Child Maltreatment: Brief Communication

Child maltreatment has serious consequences, including increasing an individual's risk of physical and mental health problems across their life course. Objective: Here we show that there is an important public health message to focus, not only on approaches that prevent or detect childhood maltreatment, but also to explore methods of prevention and detection of mental ill health. Results: The study Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis (2019) showed that all different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Conclusion: It is important to highlight emotional violence may actually be more powerful than physical and sexual abuse in its impact on adolescent suicide behaviors in low- and middle-income countries. Keywords: Child Maltreatment; Mental Health; Prevention.

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Childhood maltreatment and adult suicidality: a comprehensive systematic review with meta-analysis

Psychological Medicine ◽

10.1017/s0033291718003823 ◽

2019 ◽

Vol 49 (07) ◽

pp. 1057-1078 ◽

Cited By ~ 33

Author(s):

Ioannis Angelakis ◽

Emma Louise Gillespie ◽

Maria Panagioti

Keyword(s):

Systematic Review ◽

Childhood Abuse ◽

Childhood Maltreatment ◽

Emotional Abuse ◽

Suicide Attempts ◽

Meta Analysis ◽

Current Evidence ◽

Bibliographic Databases ◽

Increased Risk ◽

Different Types

AbstractThis comprehensive systematic review and meta-analysis aims to quantify the association between different types of childhood maltreatment and suicidality. We searched five bibliographic databases, including Medline, PsychINFO, Embase, Web of Science and CINAHL, until January 2018. Random-effects meta-analysis was employed followed by univariable and multivariable meta-regressions. Heterogeneity was quantified using theI2statistic and formal publication bias tests were undertaken. The methodological quality of the studies was critically appraised and accounted in the meta-regression analyses. Data from 68 studies based onn= 261.660 adults were pooled. All different types of childhood maltreatment including sexual abuse [odds ratio (OR) 3.17, 95% confidence interval (CI) 2.76–3.64], physical abuse (OR 2.52, 95% CI 2.09–3.04) and emotional abuse (OR 2.49, 95% CI 1.64–3.77) were associated with two- to three-fold increased risk for suicide attempts. Similar results were found for the association between childhood maltreatment and suicidal ideation. Complex childhood abuse was associated with a particularly high risk for suicide attempts in adults (OR 5.18, 95% CI 2.52–10.63). Variations across the studies in terms of demographic and clinical characteristics of the participants and other core methodological factors did not affect the findings of the main analyses. We conclude that there is solid evidence that childhood maltreatment is associated with increased odds for suicidality in adults. The main outstanding challenge is to better understand the mechanisms which underpin the development of suicidality in people exposed to childhood maltreatment because current evidence is scarce.

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Child maltreatment and mental health problems in adulthood: birth cohort study

The British Journal of Psychiatry ◽

10.1192/bjp.2018.207 ◽

2018 ◽

Vol 213 (6) ◽

pp. 698-703 ◽

Cited By ~ 25

Author(s):

Steve Kisely ◽

Amanuel Alemu Abajobir ◽

Ryan Mills ◽

Lane Strathearn ◽

Alexandra Clavarino ◽

...

