPP), cognitive-behavioral therapy (CBT), or applied relaxation training (ART). Differences in demographic and clinical variables between those with and without HCA were compared. The primary analysis addressed odds of meeting clinical response criteria on the Panic Disorder Severity Scale (PDSS) between treatments, as moderated by HCA. This effect was examined via continuous outcomes on the PDSS and psychosocial functioning (Sheehan Disability Scale). RESULTS: Compared with patients without HCA (N=154), patients with HCA (N=46) experienced significantly more severe symptoms of PD (d=0.60), agoraphobia (d=0.47), and comorbid depression (d=0.46); significantly worse psychosocial impairment (d=0.63) and anxiety sensitivity (d=0.75); greater personality disorder burden (d=0.45)-particularly with cluster C disorders (d=0.47)-and more severe interpersonal problems (d=0.54). HCA significantly moderated the likelihood of clinical response, predicting nonresponse to ART (B=-2.05, 95% CI=-4.17 to -0.30, OR=0.13, z=-2.14, p=0.032) but not CBT or PFPP. HCA did not interact with treatment condition to predict slopes of PDSS change. CONCLUSIONS: The results of this study highlight the importance of HCA in formulating treatment recommendations. Increased awareness of HCA's effects on severity of PD and treatment responsiveness among patients with PD may improve outcomes.

Mechanisms in the intergenerational effect of maternal childhood maltreatment on offspring externalizing symptoms: The role of maternal and paternal parenting.

BACKGROUND: Although maternal childhood maltreatment has been associated with offspring externalizing symptoms, little is known about the potential mechanisms that contribute to breaking the intergenerational effect of maternal childhood maltreatment. OBJECTIVE: The current study aimed to (a) investigate the intergenerational effect between maternal childhood maltreatment and offspring externalizing symptoms in the Chinese family; (b) examine maternal supportive and harsh parenting as potential mediators of this intergenerational effect; and (c) explore the moderating roles of paternal support parenting, as well as paternal harsh parenting, in this mediation process of maternal supportive and harsh parenting. PARTICIPANTS AND SETTING: The sample consisted of 1111 mother-father-child triads from Beijing, recruited when the children were one and three years old. METHODS: Mothers completed the Childhood Trauma Questionnaire, and both parents completed the Infant-Toddler Social and Emotional Assessment and Comprehensive Early Childhood Parenting Scale. RESULTS: Our results showed that maternal childhood maltreatment was a risk factor for offspring externalizing symptoms at T2 (ß = 0.24, t = 6.51, p < .001), and this effect was mediated by maternal supportive (indirect effect = 0.03, 95%CI = [0.02, 0.05]) and harsh parenting (indirect effect = 0.03, 95%CI = [0.02, 0.07]) at T1. Furthermore, paternal harsh parenting moderated the indirect effect of maternal childhood maltreatment on child externalizing symptoms through maternal supportive parenting. CONCLUSIONS: These findings contribute to our understanding and provide valuable information for disrupting the intergenerational effect of maternal childhood maltreatment.

Harsh parenting trajectories from childhood through adolescence and socioemotional competences at age 18: 2004 Pelotas Birth Cohort Study.

BACKGROUND: Limited research has explored the course of harsh parenting practices throughout childhood and adolescence and its impact on socioemotional competences from a longitudinal perspective. This study examined the association between harsh parenting trajectories and socioemotional competences at age 18. METHODS: Data from the 2004 Pelotas (Brazil) Birth Cohort study, originally comprising 4231 live births, were used. Harsh parenting was measured using the parent-report version of the Parent-Child Conflict Tactics Scale at ages 6, 11, 15 and 17 years, and trajectories were identified using a group-based modelling approach. Socioemotional competences were emotion regulation, assessed by the Emotional Regulation Index for Children and Adolescents; self-esteem, measured by the self-report Rosenberg Self-esteem Scale; prosocial behaviour and peer relationship problems, both assessed by the Strengths and Difficulties Questionnaire. Multivariate linear and Poisson regression models were applied to examine the effects of harsh parenting trajectories on socioemotional competences, adjusting for confounding variables. RESULTS: We identified three trajectories: a "low harsh parenting" trajectory (49.7 %), a "moderate harsh parenting" (44.7 %), and a "high harsh parenting" trajectory (5.6 %). Compared to those belonging to the low harsh parenting trajectory group, adolescents who experienced either a moderate or high harsh parenting trajectory exhibited lower scores in emotion regulation self-esteem scales and prosocial behaviour, along with higher scores of peer relationships problems. LIMITATIONS: Data on harsh parenting at 15 and 17 years were available only for a sub-sample. CONCLUSIONS: Our study extends the evidence of the adverse effects of persistent harsh parenting on socioemotional competences during adolescence.

