This study examined the peritraumatic responses to childhood sexual abuse among Jewish ultra-Orthodox adult survivors. Studies on childhood sexual abuse among closed societies are scarce. However, recent studies have stressed the importance of examining peritraumatic responses to childhood sexual abuse by exploring the top-down processes often embedded in survivors’ socio-cultural and religious contexts. Forty-eight narratives provided by women and men who experienced childhood sexual abuse in the ultra-Orthodox society in Israel were analyzed using a qualitative inductive thematic analysis. Crucial gender differences were found between women and men, indicating how their socio-cultural and religious context, particularly norms of female purity, obedience to religious authority, and community insularity, shaped their peritraumatic responses. These factors led women to internalize the abuse and men to comply with abusive religious figures. Specifically, the women who experienced intrafamilial abuse shared several peritraumatic responses, such as ignoring the abuse, dissociation and having faith in the future. The men who experienced abuse, mainly by religious figures, described their limited ability to resist the abuse. Both the women and men described how family and family-community dynamics often shaped social expectations, which were central to their peritraumatic responses to childhood sexual abuse. The discussion highlights the central role of top-down processes with a unique focus on the role of family and family-community dynamics.
Background Chronic nociplastic pain is defined by persistent alterations in central pain processing, typically occurring without identifiable tissue damage. Existing evidence indicates that adverse childhood experiences (ACEs), including physical, emotional, and sexual abuse and neglect, may increase susceptibility to the development of these conditions across the lifespan. Objective This systematic review and meta-analysis aimed to evaluate and synthesize evidence regarding the association between ACEs and chronic nociplastic pain. Participants and Setting: The review included observational studies involving individuals with a history of childhood or adolescent abuse, conducted in various countries and clinical settings. Methods The protocol was registered with PROSPERO, and the review followed Cochrane and PRISMA 2020 guidelines. We searched PubMed, EMBASE, Web of Science, PsycINFO, and LILACS. Two independent reviewers performed data selection, extraction, and risk-of-bias assessment. We used a random-effects model for meta-analysis. We assessed heterogeneity using the I2 test and publication bias using Egger’s test. Results The systematic search initially identified 617 records. After screening and eligibility assessment, eight studies, comprising 120,616 participants in total, were included in the systematic review and meta-analysis. The pooled prevalence of chronic nociplastic pain among individuals exposed to ACEs was 24.86% (95% CI: 7.53–48.01). Substantial heterogeneity was observed (I2 = 99.7%). Egger’s test indicated small-study effects consistent with possible publication bias; however, this result should be interpreted with caution due to the limited number of studies and extreme heterogeneity. Conclusions Current evidence indicates a high pooled prevalence of nociplastic pain among individuals exposed to ACEs. Nevertheless, given the extreme heterogeneity, this estimate should be regarded as a descriptive aggregation rather than a definitive clinical measure. Additional research employing standardized designs and more homogeneous samples is warranted. These findings underscore the potential importance of trauma-informed care in chronic pain management.
The main objective of this study was to systematically and meta-analytically review the scientific literature on the prevalence of psychopathic traits in the general child and adolescent population. A search of 11 bibliographic databases identified 18 studies published up to August 2026, in which 27,216 children and adolescents from 19 samples were assessed. Joint prevalence rates were calculated using inverse variance heterogeneity (IVhet) and random-effects models. Meta-regression analyses were performed to examine whether sex, age, country of origin, and psychopathic-trait instrument influenced prevalence. The meta-analytical results obtained allow us to estimate that the prevalence rate of psychopathic traits in the general child and adolescent population is between 3.04% (95% CI [1.61, 4.64]) and 4.15% (95% CI [3.12, 5.32]) for IVhet and random-effects models, respectively. This prevalence is similar to that found in adult samples from the general population, although slightly lower. Age, sex, country of origin, and psychopathic-trait instrument do not appear to significantly influence the prevalence of psychopathic traits, although these findings remain inconclusive given the limited number of available studies. These results and conclusions are discussed in the context of different theoretical perspectives on defining psychopathic traits in children and adolescents, and on their possible evolutionary trajectories throughout childhood, adolescence, and adulthood.
