The role of adverse childhood experiences in predicting child abuse perpetration among married mothers in Alexandria, Egypt: a cross-sectional study.

BACKGROUND: Adverse childhood experiences (ACEs) are receiving increased amounts of attention as a critical public health issue. ACEs have a massive impact on future violence victimization and perpetration. They are also associated with lifelong mental and physical health consequences as well as premature mortality. The present study aimed to investigate the role of different ACEs among married mothers in predicting the risk of child abuse perpetration in offspring. METHODS: A cross-sectional study was conducted on 350 mothers of children aged 2-12 years attending family health centres in Alexandria. The mothers completed a predesigned interview questionnaire on sociodemographic data and data related to ACEs, spousal violence, and child abuse perpetration. Suitable bivariate and multivariate statistical tests were used to analyse the collected data using version 20.0 of the Statistical Package for Social Sciences (SPSS). RESULTS: Two-thirds of mothers (66.3%) reported ever having been exposed to any ACE, and 18.6% of them had experienced 3 or more ACEs. Psychological abuse (46%) and witnessing domestic violence (17%) were the most common. Psychological aggression (95.4%), minor physical assault (79%), and neglect (52%) were the most common forms of child abuse perpetrated by the mothers. The number of ACEs experienced by mothers showed a moderate positive significant correlation with the 5 forms of child abuse examined. Different ACEs, mother's age, socioeconomic status, and current exposure to spousal violence were found to be independent predictors of different forms of child abuse (psychological aggression, neglect, minor physical assault, and severe physical assault). CONCLUSION: Different practices of family violence are strongly connected throughout different stages of an individual's life and across generations. Further understanding of the interconnections among forms of violence and addressing them should be prioritized. Additionally, concerted national strategies across all levels and sectors are needed to address this complex problem.

Efficacy of a multi-component psychosocial intervention program for caregivers of persons living with neurocognitive disorders, Alexandria, Egypt: A randomized controlled trial.

BACKGROUND: Unlike other chronic diseases, dementia caregiving is associated with enormous psychological burden, which stresses the need for caregivers-directed psychosocial interventions. Aim: This randomized controlled trial (RCT) was conducted to evaluate the short-term efficacy of a multi-component psychosocial intervention program for informal caregivers of persons with neurocognitive disorders in Alexandria, Egypt. METHODS: Informal caregivers (120) were randomly assigned into intervention and control groups. The intervention group (60) participated in a multi-component program of 8 sessions, including psycho-education, group cognitive-behavioral therapy, and group social support. Program primary outcomes were assessed after program termination (post-1), and three months later (post-2). Measured outcomes included caregivers' knowledge, depression and anxiety symptoms, and perceived burden. RESULTS: Caregivers' depression, anxiety, and perceived burden demonstrated significant drop at post-1, and post-2 compared to the control group (P< 0.001). The intervention group showed significant negative absolute change on depression, anxiety, and perceived burden measures, while on the dementia-related knowledge measure, a significant positive absolute change was found at post-1, and post-2 (P< 0.001), in comparison to controls. All outcome measures recorded a large effect size; the highest was for knowledge (partial eta2 = 0.98), and the least was for perceived burden (partial eta2 = 0.71). CONCLUSION: A multi-component psychosocial intervention for caregivers of persons with neurocognitive disorders demonstrated a short-term efficacy in reducing their burden, depression, and anxiety, as well as improving caregivers' knowledge. However, further research is needed to investigate long-term efficacy of the intervention.