Theses defended
Mitigar - Consequences of child maltreatment in adults in Portugal and public health actions
October 19, 2018
Clinical Psychology, Utrecht University, Nederland
Kleber Rolf
,
José Manuel Mendes
e
Luisa Sales
Exposure to child maltreatment (CM) is a well-known threat to the normal development of a child with recognized consequences in subsequent life-stages. It is a major risk factor for several mental health disorders and increased disability, having huge associated economic costs. However, this subject has been less studied in South European than in Western European countries. Besides, studies have explored more often sexual and physical abuse than other less evident forms such as emotional abuse and neglect, and they have targeted frequently only clinical samples or substantiated cases of CM. But how does it affect adults in the community? And how can public health systems reduce the burden of CM across the life-span? For countries like Portugal, having a high prevalence of mental health disorders compared with other European counterparts, it urges to know more about CM consequences and how they can be mitigated.
Our project investigated the prevalence of five forms of CM - sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect - in a sample of 1200 adults in the Portuguese community, and analysed its associations with psychological symptoms, revictimization and post-traumatic stress disorder. We also explored the role of combat exposure of fathers during the colonial wars and post-traumatic stress diagnosis in the transmission of consequences of CM to the offspring. Further, we analysed the assumption of using public health actions to mitigate CM consequences in adults in the community. Finally, we documented opinions of 91 European professionals, using the Delphi method.
From the findings we obtained in the Portuguese sample, we concluded that more than 14% of adults in the community reported exposure to moderate or severe maltreatment during their childhood. Emotional neglect was the most endorsed, while emotional abuse was the strongest predictor for psychological symptoms and post-traumatic stress disorder. Adults exposed to moderate or severe maltreatment have had more than double the likelihood to be revictimized across the life-span and greater probability to suffer from post-traumatic stress disorder. Exposure to the colonial wars Portugal was involved in the transmission of consequences of CM from the war veterans to their offspring.
Our analysis of resilience and therapeutic interventions for consequences of CM provided insights about transdiagnostic features to be targeted by public health programs, namely the emotion regulation, social skills, and self-concept. Experts participating in the Delphi study also underlined the need for public health actions to mitigate CM consequences in adults.
Our findings support the assumption that emotional abuse is as injurious as other more evident forms of CM, thus it deserves improvement of prevention and intervention on its consequences. By increasing awareness about long-term CM consequences, training professionals and developing interventions targeting emotion regulation, public health systems can be better equipped to face the burden of CM. The use of technologies of information represents a good opportunity to provide low-cost care for CM affected persons.
Keywords - Child Maltreatment; Emotional Abuse; Portugal; Public Health; Emotional Regulation; Social Skills; Self-Concept; Technologies of Information.
Public Defence date
Doctoral Programme
Supervision
Abstract
Our project investigated the prevalence of five forms of CM - sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect - in a sample of 1200 adults in the Portuguese community, and analysed its associations with psychological symptoms, revictimization and post-traumatic stress disorder. We also explored the role of combat exposure of fathers during the colonial wars and post-traumatic stress diagnosis in the transmission of consequences of CM to the offspring. Further, we analysed the assumption of using public health actions to mitigate CM consequences in adults in the community. Finally, we documented opinions of 91 European professionals, using the Delphi method.
From the findings we obtained in the Portuguese sample, we concluded that more than 14% of adults in the community reported exposure to moderate or severe maltreatment during their childhood. Emotional neglect was the most endorsed, while emotional abuse was the strongest predictor for psychological symptoms and post-traumatic stress disorder. Adults exposed to moderate or severe maltreatment have had more than double the likelihood to be revictimized across the life-span and greater probability to suffer from post-traumatic stress disorder. Exposure to the colonial wars Portugal was involved in the transmission of consequences of CM from the war veterans to their offspring.
Our analysis of resilience and therapeutic interventions for consequences of CM provided insights about transdiagnostic features to be targeted by public health programs, namely the emotion regulation, social skills, and self-concept. Experts participating in the Delphi study also underlined the need for public health actions to mitigate CM consequences in adults.
Our findings support the assumption that emotional abuse is as injurious as other more evident forms of CM, thus it deserves improvement of prevention and intervention on its consequences. By increasing awareness about long-term CM consequences, training professionals and developing interventions targeting emotion regulation, public health systems can be better equipped to face the burden of CM. The use of technologies of information represents a good opportunity to provide low-cost care for CM affected persons.
Keywords - Child Maltreatment; Emotional Abuse; Portugal; Public Health; Emotional Regulation; Social Skills; Self-Concept; Technologies of Information.