Child physical abuse: factors influencing the associations between self-reported exposure and self-reported health problems: a cross-sectional study
Tóm tắt
Child physical abuse (CPA) is an extensive public health problem because of its associations with poor health outcomes. The aim of this study was to examine which of the background factors of CPA committed by a parent or other caregiver relates to self-reported poor health among girls and boys (13; 15 and 17 years old): perpetrator, last year exposure; severity and frequency; socioeconomic load and foreign background. In a cross-sectional study in a Swedish county (n = 8024) a path analysis was performed to evaluate a model where all background variables were put as predictors of three health-status variables: mental; physical and general health problems. In a second step a log linear analysis was performed to examine how the distribution over the health-status categories was different for different combinations of background factors. Children exposed to CPA reported poor health to a much higher extent than those who were not exposed. In the path analysis it was found that frequency and severity of abuse (boys only) and having experienced CPA during the last year, was significantly associated with poor health as well as socioeconomic load in the families. Foreign background was significantly negatively associated with all three health indicators especially for girls. Neither mother nor father as perpetrator remained significant in the path analysis, while the results from the log linear analyses showed that mother-abuse did in fact relate to poor general health and mental as well as physical health problems among boys and girls. Father-abuse was associated with poor mental health if severe abuse was reported. Poor mental health was also associated with mild father-abuse if exposure during the last year was reported. Despite the limitations that cross-sectional studies imply, this study provides new knowledge about factors associated with poor health among physically abused children. It describes details of CPA that have significant associations to different aspects of poor health and thus what needs to be addressed by professionals within mental health providers and social services. Understanding how different factors may contribute to different health outcomes for exposed children is important in future research and needs further studies.
Tài liệu tham khảo
Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. Lancet. 2009;373:68–81.
Hazen AL, Connelly CD, Roesch SC, Hough RL, Landsverk JA. Child maltreatment profiles and adjustment problems in high-risk adolescents. J Interpers Violence. 2009;24:361–78.
Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006;256:174–86.
Bonomi AE, Cannon EA, Anderson ML, Rivara FP, Thompson RS. Association between self-reported health and physical and/or sexual abuse experienced before age 18. Child Abuse Negl. 2008;32:693–701.
Drevin J, Stern J, Annerback EM, Peterson M, Butler S, Tyden T, Berglund A, Larsson M, Kristiansson P. Adverse childhood experiences influence development of pain during pregnancy. Acta Obstet Gynecol Scand. 2015;94:840–6.
Kalmakis KA, Chandler GE. Health consequences of adverse childhood experiences: a systematic review. J Am Assoc Nurse Pract. 2015;27:457–65.
Widom CS, Czaja S, Wilson HW, Allwood M, Chauhan P. Do the long-term consequences of neglect differ for children of different races and ethnic backgrounds? Child Maltreat. 2013;18:42–55.
Annerback EM, Sahlqvist L, Svedin CG, Wingren G, Gustafsson PA. Child physical abuse and concurrence of other types of child abuse in Sweden-associations with health and risk behaviors. Child Abuse Negl. 2012;36:585–95.
Kendall-Tackett K. The health effects of childhood abuse: four pathways by which abuse can influence health. Child Abuse Negl. 2002;26:715–29.
Kiser LJ, Stover CS, Navalta CP, Dorado J, Vogel JM, Abdul-Adil JK, Kim S, Lee RC, Vivrette R, Briggs EC. Effects of the child-perpetrator relationship on mental health outcomes of child abuse: it’s (not) all relative. Child Abuse Negl. 2014;38:1083–93.
Goldsmith RE, Freyd JJ, DePrince AP. Betrayal trauma: associations with psychological and physical symptoms in young adults. J Interpers Violence. 2012;27:547–67.
Bacon H, Richardson S. Attachment theory and child abuse: an overview of the literature for practitioners. Child Abuse Rev. 2001;10:377–97.
Bowlby J. A secure base: clinical applications of attachment theory. London: Routledge; 1988.
Broberg A, Almqvist K, Tjus T, Iliste A, Nilsson B. Klinisk barnpsykologi: utveckling på avvägar (Clinical Child Psychiatry). Stockholm: Natur och kultur; 2003 (In Swedish).
Muller RT, Gragtmans K, Baker R. Childhood physical abuse, attachment, and adult social support: test of a mediational model. Can J Behav Sci. 2008;40:80–9.
Allen CM, Epperson DL. Perpetrator gender and type of child maltreatment: overcoming limited conceptualizations and obtaining representative samples. Child Welfare. 1993;72:543–54.
Hamby S, Finkelhor D, Turner H. Perpetrator and victim gender patterns for 21 forms of youth victimization in the National Survey of Children’s Exposure to Violence. Violence Vict. 2013;28:915–39.
