Background Childhood sexual abuse (CSA) is linked to disrupted body boundaries and difficulty inhabiting the body as an integrated part of self. Such disruptions are thought to be encoded procedurally rather than verbally, so self-report may not fully capture them. The Mirror Game, a nonverbal dyadic task, allows such functioning to be observed directly. Objective This study examined whether adult women with self-reported CSA differ from a comparison group in nonverbal behavior and dyadic coordination during the Mirror Game, and whether CSA severity is associated with these behaviors. Methods Thirty-nine Israeli women (23 survivors, 16 without reported CSA) completed a 15-min Mirror Game with a female expert player blind to group status. Interactions were coded with the Mirror Game Scales; the Together and Free composites were primary outcomes, and the 20 individual scales were exploratory. CSA severity was assessed with the Childhood Trauma Questionnaire sexual abuse subscale. Results Survivors scored lower than the comparison group on Together, g = 1.12, 95% CI [0.44, 1.80], and Free, g = 1.19, 95% CI [0.50, 1.88], and were more often classified as Difficult to Play With (87.0% vs. 37.5%). Across the full sample, sexual abuse scores correlated negatively with Together, r = −0.47, and Free, r = −0.50. Exploratory analyses showed lower scores among survivors on 15 of 20 scales. Conclusions Survivors showed a broad, though not uniform, pattern of constricted embodied and relational engagement. Findings support the Mirror Game as an observational complement to verbal report of the embodied consequences of CSA.
Background Cumulative childhood interpersonal trauma (CCIT) is highly prevalent and has been consistently associated with persistent relational difficulties in adulthood. Victims frequently report lower dyadic adjustment, a key determinant of health, well-being, and trauma recovery. However, the mechanisms linking CCIT to impaired couple functioning remain insufficiently understood. Objective This study examined a sequential model in which symptoms of complex posttraumatic stress disorder (C-PTSD) – including posttraumatic stress (PTS) and disturbances in self-organization (DSO) – and subsequent attachment insecurities (avoidance and anxiety) were tested as explanatory mechanisms in the association between CCIT and dyadic adjustment within a clinical sample. Participants and settings A total of 907 adults seeking therapy for sexual and relational difficulties completed validated measures as part of their intake assessment. Results Path analyses revealed significant sequential associations whereby CCIT was indirectly associated with lower dyadic adjustment through DSO then attachment avoidance (β = −0.034, 95% CI [−0.053, −0.020]), as well as through DSO then attachment anxiety (β = −0.008, 95% CI [−0.016, −0.003]). In contrast, CCIT was positively associated with dyadic adjustment through PTS alone (β = 0.060, 95% CI [0.032, 0.093]) but negatively associated with dyadic adjustment through the sequential association via PTS then attachment anxiety (β = −0.006, 95% CI [−0.013, −0.002]). Although statistically significant, the sequential indirect effects were small in magnitude and should not be interpreted as evidence of substantial clinical effects. The final model explained 24.8% of the variance in dyadic adjustment. Conclusion These results point to the relevance of addressing self-organization impairments and attachment dynamics in clinical interventions aimed at improving relational functioning among CCIT victims.
Background Nurse-home visiting programs starting prenatally are a promising approach for preventing child maltreatment including injuries. Understanding which families benefit the most can inform policies to ensure greater impact and efficiency. Objective We investigated whether maternal history of childhood maltreatment (CM) moderated Nurse-Family Partnership (NFP) impact on child outcomes. Participants and setting We utilized secondary data from the Canadian NFP randomized controlled trial (RCT) involving 739 mothers aged 14–24 years and their 737 children in British Columbia (data collected 2013–2019). Methods Baseline data, including maternal CM history, were collected during pregnancy and before random assignment to existing services or NFP plus existing services. Data on main child outcome indicators: injuries (emergency department events), problem behaviour and language (maternal report) and language and cognition (in-home observations) were collected at age two years. Results Many maternal participants reported CM exposure (73.1%), including 57% medium-to-severe and 41.8% severe thresholds. CM history significantly moderated NFP impacts on selected child outcomes including injuries (adjusted differences in rate differences =102.92, 95% CI: 15.18, 193.45) and language via maternal report (adjusted differences in mean differences = −82.52, 95% CI: −150.77, −14.27). Conclusions A maternal history of CM moderated NFP impacts on injuries and language, but not all child outcomes examined. Researchers are encouraged to harness existing RCT data to learn how prevention program outcomes vary across populations. Policymakers may then apply this nuanced guidance to inform the refinement of prevention programs for families with unmet needs, fulfilling the ethical obligation to ensure that programs are effective for all.