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Cohort Study ◽

Child Maltreatment ◽

Birth Cohort ◽

Emotional Abuse ◽

Mental Health Problems ◽

Psychiatric Morbidity ◽

Self Report ◽

Birth Cohort Study

BackgroundRetrospective studies have shown a high association between child abuse and subsequent psychiatric morbidity. Prospective studies are rarer.AimsTo examine, using a prospective record-linkage analysis, whether substantiated child maltreatment is associated with adverse psychological outcomes in early adulthood.MethodThe participants were 3778 mother and child pairs enrolled in a population-based birth cohort study in Brisbane, Australia. Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. The primary outcomes were the internalising and externalising scales of the Youth Self-Report and the Centre for Epidemiological Studies-Depression scales (CES-D) at approximately 21 years of age. A subset completed the Composite International Diagnostic Interview-Auto version (CIDI-Auto).ResultsIn total, 171 (4.5%) participants had a history of substantiated child maltreatment, most commonly emotional abuse (n= 91), followed by physical abuse (n= 78), neglect (n= 73) and sexual abuse (n= 54). After adjustment for potential confounders, depressive symptoms on the CES-D, as well as internalising and externalising behaviours were strongly associated with substantiated abuse in all forms, except sexual abuse. The results for the subset of the sample who completed the CIDI-Auto were less clear. Anxiety, especially post-traumatic stress disorder, showed the strongest association whereas the findings for depressive disorder were equivocal. However, across all diagnostic categories, emotional abuse and neglect, as well as multiple forms of abuse, showed a consistent association.ConclusionsChild maltreatment, particularly neglect and emotional abuse, has serious adverse effects on early adult mental health. These two warrant the attention given to other forms of child maltreatment. Children experiencing more than one type of maltreatment are at particular risk.Declaration of interestNone.

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Association between Childhood Maltreatment and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: The Moderating Role of Depressive Symptoms

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176025 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6025

Author(s):

Meiqian Gong ◽

Sheng Zhang ◽

Wenyan Li ◽

Wanxin Wang ◽

Ruipeng Wu ◽

...

Keyword(s):

Sexual Abuse ◽

Depressive Symptoms ◽

Suicidal Ideation ◽

Suicidal Behavior ◽

Childhood Maltreatment ◽

Emotional Abuse ◽

Suicide Attempts ◽

Chinese Adolescents ◽

Increased Risk ◽

Moderating Role

Suicidal behavior is a major public health concern worldwide and has become the second-leading cause of death among adolescents. The purposes of this study were to investigate the associations between childhood maltreatment and suicidal behavior and to test whether depressive symptoms have moderating effects on these associations. A multistage stratified cluster randomized sampling method was adopted to collect data from 21,019 high school students in Guangdong Province, China. The prevalence of suicidal ideation and suicide attempts among Chinese adolescents were 18.2% and 3.6%, respectively. Physical abuse (adjusted odds ratios (AOR) = 1.35, 95% confidence intervals (CI) = 1.32–1.38), emotional abuse (AOR = 1.26, 95% CI = 1.25–1.28), sexual abuse (AOR = 1.25, 95% CI = 1.21–1.30), physical neglect (AOR = 1.09, 95% CI = 1.08–1.11), and emotional neglect (AOR = 1.08, 95% CI = 1.08–1.09) were all associated with an increased risk of suicidal ideation, and these associations were also found for suicide attempts. According to stratification analyses, physical abuse/emotional abuse/sexual abuse had a stronger effect on suicidal ideation and suicide attempts among students without depressive symptoms than among students with depressive symptoms. Childhood maltreatment was associated with an increased risk of suicidal ideation and suicide attempts in Chinese adolescents. Depressive symptoms play a moderating role in the association between childhood maltreatment and suicidal behaviors.

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Using Linked Data to Examine the Epidemiology of All-Cause and Cause-Specific Mortality Following Release from Incarceration in Eleven Countries

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1478 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Rohan Borschmann ◽

Claire Keen ◽

Jesse T Young ◽

Alexander D Love ◽

Matthew Spittal ◽

...

Keyword(s):

Linked Data ◽

Mental Health Problems ◽

Meta Analysis ◽

Physical And Mental Health ◽

Relevant Evidence ◽

Analysis Methodology ◽

Increased Risk ◽

Global Epidemiology ◽

Individual Participant ◽

Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. Objectives and ApproachWe aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsUsing linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the IPDLN conference in October. Conclusion / ImplicationsThe MARIC consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.