Longitudinal Impacts of Housing Cost Burden on Physical and Psychological Aggression of Children From Age 3 to 15.

Housing cost burden is stressful for families, interfering with healthy, positive parenting. The present study uses data from the Future of Families and Child Wellbeing Study to examine the relationship between housing cost burden and aggressive parenting with children age 3 to age 15. Latent growth curve modeling finds that both types of aggressive parenting behaviors decline on average, but that housing cost burden contributes to significant ongoing risk. Results indicate within-time associations between housing cost burden and psychological aggression and associations both within- and across-time between housing cost burden and physical aggression. Housing cost burden poses a significant risk factor for families, and child maltreatment prevention approaches must incorporate strategies for addressing housing cost burden.

Specificity of Episodic Future Thinking in Adolescents: Comparing Childhood Maltreatment, Autism Spectrum, and Typical Development.

Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.

Body Evaluation and Body Ownership in Patients with Inflammatory Bowel Disease: the Role of Interoceptive Sensibility and Childhood Maltreatment.

OBJECTIVE: Inflammatory bowel diseases (IBD) are accompanied by symptoms that can vastly affect patients' representations of their bodies. The aim of this study was to investigate alterations in body evaluation and body ownership in IBD and their link to interoceptive sensibility, gastrointestinal-specific anxiety, and history of childhood maltreatment. METHODS: Body evaluation and ownership was assessed in 41 clinically remitted patients with IBD and 44 healthy controls (HC) using a topographical self-report method. Interoceptive sensibility, gastrointestinal-specific anxiety and a history of childhood maltreatment were assessed via self-report questionnaires. RESULTS: Patients reporting higher interoceptive sensibility perceived their bodies in a more positive manner. Higher gastrointestinal-specific anxiety was linked to a more negative body evaluation particularly of the abdomen in patients with IBD. Childhood maltreatment severity strengthened the positive association between interoceptive sensibility and body ownership only in those patients reporting higher trauma load. CONCLUSION: Altered body representations of areas associated with abdominal pain are linked to higher symptom-specific anxiety and lower levels of interoceptive sensibility in IBD. Particularly in patients with a history of childhood maltreatment, higher levels of interoceptive sensibility might have a beneficial effect on the patients' sense of body ownership.

[Brain injury following child maltreatment syndrome in newborns and young children. Shaken baby syndrome]. / Cherepno-mozgovaya travma v strukture sindroma zhestokogo obrashcheniya s det'mi u mladentsev i detei rannego vozrasta. Sindrom tryaski mladentsa.

BACKGROUND: Shaken baby syndrome is widely discussed in the literature. This syndrome is considered as a variant of child maltreatment syndrome. In the English-language literature, there are data on high incidence of this syndrome and difficult diagnosis. There are no such diagnosis in the Russian and reports devoted to this issue. OBJECTIVE: To assess the incidence and nature of injuries following child maltreatment/shaken baby syndrome in infants and young children. MATERIAL AND METHODS: We analyzed case records of 3668 patients aged 1-36 month between 2017 and 2021 with injury/suspected traumatic brain injury (TBI). Mild TBI was in 47.2% of patients, moderate and severe - in 56.8% of patients. Twenty-eight children admitted with GCS score 3-8. CT was performed in case of risk factors for intracranial injuries (1703 patients). Abnormalities were found in 71.6% of cases. Sixty-four children required surgical treatment. Overall mortality rate was 0.7%. RESULTS: Accidental trauma was found in 3664 cases. We verified child maltreatment/shaken baby syndrome in only 4 (0.1%) cases. At the alleged moment of injury, there were male persons (cohabitant or guardian) with the child that is consistent with literature data. In all 4 cases, we observed severe combined TBI. In one case, brain damage was regarded as a result of chronic trauma. Indeed, MRI diagnosed thrombosis of bridging veins along convexital parts of the frontal, parietal and occipital lobes. There were GOS grade I in 2 patients (death), grade III in 1 patient (severe disability) and grade IV in 1 patient (recovery). CONCLUSION: Child maltreatment/shaken baby syndrome is less common among infants and young children in the Russian Federation. This may be due to national, cultural and religious traditions. Indeed, infants and children under 3 years of age are cared for by female persons. The mechanism of injury (shaking) leads to typical multiple injuries involving various organs and systems. These damages require multidisciplinary approach to diagnosis and treatment. MRI-confirmed thrombosis of bridging veins may be an additional diagnostic sign indicating the mechanism of injury.