BACKGROUND Intimate partner violence (IPV) and child maltreatment frequently co-occur and are associated with adverse consequences for child health, safety, and wellbeing. Guardians ad litem (GALs) are commonly appointed in cases involving IPV and child maltreatment, yet little empirical evidence exists regarding the impact of attorneys guardians ad litem (AGALs) on legal outcomes in IPV-related custody disputes. OBJECTIVE The purpose of this study was to examine associations between AGAL involvement and domestic violence protective order (DVPO) case outcomes, and custody provisions. PARTICIPANTS AND SETTING We conducted a retrospective observational study using administrative court records of 606 DVPO cases involving custody disputes filed in two counties in Central North Carolina between 2006 and 2022. METHODS We conducted descriptive, bivariate, and multivariable regression analyses to examine associations between AGAL involvement and final DVPO disposition (granted, dismissed, denied), and custody outcomes. RESULTS Cases involving an AGAL had nearly three times the odds of including a custody provision in the final order compared with cases without AGAL involvement (aOR = 2.99, 95% CI: 1.17-7.66). Compared to cases without an AGAL, AGAL involvement was associated with lower odds of involuntary DVPO dismissal (vs. granted) (aOR = 0.31, 95% CI: 0.16-0.59) and lower odds of resolution through a consent order (vs. DVPO issued after an evidentiary hearing) (aOR = 0.20, 95% CI: 0.07-0.56). CONCLUSION Findings suggest that AGAL involvement may facilitate custody determinations in DVPO cases. Additional research is needed to understand the mechanisms through which AGALs influence legal outcomes and to evaluate their impact on longer-term child and family wellbeing.
Background Violence against girls remains a major public health challenge in low- and middle-income countries (LMICs), and schools represent a critical platform for primary prevention. Objective To review the effectiveness of school-based interventions for preventing violence against girls in LMICs systematically. Methods Seven databases were searched from inception to April 5, 2025, supplemented by grey literature searches. Eligible studies were intervention trials or longitudinal observational studies with a control arm in LMICs reporting sex-disaggregated outcomes for school-based interventions targeting physical, sexual, emotional violence, bullying and cyberbullying against girls. Heterogeneity precluded meta-analysis; narrative synthesis and vote counting based on direction of effect were conducted. The review is registered with the Open Science Framework. Results Twenty-seven articles reporting 29 interventions met the inclusion criteria: 11 curriculum-based, seven multilevel, six single-component, and five multicomponent interventions. Evidence from curriculum-based empowerment self-defence programmes indicated the most consistent favourable effects on sexual violence victimisation. By contrast, multicomponent and multilevel interventions had broader but more heterogeneous potential to prevent victimisation and perpetration. Across intervention types, effects on bullying were predominantly favourable direction. Measurement of victimisation and perpetration was unbalanced, with sexual violence perpetration substantially underrepresented. No eligible studies were identified from the Central Africa, Caribbean, or Pacific Island countries. Conclusions School-based interventions show potential to reduce violence against girls, with curriculum-based approaches offering the most consistent short-term benefits in preventing sexual violence victimisation. Effectiveness of multilevel and multicomponent interventions remains heterogeneous, and evidence on sustainability and scalability is limited across intervention types.