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Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders

The Canadian Journal of Psychiatry ◽

10.1177/0706743718784938 ◽

2018 ◽

Vol 64 (3) ◽

pp. 180-189

Author(s):

Laura M. Heath ◽

Jill Torrie ◽

Kathryn J. Gill

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Psychological Distress ◽

Mood Disorder ◽

Mood Disorders ◽

Emotional Abuse ◽

Substance Dependence ◽

Physical And Mental Health ◽

Parental History ◽

History Of

Objective: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. Methods: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. Results: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. Conclusions: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

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The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

International Journal for Population Data Science ◽

10.23889/ijpds.v5i1.1145 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Rohan Borschmann ◽

Holly Tibble ◽

Matthew J Spittal ◽

David Preen ◽

Jane Pirkis ◽

...

Keyword(s):

Mental Health Problems ◽

Meta Analysis ◽

Individual Participant Data ◽

Physical And Mental Health ◽

Relevant Evidence ◽

Analysis Methodology ◽

Increased Risk ◽

Global Epidemiology ◽

Individual Participant ◽

Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. ObjectivesTo comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. MethodsWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsThe combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. ConclusionsThe consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. Key wordsMortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.

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Child maltreatment (neglect and abuse) in the 1958 birth cohort: an overview of associations with developmental trajectories and long-term outcomes

Longitudinal and Life Course Studies ◽

10.1332/175795920x15891281805890 ◽

2020 ◽

Vol 11 (4) ◽

pp. 431-458

Author(s):

Chris Power ◽

Leah Li ◽

Snehal M. Pinto Pereira

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Child Maltreatment ◽

Birth Cohort ◽

Childhood Abuse ◽

Physical Functioning ◽

Childhood Maltreatment ◽

Cognitive Abilities ◽

Blood Lipids ◽

Adult Health

Childhood maltreatment types (neglect and psychological, physical or sexual abuse) are associated with many poor outcomes in adulthood. Yet, research mainly focuses on the cumulative adversity burden rather than specificities and commonalities of associations with adult outcomes and intervening pathways. This overview therefore summarises evidence from several research studies using the 1958 British Birth Cohort on specific maltreatment types, child development trajectories, adult intermediaries and outcomes. About one in five participants were identified as neglected or abused in childhood. Neglect was associated with key dimensions of development: slower height growth, delayed maturation, faster BMI gain, and poorer emotional and cognitive development. Associated adulthood outcomes included harmful behaviours (notably smoking), poorer physical health (shorter height, excess BMI, poorer blood lipids and glucose, poor-rated health and physical functioning), worse mental health, lower socio-economic circumstances (e.g. poorer living conditions) and elevated mortality in mid-adulthood. Childhood abuse associations were less widespread and were often only for specific types: most were unrelated to childhood height and cognitive abilities, but all were associated with poorer child emotional development, adult mental health, smoking, blood lipids and self-rated health. Additionally, physical abuse was associated with faster BMI gain, higher adult BMI, blood glucose, inflammation and mortality in mid-adulthood; sexual abuse with faster BMI gain, higher adult BMI, poor physical functioning at 50y and higher mortality in mid-adulthood. Adult health measures associated with child maltreatment are key predictors of serious disease, disability and death. Therefore, child maltreatment associations with these measures represent an important burden for individuals and society.

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Childhood Maltreatment and Risk of Harm to Self and Others: The Role of Sex and Polyvictimization

International Journal of Child and Adolescent Resilience ◽

10.7202/1072592ar ◽

2020 ◽

Vol 7 (1) ◽

pp. 108-122

Author(s):

Shannon L. Stewart ◽

Ashley Toohey ◽

Natalia Lapshina

Keyword(s):