Public Health Nurses in an Internal Negotiation Process When There Is Concern About the Child's Care.

The aim of the study was to explore and describe how public health nurses at child health clinics experience and perceive the follow-up of children and families when there is concern about the child's care. The goal was to contribute to knowledge development to guide health-promoting nursing care for children and their families. Theoretical perspectives included health promotion, child-centered and family-centered care, in addition to nursing care. An exploratory qualitative design informed by a hermeneutic approach was used. Data were collected in 3 focus groups with 16 public health nurses and analyzed using latent content analysis. The findings detail public health nurses' internal negotiation processes in the follow-up of children and the family, and the ways these negotiation processes were influenced by various prerequisites, the approaches for follow-up, dilemmas that affected public health nurses' approaches, and prolonged dwellings on past responses to children and families of concern. The lack of routines and goals for follow-up, a dominant parental perspective, and ambiguity related to health promotion and disease prevention, all created challenges for the public health nurses. Based on these findings, a model of public health nurse's follow-up when there is concern about the child's care was developed for future research.

Timing and chronicity of child maltreatment in Germany: results from a representative sample.

OBJECTIVES: Child maltreatment (CM) is a major risk factor across the lifespan. While research on CM and its consequences has risen strongly during the last decades, research is mainly focused on the prevalence of types of CM incidents. As valid prevalence rates on timing and chronicity of CM are lacking to date, we aimed to assess the timing of experienced CM by describing the age of onset, duration, and prevalence at each year of age for each CM subtype in a population-based sample. STUDY DESIGN: Cross-sectional, observational study in a representative sample. METHODS: Using different sampling steps including a random route procedure, a probability sample of the German population above the age of 16, encompassing 2514 persons (50.6% female, mean age: 50.08 years) was generated. Participants were asked about sociodemographic information in a face-to-face interview, CM was assessed using the ICAST-R questionnaire. RESULTS: The earliest mean age of onset was seen in neglect with 8.07 (±3.07) years for boys and 7.90 (±2.96) years for girls, while the mean age of onset for sexual abuse was in adolescence with 13.65 (±3.86) years for boys and 13.91(±3.17) years for girls. The overall duration of CM was lowest for sexual abuse with 2.12 (±2.01) years for boys and 2.35 (±1.73) years for girls, the highest duration was seen for emotional abuse with 4.00 (±3.54) years for boys and 4.21 (±3.77) years for girls. CONCLUSIONS: Our novel results provide important epidemiological information for prevention efforts.

Cigarette Smoking in Women Victims of Police-Reported Intimate Partner Violence: The Role of Childhood Maltreatment, Type of Partner Abuse, and Psychological Distress Symptoms.

Existing research on the relationship between intimate partner violence (IPV) and cigarette smoking primarily involves low-risk, physical IVP-focused studies on community women. As a result, the risks associated with cigarette smoking in women victims of severe IPV have not been fully explored. This study examined the association between exposure to different forms of childhood maltreatment, exposure to physical, psychological, and sexual IPV, and current psychological distress symptoms with cigarette smoking in a high-risk sample of women victims of police-reported severe IPV. Participants included 162 women victims of police-reported severe IPV recruited in shelters for domestic violence and Child Protective Services in Portugal. Participants provided self-reports on childhood maltreatment physical, psychological, and sexual violence), physical, psychological, and sexual IPV, psychological distress symptoms (anxiety, depressive, somatic, and posttraumatic stress disorder symptoms), and daily cigarette consumption. Results revealed significant associations between daily cigarette consumption and exposure to IPV, physical abuse during childhood, psychological IPV, and anxiety symptoms in women experiencing police-reported severe IPV. Childhood maltreatment may increase vulnerability for emotion dysregulation, promoting addictive behaviors to regulate distress. Smoking can be an unhealthy regulating strategy to reduce the distress related to chronic exposure to psychological IPV. Future effective health promotion interventions in women facing severe forms of IPV may target emotional regulation and incorporate a trauma-focused approach.

