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Child maltreatment predicted substance abuse, violent delinquency and suicide
Chronic child maltreatment is a “robust indicator” of a range of future negative outcomes, including substance abuse, violent delinquency and suicidal behavior, according to new study results. However, with the right intervention, these outcomes can be avoided or mitigated.
“Although primary and secondary prevention remain important approaches, this study suggests that enhanced tertiary prevention may pay high dividends across a range of medical and behavioral domains,” the researchers wrote.
Melissa Jonson-Reid, PhD, and colleagues of Washington University in St. Louis sampled 5,994 low-income children aged 1.5 to 11 years from St. Louis, including 3,521 children with maltreatment reports, who were followed from 1993 to 2009. To identify adverse outcomes before the age of 18 years, the researchers accessed administrative and treatment records of substance abuse, brain injury, mental health treatment, sexually transmitted disease, violent delinquency and suicide attempts. They also measured mental health treatment, child maltreatment perpetration or substance abuse in adulthood.
Two groups were selected and compared: children who received assistance from the grant program Aid to Families with Dependent Children (AFDC) and had official maltreatment reports, and a comparison group of children of similar age who were randomly selected and had no child maltreatment reports. The researchers used multivariate analysis to control for potential confounders, including the parent’s age at the child’s birth, education status, parental history of mental health and child demographics.
Using the Statistical Analysis System, version 9.2, the researchers determined the associations between maltreatment reports and adverse outcomes.
The results showed that chronic child maltreatment predicted negative outcomes in a linear fashion (eg, percentages with at least one negative outcome: no maltreatment, 29.7%; one report, 39.5%; and four reports, 67.1%).
According to the researchers, suicide attempts before the age of 18 years “showed the largest proportionate increase with repeated maltreatment” — no report vs. at least four reports resulted in a 625% increase. After controlling for other adverse child outcomes, the dose-response was reduced, they wrote.
“The number of maltreatment reports is a strong general predictor of negative outcomes in both childhood and adulthood,” the researchers wrote, “although the relationship between repeated reports of maltreatment and problematic substance abuse in young adulthood did not persist once adverse childhood outcomes were controlled.”
The researchers concluded that there is a need for a better understanding of how the quality and timing of intervention can alter the negative trajectories associated with maltreatment.
Disclosure: The researchers report no relevant financial disclosures.
