Child maltreatment is mediating long-term consequences of household dysfunction in a population representative sample.
Adolescent
Adult
Adult Survivors of Child Abuse
/ psychology
Anxiety
/ epidemiology
Child
Child Abuse
/ psychology
Cross-Sectional Studies
Depression
/ epidemiology
Domestic Violence
/ psychology
Family Characteristics
Female
Germany
Health Status
Humans
Male
Substance-Related Disorders
/ epidemiology
Adverse childhood experiences (ACE)
Child maltreatment
Intimate partner violence (IPV)
Mentally ill parents
Parental separation
Parental substance abuse
Journal
European psychiatry : the journal of the Association of European Psychiatrists
ISSN: 1778-3585
Titre abrégé: Eur Psychiatry
Pays: England
ID NLM: 9111820
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
15
10
2018
revised:
28
01
2019
accepted:
29
01
2019
pubmed:
12
2
2019
medline:
19
6
2019
entrez:
12
2
2019
Statut:
ppublish
Résumé
Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs. A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey. The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95-5.55), just as household substance abuse (ORs 5.32-6.98), violence against the mother (ORs 4.43-10.26), incarceration of a household member (ORs 6.11-14.93) and parental separation (OR 3.37-4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood. ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.
Sections du résumé
BACKGROUND
Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs.
METHODS
A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey.
RESULTS
The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95-5.55), just as household substance abuse (ORs 5.32-6.98), violence against the mother (ORs 4.43-10.26), incarceration of a household member (ORs 6.11-14.93) and parental separation (OR 3.37-4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood.
CONCLUSIONS
ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.
Identifiants
pubmed: 30743239
pii: S0924-9338(19)30018-5
doi: 10.1016/j.eurpsy.2019.01.018
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
10-18Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.