M9 Critical Appraisal Study Paper

The purpose of this assignment is to present a complete critical appraisal of a new topic of your choice, relative to your discipline, expressed as a focused PICOT question, using the theory and processes that have been presented in this course.

A critical appraisal study typically includes 3-5 current (within the past 5 years) high-quality, peer-reviewed, research studies ***PLEASE USE 3****.

Remember we are looking for the best available evidence for inclusion, using accepted standards for evidence-based practice. This assignment should be completed as a paper. To enhance organization, ensure all headings (and subheadings, where applicable) are clearly specified and all components of the critical appraisal study are addressed.
The document should be 6-8 pages in length, not including the title page and references.

Your critical appraisal/review summary should include the following information and sections:
Title/cover page
Abstract (structured): This should be a structured abstract for your review summary as a whole. The usual headings are Purpose, Methods, Results, and Conclusion. Follow current APA formatting rules and remember that abstracts should be concise. While the (structured) abstract appears first in the paper, this section is always written last.
Introduction (include the following):
Importance of the problem
Search strategy: Identify the databases you searched (e.g., PubMed, Ovid, CINAHL)
Inclusion and exclusion criteria used, relative to the search strategy (e.g., a certain date range; specific article types, such as systematic reviews and RCTs; specific topic areas)
Results of search: Indicate how many relevant research journal articles were located
Clinical Scenario
Focused PICOT Question

****clinical scenario and PICOT question are located in the attached doc PLEASE READ and include in paper********************

For each article (note the articles you select should constitute your “best evidence”):
Follow the outline in Box 19.1 (Melnyk & Fineout-Overholt, 2015) for quantitative research studies. Note examples for a descriptive correlational study and an RCT are provided. Use the general guidelines, drawing on the examples, for research articles with other study designs, such as systematic reviews and cohort studies.
Should you elect to include (appropriately) qualitative research studies, also, follow the guidelines in Box 20.2.
Include the ranking for the level of evidence (e.g., 1a or 1b). Use the Oxford Centre for Evidence-Based Medicine definitions and levels

https://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford

Provide a brief conclusion at the end of each article
Discussion/Clinical Bottom Line: This section should synthesize (via comparing and contrasting) the evidence from the research articles. A final “bottom line” recommendation should be put forth, based on the combined findings.
References
General Guidelines
Do not exceed 8 pages, excluding the title and references pages.
Limit the peer-reviewed journal research articles to no fewer than 3, no more than 5.
Follow current APA formatting and scholarly writing guidelines.
Please include your research articles with your assignment submission.

ANSWER

M9 Critical Appraisal Study Paper

Abstract

Purpose: To examine whether children exposed to sexual and physical abuse have a greater risk for developing mental health disorders over their lifetime.

Methods: The article on predictors of psychopathology by Adams (2018) relied on a cross-sectional study. The article on enduring neurobiological influences of childhood exploitation by Teicher et al., (2016) focused on a systematic review. The article on child sexual abuse and later nurturing stress by Hugill, Berry, and Fletcher (2017) relied on a systemic review of studies that included cross-sectional, prospective design, case-control design, and secondary data analysis.

Results: Adams (2018) found out that child sexual abuse after five years has a great detrimental effect on mental health. Teicher et al., (2016) found out that childhood maltreatment has a significant impact on brain development linked to mental health issues. Hugill, Berry, and Fletcher (2017) revealed a significant link between child sexual abuse and parenting stress, which brought about depression.

Conclusion: Children who encounter physical and sexual abuse during their childhood are more likely to have mental health issues than those without exposure to physical and sexual abuse.

Introduction

Importance of the Problem

Reports of child abuse especially sexual and physical abuse date back to ancient civilization. Childhood physical and sexual abuse are against basic human rights. There are varying aspects of child abuse, physical and sexual abuse being the most common. Sexual and physical abuse has been linked to the affected person’s trauma and causes varying psychological problems in adulthood. People who experience childhood sexual abuse are more likely to encounter mental health disorders. When children experience trauma due to sexual and physical abuse, the brain structure and development are likely altered. Understanding the influence of child physical and sexual exploitation plays a great role in ensuring that children develop healthily. Various studies have focused on the influence of child physical and sexual exploitation on mental health disorders over a lifetime. Therefore, this paper will focus on the critical appraisal of child abuse and its impact on mental health. There is high-quality research evidence that childhood sexual and physical abuse is linked to the increase of mental health disorders. Children who have encountered childhood physical and sexual abuse are more likely to encounter mental health disorders than those with no childhood physical and sexual abuse.

Search Strategy

The search strategy began with developing a research topic and the development of a PICOT Question. The next step was to search for databases. This included reviewing databases to find out which has the best articles to offer sufficient evidence related to the research evidence. PubMed was chosen since it is a reliable, huge, and highly authoritative resource. After selecting a database, the search terms or keywords to be included in the search were selected. The search relied on a specific approach to obtain relevant articles. The search approach was searching with keywords. Searching by keywords means breaking down the research topic into main ideas, which become simple keywords to search the PubMed database.

The main keywords used were “childhood sexual abuse”, “sexual trauma”, “developmental issues”, and “mental health”. The inclusion and exclusion criteria were important in selecting the most appropriate study designs and other factors that make the study eligible. The article was excluded if they failed to meet particular outcomes of interest consistently and appropriately, the study design used, peer review, participants, relevant comparison group, and date. The articles were only included if they were five years old or less. The articles were only included if they were systematic reviews and cross-sectional studies.

