Child abuse has negative health consequences. Early detection and preventive measures lead to avoidance of prolonged and more complex problems. School nurses have a child protection role and should pay attention to vulnerable children. Through health dialogues and other interactions with pupils, school nurses have the opportunity to detect child abuse. The aim of the study was to explore how school nurses detect child abuse and initiate support measures. Focus group interviews were conducted with 23 school nurses. The data were analyzed using a grounded theory approach. Results showed that the main concern of the school nurses was support and assistance to children who are abused which was preceded by a trust-creating and trust-strengthening process. Trust contains self-confidence and confidence in the system and trust can be strengthened or undermined. Building trustful relations is time consuming and is facilitated by networking, refined assessment instruments, and collaboration.

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental illhealth is crucial.

Emotion regulation has been put forward as an important transdiagnostic process. However, previous analyses of the relationships between emotion regulation strategies and symptoms of psychopathology in children and adolescents have produced mixed results. The present meta-analysis examines the relationships between youth's habitual use of three adaptive (acceptance, problem-solving, and cognitive reappraisal) and three maladaptive (rumination, avoidance, and suppression) strategies with symptoms of depression, anxiety, aggression, and addiction. A total of 181 articles with 386 effect sizes were analyzed. Rumination, avoidance, and acceptance showed the largest effect sizes across all symptoms. Maladaptive strategies showed, in general, larger effect sizes than adaptive strategies. Effect sizes were generally larger for internalizing compared to externalizing symptoms. The findings underscore the importance of emotion regulation for mental health in youth. Public Health Significance StatementEmotion regulation strategies are significantly linked to symptoms of psychopathology in youth. Rumination, avoidance, and acceptance show the largest effects across symptoms. Emotion regulation strategies should be taught in school and clinical practice for prevention and treatment.

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