"The abuse of minors you witness or experience": A qualitative study of former professional ballet school students' characterizations of maltreatment.

BACKGROUND: The number of recent media reports of child maltreatment (CM) at international professional ballet schools surpasses the few studies on CM in dance. In general, studies on dance largely focus on psychological maltreatment. There is also little research on student experiences across the entire professional ballet school context, which typically include dance, academic, social life, and healthcare experiences, and for some students, living in residence or a homestay from a young age. OBJECTIVE: To explore how former professional ballet school students characterize and make sense of experiences of CM across the entire school context in dance training, academics, social life, living (e.g., in residence, homestay), and healthcare. PARTICIPANTS AND SETTING: Participants were 15 former professional ballet school students (12 women, three men) aged 18-27 years old across six countries. METHODS: Data from online semi-structured interviews and questionnaires were analyzed using reflexive thematic analysis. RESULTS: Experiences were interpreted in the wider context of participants' former ballet schools. Themes included: 1) psychological maltreatment in and beyond the studio; 2) neglect and devaluation: costs of over-prioritizing ballet; 3) physicalabuse: outdated but still rationalized as instrumental; and 4) sexual abuse in blurred private and public spaces. CONCLUSIONS: Participants used CM vocabulary to describe their own and peers' experiences and emphasized that CM should not be normalized. Sense making about experiences suggested a need for more ballet school community awareness about the multiple potential forms of harm of CM, as well as more research, intervention, and advocacy about CM at ballet schools.

Suicidal ideation in medical students of Hebei province: prevalence and associated factors.

Objectives: This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors. Methods: A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI. Results: The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98). Conclusion: The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.

Let it go, let it go: Stop measuring child maltreatment as a binary yes/no.

Numerous methods are used in the measurement of child maltreatment (CM) exposure. As a science, it is necessary that the field of CM research evaluate its measurement approaches periodically to ensure that the common approaches are the best approaches. A prominent method for measuring CM in research as a predictor variable is to conceptualize CM as a two-level, yes/no binary variable (e.g., 0 = No CM exposure, 1 = CM exposure). While there is no consensus on what method is the best approach for measuring CM, empirical evidence suggests that the binary measurement approach to CM has significant limitations. The current paper sought to progress the field of CM and trauma research forward by reviewing several lines of research demonstrating why the use of a binary yes/no CM measurement approach is problematic. As evidence for why a binary measurement of CM should be halted, this paper reviews research on: why the characteristics or details of CM exposure matter, risk of CM "contamination," and CM's relation with environmental or systemic factors. The ethical and clinical implications of a CM binary measurement approach are also discussed. Several recommendations for the field are provided on how researchers can improve the measurement of CM and ensure accurate and replicable studies are being published.

Childhood Maltreatment and Perinatal Complications: A Scoping Review of Official Health Data.

Child maltreatment (CM) poses significant risks to victims, resulting in enduring physical, psychological, and developmental consequences. Adult survivors of CM seem especially vulnerable to perinatal complications. However, existing research on perinatal outcomes presents mixed results and relies heavily on self-reported data, which may not align with official medical data. Hence, a systematic review using official health data may provide clarity on this association; it may orient future research and the provision of perinatal services. This scoping review aimed to synthesize and evaluate the quality of the literature that utilizes official health data to explore associations between CM and perinatal complications. Following Arksey and O'Malley's model, searches across four databases (PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations/Thesis) produced 8,870 articles. After screening, 23 articles met the inclusion criteria (e.g., recorded perinatal complications using official health data, and peer-reviewed studies or dissertation). Evidence indicates CM survivors have less prenatal care visits, more fetal loss and preterm births, lower gestational age, and increases in emergency cesarean sections. Adults had more cervical insufficiency, lower episiotomies and sphincter ruptures, and overall pregnancy and postpartum complications while adolescents had lower Apgar scores. No associations were observed on other outcomes (e.g., vaginal bleeding, group B streptococcus, and fetal distress). Mixed findings emerged for other perinatal and maternal health concerns such as birth weight and blood pressure. CM survivors may face an increased risk of experiencing perinatal complications. Findings point to the relevance of leveraging health data for CM research and adopting trauma-informed practices in perinatal services.