Childhood Maltreatment: Emotional Consequences and Potential Intervention

童年虐待：情感后果和潜在干预

• 批准号: MR/N006194/1
• 负责人: Jennifer Lau
• 金额: $ 43.47万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FN006194%2F1
• 关键词: Childhood; Maltreatment; Emotional; Consequences; Potential; Childhood; Maltreatment; Emotional; Consequences; Potential

Childhood maltreatment, which includes the abuse and neglect of children and young people, is a significant problem that occurs in all countries in the world. Early maltreatment has serious, long-lasting consequences on an individual's health and well-being, but can also impact economic growth. Most estimates of the prevalence of childhood maltreatment have come from surveys conducted in high-income countries, with outstanding questions remaining on the nature and extent of child abuse and neglect among lower-income countries and, within these countries, among the most disadvantaged sectors. The evidence base is poor because of cultural stigma associated with childhood maltreatment and cultural norms around the acceptability of abuse as a form of discipline and punishment. Moreover, the economic context of these countries enables the general exploitation of children in the labour force. This could not only increase the likelihood of other forms of abuse and neglect but also make their presence less transparent. The first major goal of our research is to study the frequency of different forms of abuse and neglect among working children and young people in North India and Nepal. This work will directly contribute to our understanding of the scope of the problem and facilitate, among governmental and non-governmental organisations, specific recommendations for preventing violence against children, which are key ongoing priorities for the World Health Organisation and United Nations. Dissemination of our findings locally will also enable gradual change in attitudes and perceptions, shifting cultural norms and practices. Although the effects of childhood maltreatment on later-life health and functioning are well-documented, the pathways by which early-life adversity increases vulnerability on these negative outcomes are less well-understood. Prior research suggests that early adversity affects how the brain develops, particularly how it responds to, and manages stress. We do not know much about how these effects on the brain affect the way we process emotional information and think about the world - even though cognitive factors are directly targeted in psychological therapies. The second major goal of our research is to investigate how childhood abuse and neglect alters the processing of emotional information. We expect that as early maltreatment can leave scars on the developing brain, this affects the way that its victims attend to threatening information (showing vigilance for threat cues) and appraise ambiguous information (showing a tendency to interpret situations negatively or with hostile intent). These negative patterns of thinking may then increase the likelihood of developing anxiety, depression and aggressive responses towards stressful events - and even reinforce these negative problems. Although these disturbed patterns of thinking have been reported in physically abused children and young people, these studies have largely been conducted in high-income countries. Identifying these cognitive-emotional disturbances in maltreated young people from lower-income countries lays the foundation for developing a novel treatment tool to directly target these negative thought patterns in young people from these poorer countries. Developing and piloting a novel training intervention tool to encourage more adaptive ways of processing emotional information is the third major goal of our research. Specifically, cognitive bias modification is a technique used to correct negative thinking patterns, and therefore negative responses towards stress. It has been successfully used in adults with mood and anxiety problems, and in children and young people with emotional and aggressive problems. We will adapt this programme for use in maltreated young people and test whether this programme modifies negative thought patterns and, in doing so, normalises dysfunctional brain circuits, so that they resemble those of non-abused young people.

儿童虐待包括对儿童和年轻人的虐待和忽视，是世界上所有国家的一个重大问题。早期的虐待对个人的健康和福祉产生了严重，长期的后果，但也会影响经济增长。关于儿童虐待的大多数估计是来自高收入国家进行的调查，在低收入国家之间以及在这些国家内最弱势的部门中，剩下的问题和虐待儿童和忽视的范围仍然存在。证据基础很差，因为与儿童虐待以及围绕虐待的可接受性作为纪律和惩罚的一种文化规范相关的文化污名和文化规范。此外，这些国家的经济背景可以使劳动力中的儿童普遍开采。这不仅可以增加其他形式的虐待和忽视的可能性，而且会使他们的存在降低透明。我们研究的第一个主要目标是研究北印度和尼泊尔在职儿童和年轻人中不同形式的虐待和忽视的频率。这项工作将直接有助于我们理解问题的范围，并在政府和非政府组织中促进预防对儿童的暴力行为的具体建议，这是世界卫生组织和联合国的关键优先事项。我们当地的发现也将逐步改变态度和看法，改变文化规范和实践。尽管儿童虐待对后期生活和运作的影响有充分的记录，但早期生活逆境增加对这些负面结果的脆弱性的途径较少被理解。先前的研究表明，早期的逆境会影响大脑的发展方式，尤其是对大脑的反应和管理压力。我们对这些对大脑的影响如何影响我们处理情绪信息并思考世界的方式并不了解 - 即使认知因素直接针对心理疗法。我们研究的第二个主要目标是调查儿童虐待和忽视如何改变情感信息的处理。我们预计，随着早期的虐待可能会使发育中的大脑留下伤痕，这会影响受害者参加威胁信息的方式（表现出对威胁提示的警惕）和评估歧义的信息（表明倾向于对情况进行负面解释或以敌对意图解释情况）。这些负面的思维方式可能会增加对压力事件的焦虑，抑郁和积极反应的可能性，甚至加剧了这些负面问题。尽管这些令人不安的思维模式已在受虐待的儿童和年轻人中报道，但这些研究在很大程度上是在高收入国家进行的。确定来自低收入国家的虐待年轻人的认知情绪障碍为开发一种新颖的治疗工具奠定了基础，以直接针对来自这些贫穷国家的年轻人的这些负面思维模式。开发和试行一种新颖的培训干预工具来鼓励更多适应性的方法来处理情感信息，这是我们研究的第三个主要目标。具体而言，认知偏置修饰是一种用于纠正负面思维模式的技术，因此对压力的负面反应。它已成功地用于有情绪和焦虑问题的成年人，以及有情感和积极问题的儿童和年轻人。我们将适应该程序用于虐待年轻人，并测试该程序是否修改了负面的思维模式，并在此过程中可以使功能障碍的脑电路正常化，从而使它们类似于未虐待的年轻人。