Identifying Potential Mediators and Moderators of the Association Between Child Maltreatment and Bullying Perpetration and Victimization in School

A growing body of literature is demonstrating associations between childhood maltreatment and bullying involvement at school. In this literature review, four potential mediators (explanatory) and three potential moderators (mitigates or exacerbates) of the association between childhood maltreatment and school bullying are proposed. Mediators include emotional dysregulation, depression, anger, and social skills deficits. Moderators reviewed include quality of parent–child relationships, peer relationships, and teacher relationships. Although there might be insurmountable challenges to addressing child maltreatment in primary or universal school-based prevention programs, it is possible to intervene to improve these potentially mediating and moderating factors.     

Child Maltreatment and Children's Developmental Trajectories in Early to Middle Childhood

Associations between experiencing child maltreatment and adverse developmental outcomes are widely studied, yet conclusions regarding the extent to which effects are bidirectional, and whether they are likely causal, remain elusive. This study uses the Fragile Families and Child Wellbeing Study, a birth cohort of 4,898 children followed from birth through age 9. Hierarchical linear modeling and structural equation modeling are employed to estimate associations of maltreatment with cognitive and social‐emotional well‐being. Results suggest that effects of early childhood maltreatment emerge immediately, though developmental outcomes are also affected by newly occurring maltreatment over time. Additionally, findings indicate that children's early developmental scores predict their subsequent probability of experiencing maltreatment, though to a lesser extent than early maltreatment predicts subsequent developmental outcomes.     

Exploring policies for the reduction of child physical abuse and neglect

Policies can be powerful tools for prevention given their potential to affect conditions that can improve population-level health. Given the dearth of empirical research on policies’ impacts on child maltreatment, this article (a) identifies 37 state policies that might have impacts on the social determinants of child maltreatment; (b) identifies available data sources documenting the implementation of 31 policies; and (c) utilizes the available data to explore effects of 11 policies (selected because they had little missing data) on child maltreatment rates. These include two policies aimed at reducing poverty, two temporary assistance to needy families policies, two policies aimed at increasing access to child care, three policies aimed at increasing access to high quality pre-K, and three policies aimed at increasing access to health care. Multi-level regression analyses between within-state trends of child maltreatment investigation rates and these 11 policies, controlling for states’ childhood poverty, adults without a high school diploma, unemployment, child burden, and race/ethnicity, identified two that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care. These findings are correlational and are limited by the quality and availability of the data. Future research might focus on a reduced number of states that have good quality administrative data or population-based survey data on child maltreatment or reasonable proxies for child maltreatment and where data on the actual implementation of specific policies of interest can be documented.     

A longitudinal study of the effects of chronic maltreatment on children's behavioral and emotional problems

OBJECTIVE: The aim of the present longitudinal study was to examine the links between chronicity of maltreatment and child behavioral and emotional problems. METHOD: Forty-nine maltreated children (32 victims of continuous, or chronic, maltreatment; 17 victims of transitory maltreatment) and their mothers were evaluated in their homes three times over a period of 6 years: at the time of recruitment (T1), 3 years following the initial evaluation (T2) and 6 years following the initial evaluation (T3). The home visits were designed to obtain longitudinal assessments of different types of behavioral and emotional problems in the children, and of the mothers' self-reported potential for abuse to help determine the chronic/transitory aspect of the maltreatment situation. Child Protection Services (CPS) files were also consulted at each assessment time in order to obtain more accurate information regarding the chronic/transitory aspect of the maltreatment situation. RESULTS: The results show that over time the victims of chronic maltreatment (Chronic group; CH) had significantly more emotional problems (i.e., Anxiety/Depression) than those victims of transitory maltreatment (Transitory group; TR). There was also a tendency for CH children to exhibit more aggressive behavior and social withdrawal problems than the children in the TR group. Furthermore, at T3, the proportion of children in the CH group showing a clinical level of behavior problems in general was significantly higher than in the TR group. CONCLUSIONS: The study confirms that there are differences among maltreated children in levels of behavior and emotional problems and shows that chronicity must be taken into consideration in order to identify more clearly the impact of maltreatment on the child. Chronically maltreated children appear to be at high-risk for developing clinical levels of problems. The results also suggest that intervention efforts resulting in an improvement of the family situation (i.e., reduction or elimination of maltreatment), also lead to an improvement in the behavior of children.     