Annerback EM, Wingren G, Svedin CG, Gustafsson PA. Prevalence and characteristics of child physical abuse in Sweden—findings from a population-based youth survey. Acta Paediatr. 2010;99:1229–36.
Nilsson D, Nordas E, Pribe G, Svedin CG. Child physical abuse—high school students’ mental health and parental relations depending on who perpetrated the abuse. Child Abuse Negl. 2017;70:28–38.
Finkelhor D, Vanderminden J, Turner H, Hamby S, Shattuck A. Child maltreatment rates assessed in a national household survey of caregivers and youth. Child Abuse Negl. 2014;38:1421–35.
Radford L, Corral S, Bradley C, Fisher HL. The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse Negl. 2013;37:801–13.
Hindberg B. Sårbara barn: att vara liten, misshandlad och försummad (Vulnerable children: to be small, maltreated and neglected). Stockholm: Gothia; 2006 (In Swedish).
Meadow R. ABC of child abuse. 3rd ed. Bristol: BMJ publisher group; 2002.
Janson S, Jernbro C, Långberg B. Kroppslig bestraffning och annan kränkning av barn i Sverige—en nationell kartläggning 2011 (Corporal punishment). Stockholm: Allmänna Barnhuset och Karlstads universitet; 2011 (In Swedish).
Otterman G, Lainpelto K, Lindblad F. Factors influencing the prosecution of child physical abuse cases in a Swedish metropolitan area. Acta Paediatr. 2013;102:1199–203.
Bremfelt S. Social health inequalities in Swedish children and adolescents—a systematic review. 2nd ed. Stockholm: Swedish National Institute of Public Health; 2011.
Elgar FJ, Pfortner TK, Moor I, De Clercq B, Stevens GW, Currie C. Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. Lancet. 2015;385:2088–95.
Barnfattigdomen i Sverige—Årsrapport 2013 (Child poverty in Sweden—Annual report 2013). (Foundation) RbStC ed. Stockholm: Rädda barnen; 2013. (In Swedish).
Questionnaire “Liv och Hälsa ung”. https://www.landstingetsormland.se/PageFiles/34653/%c3%85rskurs%209%202011.pdf. Accessed 30 May 2018 (In Swedish).
Murray A, Straus SLH, Louise Warren W. The conflict tactics scales handbook. Los Angelses: Western Psychlogical Services; 2003.
Boendeutgifter och ekonomi, Statistiska centralbyrån (Accomodation Expenses and Finances, Statistics of Sweden). http://www.statistikdatabasen.scb.se/pxweb/sv/ssd/START__HE__HE0103__HE0103E/?rxid=3bcdcb18-19f4-44b8-b458-9af83d77675c. Accessed 30 May 2018.
Brown TA. Confirmatory factor analysis for applied research. New York: Guildford Press; 2006.
Hu LBPM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Eq Model Multidiscip J. 1999;6:1–55.
Muthén IK, Muthén BO. Mplus user’s guide, 7th Edn. Los Angeles: Muthén & Muthén; 1998–2017.
Cleary M, Horsfall J, Escott P. Marginalization and associated concepts and processes in relation to mental health/illness. Issues Mental Health Nurs. 2014;35:224–6.
Vasas EB. Examining the margins: a concept analysis of marginalization. Adv Nurs Sci. 2005;28:194–202.
Rothman KJ, Greenland S. Causation and causal inference in epidemiology. Am J Public Health. 2005;95(Suppl 1):144–50.
Annerback EM, Svedin C, Gustafsson P. Characteristic features of severe child physical abuse—a multi-informant approach. J Fam Violence. 2009;25:165–72.
Kendall-Tackett K, Becker-Blease K. The importance of retrospective findings in child maltreatment research. Child Abuse Negl. 2004;28:723–7.
Kristensen P. Bias from nondifferential but dependent misclassification of exposure and outcome. Epidemiology. 1993;4:180–2.
Kristensen P. Avhengige målefeil i observasjonsstudier (Dependent bias in observational studies). Tidsskr Nor Laegeforen. 2005;125:173–5 (In Norwegian).
Hawker DS, Boulton MJ. Twenty years’ research on peer victimization and psychosocial maladjustment: a meta-analytic review of cross-sectional studies. J Child Psychol Psychiatry. 2000;41:441–55.
Edelbrock C. Assesing child psychopathology in developmental follow-up studies. In Friedman SL, Haywood HC, editors. Developmental follow-up concepts, domains and methods. San Diego: Academic Press; 1994.
De Los Reyes A, Augenstein TM, Wang M, Thomas SA, Drabick DA, Burgers DE, Rabinowitz J. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull. 2015;141:858–900.
Hambrick EP, Tunno AM, Gabrielli J, Jackson Y, Belz C. Using multiple informants to assess child maltreatment: concordance between case file and youth self-report. J Aggress Maltreat Trauma. 2014;23:751–71.