Results of Search

The search results identified three relevant articles that were both qualitative and quantitative studies. The articles focused on the association amid sexual and physical exploitation and leading to mental health disorders.

Adams, J., Mrug, S., & Knight, D. C. (2018). Characteristics of child physical and sexual abuse as predictors of psychopathology. Child abuse & neglect, 86, 167-177.

In 2018, Adams, Mrug, and Knight published an article that focused on child sexual and physical abuse characteristics as predictors of psychopathology. The research focused on whether there is a link between physical and sexual abuse and psychopathology. Adams, Mrug, and Knight (2018) hypothesized that long duration, earlier onset, and greater harshness duration of juvenile abuse would separately envisage PTSD, higher depression, and anxiety and that these links would be stronger in females compared to males. Considerably, prior findings indicate that the abuse onset, severity, and duration moderate the association between psychopathology and victimization.

One of the greatest challenges in the previous research on abuse characteristics is that they are highly inter-correlated; thus, their impacts on the mental health outcome become unclear. However, Adams, Mrug, and Knight (2018) closed the gap by examining the link between physical and sexual exploitation characteristics and the mental health effects. The study examined the relationship through a cross-sectional study with a sample size of 1270 emerging adults and late adolescents and a mean age of 19 years. Through a two-stage probability sampling, the participants were recruited from three metropolitan areas, Houston, Birmingham, CA, and Los Angeles.

The independent variables were the onset and duration of physical and sexual abuse, while the dependent variables were the anxiety symptoms, PTSD symptoms, and depressive symptoms. The study results supported the hypothesis since the onset during any development stage, adolescence, childhood, and early childhood, as well as duration and severity, were linked to more anxiety, depressive symptoms, and PTSD. The sex differences also indicated more detrimental impacts for sexual and physical abuse among females than males.

Teicher, M. H., & Samson, J. A. (2016). Annual research review: enduring neurobiological effects of childhood abuse and neglect. Journal of child psychology and psychiatry, 57(3), 241-266.

In 2016, Teicher and Samson researched how maltreatment alters brain development. The main aim of the review was to synthesize neuroimaging results in children who encountered physical abuse and caregiver neglect and adolescents, children, and young adults that experienced sexual and physical exploitation. The research question was whether there is a link between timing and type of exposure, reversibility, gender variances, and the relationship between psychopathology and brain alterations. The review scrutinized a wide-ranging body of evidence about the possible neurobiological shortfalls of physical and sexual abuse.

The review included 255 studies represented through statistical analysis on the link between brain growth and functionality and childhood mistreatment. The comprehensive review found out that childhood maltreatment greatly impacts brain development. The variations in brain growth and functioning can be linked to the adaptive reactions during hardship. Considerably, psychiatric illnesses are linked to the functional and structural abnormalities of the brain that come directly from childhood abuse.

Hugill, M., Berry, K., & Fletcher, I. (2017). The association between historical childhood sexual abuse and later parenting stress: A systematic review. Archives of women’s mental health, 20(2), 257-271.

In 2017, Hugill, Berry, and Fletcher researched the association between childhood sexual and physical abuse and how it influences later parenting stress. Considerably, an individual’s childhood experience is likely a determinant of their future parenting practices. Hugill, Berry, and Fletcher (2017) reviewed studies that investigate the relationship between child sexual abuse and their future nurturing to identify and examined any moderators of the association and evaluate the value of the evidence base. Fourteen studies reached the inclusion conditions. Seven studies found a straight relationship amid childhood sexual abuse and future nurturing stress. In comparison, two studies indicated lack of relationship, and five studies proposed other variables which may impact the association amid childhood sexual abuse and nurturing anxiety. The study findings indicated that the existence of the relationship between childhood sexual manipulation and nurturing stress is influenced by depression and other stressors.

Clinical Scenario

Serena is a psychotherapist in a County Mental Health Clinic in Los Angeles; she has been a psychotherapist for the last five years. Serena treats individuals who are affected by many diverse mental health disorders such as bipolar, anxiety, major depressive disorder, ADHD, and much more. Serena’s patients present different life experiences along with unique contributing factors causing their cognitive distortions. Throughout her work, Serena has been concerned about learning more about trauma and its effect on individuals. One of the traumas she’s more interested in is child sexual or physical abuse. Serena is interested to know if adults who have been exposed to sexual or physical abuse as children are at greater risk of developing debilitating mental health conditions over their lifetime compared to those with no exposure to sexual or physical abuse as children?

Focused PICOT Question

Are individuals who are affected by many different mental health disorders who have been exposed to sexual or physical abuse as children compared with those without exposure to sexual or physical abuse as children at greatest risk for developing debilitating mental health disorders over their lifetime?

References

Adams, J., Mrug, S., & Knight, D. C. (2018). Characteristics of child physical and sexual abuse as predictors of psychopathology. Child abuse & neglect, 86, 167-177.

Hugill, M., Berry, K., & Fletcher, I. (2017). The association between historical childhood sexual abuse and later parenting stress: A systematic review. Archives of women’s mental health, 20(2), 257-271.

Teicher, M. H., & Samson, J. A. (2016). Annual research review: enduring neurobiological effects of childhood abuse and neglect. Journal of child psychology and psychiatry, 57(3), 241-266.