Timing of the first report and highest level of child protection response in association with early developmental vulnerabilities in an Australian population cohort

BackgroundChildhood maltreatment is associated with early childhood developmental vulnerabilities. However, the extent to which higher levels of child protection responses confer benefit to developmental competencies, and the impact of earlier timing of first reports in relation to early childhood vulnerability remains unclear.ObjectiveWe examined associations between early developmental vulnerabilities and (1) the highest level of child protection response (where OOHC was deemed the highest response among other types of reports/responses), and (2) the developmental timing of the first child protection report.Participants and SettingParticipants included 67,027 children from the New South Wales Child Development Study, of whom 10,944 were reported to child protection services up to age 5 years.MethodsA series of Multinomial Logistic Regressions were conducted to examine focal associations.ResultsChildren with substantiated maltreatment reports showed the strongest odds of vulnerability on three or more developmental domains (adjusted OR = 4.90; 95% CI = 4.13–5.80); children placed in OOHC showed slightly better physical, cognitive and communication competencies (adjusted ORs from 1.83 to 2.65) than those with substantiated reports that did not result in OOHC placements (adjusted OR from 2.77 to 3.67), when each group was compared to children with no child protection reports. Children with first maltreatment reports occurring in the first 18 months of life showed the strongest likelihood of developmental vulnerabilities on three or more developmental domains (adjusted OR = 3.56; 95% CI = 3.15–4.01) relative to children with no child protection reports.ConclusionEarlier reports of maltreatment may signal the need for targeted remediation of early developmental competencies to mitigate early developmental difficulties.     

Child maltreatment in the "children of the nineties" a longitudinal study of parental risk factors.

OBJECTIVE: To identify and validate factors within the parental background affecting risk of child maltreatment. METHOD: A nested case-control study based on the Avon Longitudinal Study of Parents and Children ("Children of the Nineties"), a cohort of children born in Avon in 1991 through 1992. Data on the childhood and psychiatric histories of the parents, along with other data on the social and family environments, have been collected through postal questionnaires from early antenatal booking onwards. RESULTS: Out of 14,138 participating children, 162 have been identified as having been maltreated. Using logistic regression analysis, significant risk factors within the mothers' backgrounds were age < 20; lower educational achievement; history of sexual abuse; child guidance or psychiatry; absence of her father during childhood; and a previous history of psychiatric illness. Significant factors in the fathers' backgrounds were age < 20; lower educational achievement; having been in care during childhood; and a history of psychiatric illness. Significant factors on univariate, but not multivariate analysis included a parental history of childhood physical abuse; divorce or separation of the mother's parents; a maternal history of having been in care, or separated from her mother; parental alcohol or drug abuse; and a maternal history of depression. CONCLUSIONS: This study, the first of its kind in the UK, supports the findings of others that parental age, educational achievement, and a history of psychiatric illness are of prime importance in an understanding of child maltreatment. With the exception of maternal sexual abuse, a history of abuse in childhood is not significant once adjusted for other background factors. The study suggests that psychodynamic models are inadequate to explain child maltreatment, and wider models incorporating other ecological domains are needed.     

Early maltreatment is associated with greater risk of conduct problems and lack of guilt in adolescence

Previous research indicates a link between childhood maltreatment and elevated conduct problems. Yet the literature is less clear on associations between maltreatment and callousness (e.g., lack of empathy or guilt). This is a critical gap given that callousness is a robust predictor of serious aggressive and violent behavior. We examine the association between substantiated maltreatment events in childhood and adolescence (up to age 13) and conduct problems and lack of guilt at age 14. We analyze self- and parent-report data along with official maltreatment records on 557 youth (50% female; 69% non-white) from a larger dataset (Longitudinal Studies on Childhood Abuse and Neglect; N = 1354). Results of multinomial logistic regression models indicate that youth with histories of substantiated maltreatment events are more likely to have elevated conduct problems and decreased guilt at age 14, particularly if they experienced maltreatment before the age of four years old. Youth who exhibit conduct problems and also appear to lack guilt are more likely to have a personal history of substantiated maltreatment. We discuss our results in terms of their implications for theory and practice.     