Mental Health ◽

Childhood Maltreatment ◽

Mental Health Problems ◽

Poor Quality ◽

Interpersonal Trauma ◽

Children And Youth ◽

Physical And Mental Health ◽

Skill Deficits

Objectives: Research has shown that children who experience abuse and neglect are at much higher risk of experiencing negative outcomes such as physical and mental health problems, social skill deficits, and poor quality of life. The goal of this paper was to examine the relationship between polyvictimization and risk of harm to self and others, taking into account both age and sex differences. Methods: A total of 8980 participants (4156 with maltreatment history) were recruited from over 50 mental health facilities in Ontario, Canada. Group comparisons were completed to examine types of trauma experienced, and risk of harm to self and others. Results: Among our sample, we found that 29% of children and youth had experienced multiple types of interpersonal trauma. We also found that while female children and youth who had experienced trauma were at greater risk of harm to themselves, males were at greater risk of harming others. Further, our results highlight that children and youth who had experienced multiple types of maltreatment, regardless of age or sex, were at the greatest risk of harm to self and others. Implications: Findings from this research highlight that interpersonal trauma is multifaceted and add to existing evidence that there is a cumulative relationship between experiencing multiple types of maltreatment and risk in relation to harming oneself or others. Our findings underscore the importance of a background assessment that takes into account all forms of maltreatment in order to properly understand risk of harm and inform intervention.

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Sexual violence and suicidal ideation among French adults, a mediation analysis

European Journal of Public Health ◽

10.1093/eurpub/ckz186.576 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

F El-Khoury ◽

Keyword(s):

Mental Health ◽

Suicidal Ideation ◽

Sexual Assault ◽

Sexual Violence ◽

Mediation Analysis ◽

Suicide Attempts ◽

Mental Health Problems ◽

Adult Population ◽

Cross Sectional ◽

Increased Risk

Abstract Objectives Sexual violence against women is endemic and is linked with a host of mental health problems and suicidal behaviour. We test whether sexual violence is more prevalent and have more damaging psychological effects among women compared to men, and quantify its mediating role in the association between sex and suicidal ideation and behaviour. Methods We used data from the “Health Barometer” (Baromètre Santé) 2017 a cross-sectional phone survey, which recruited a nationally representative sample of French adults aged 18 to 75 years in 2017 (n = 25319). Data were weighted to be representative of the French adult population. Outcomes included suicidal ideation, imagery of suicide, and suicide attempts in the preceding year. We conducted mutlivariable mediation analysis using the counterfactual approach to evaluate the contribution that lifetime sexual violence has in the association between sex and suicidal ideation and behaviour. Results We found that women are five times more likely to have experienced sexual victimisation, and are more at risk of any suicidal ideation and imagery of suicide in the preceding year compared to men. Women and men had comparable rates of suicide attempts in the preceding year. We estimated that 47% of the increased risk of suicidal ideation in the preceding year women have compared to men is mediated by lifetime sexual assault. Lifetime sexual assault also explained 39% of the association between sex and having imagery of suicide. Discussion Our findings reiterate the importance of the prevention of sexual violence and an adequate care for sexual assault victims, especially women, in public health and mental health policies and initiatives. Key messages Women are five times more likely to have experienced sexual victimisation compared to men, and are more likely to suffer from suicidal ideation in the preceding year. Experience of lifetime sexual violence contributes substantially (around 50%) to women’s increased likelihood of suicidal ideation compared to men.

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The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis

The Canadian Journal of Psychiatry ◽

10.1177/0706743719877029 ◽

2019 ◽

pp. 070674371987702 ◽

Cited By ~ 1

Author(s):

Sawayra Owais ◽

Mateusz Faltyn ◽

Ashley V. D. Johnson ◽

Chelsea Gabel ◽

Bernice Downey ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Health Problems ◽

Meta Analysis ◽

Well Being ◽

Health Problems ◽

Indigenous Women ◽

Perinatal Mental Health ◽

Future Research ◽

Increased Risk

Objective: Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women. Methods: We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum. Results: Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [ OR] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity ( OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women ( OR 1.86; 95% CI, 1.51 to 2.28). Conclusion: Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations. Trial Registration: PROSPERO-CRD42018108638.

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