Interplay between childhood maltreatment, parental bonding, and gender effects: impact on quality of life

OBJECTIVE: The aim of this study was to examine associations between childhood adversity, parental bonding, gender, depressive symptoms, and quality of life in non-treatment-seeking adults from the community. METHOD: Effects of differential parental rearing were compared in adults who reported a high degree of childhood maltreatment (n=72) and those who reported no significant adverse events in childhood (n=69). Subjects completed retrospective measures of childhood maltreatment and perceived parenting style, as well as measures of current depressive symptoms and quality of life. RESULTS: The subjects without childhood maltreatment were younger and endorsed less current depressive symptomatology than did subjects with childhood maltreatment. While the subjects without a history of maltreatment reported more "optimal" bonding experiences with their parents, the maltreatment group members were more likely to characterize their early parental bonding experiences in terms of "affectionless control" (p<.001 for both maternal and paternal parenting), "affectionate constraint" (p=.025 for maternal parenting and p=.004 for paternal parenting), or "weak or absent" bonding (p<.001 for both maternal and paternal parenting). Results of a multiple regression analysis revealed that overall quality of paternal care (p=.015) and current level of depressive symptoms (p<.001) were significant independent predictors of adult quality of life. Gender effects between subjects providing parental bonding data were limited to the group with childhood maltreatment. CONCLUSION: These findings extend previous work documenting a relationship between early life maltreatment and suboptimal parental bonding, suggesting gender-specific effects of maternal and paternal care. Effects of childhood maltreatment on quality of life in adulthood appear to be linked with the quality of childhood paternal care and the occurrence of depressive symptomatology in adulthood, suggesting possible targets for primary or secondary prevention.     

Child maltreatment and problem gambling: A systematic review

This study systematically reviews research on child maltreatment and risk of gambling problems in adulthood. It also reviews adult problem gamblers’ risk of abusing or neglecting their own children. Multiple database searches were conducted using pre-defined search terms related to gambling and child abuse and neglect. We identified 601 unique references and excluded studies if they did not report original research, or did not specifically measure child maltreatment or gambling. Twelve studies that included multivariable analysis of childhood maltreatment exposure and problem gambling were identified. Six of seven studies examining childhood sexual abuse and four of five examining physical abuse showed a significant positive association between abuse and later gambling problems (odds ratios for sexual abuse 2.01–3.65; physical abuse 2.3–2.8). Both studies examining psychological maltreatment and two of three examining neglect identified positive associations with problem gambling. In most studies, risks were reduced or eliminated when controlling for other mental health disorders. The three studies measuring risk of child abuse and neglect among current problem gamblers suggest an increased risk for child physical abuse and medical conditions indicative of neglect although there is a considerable amount of variation among studies. Child abuse is associated with increased risk of gambling problems – gambling treatment providers should ask about maltreatment history as part of their clinical assessment. Problem gamblers may be more likely to physically abuse or neglect their children, but data here are more limited. Child welfare professionals should consider asking questions about parental gambling when assessing family risk.     

The deterioration and mobilization effects of trauma on social support: childhood maltreatment and adulthood military violence in a Palestinian community sample

OBJECTIVES: To show that exposure to childhood maltreatment deteriorates, whereas exposure to adulthood military violence mobilizes social support; second, to show that associations between traumatic events and mental health problems are mediated through social support and, subsequently, adulthood military violence is associated with low level and childhood maltreatment with high level of mental health symptoms; third, to explore whether the moderating (protecting) effect of sufficient and satisfactory social support would differ among victims of childhood maltreatment and adulthood military violence. METHOD: The participants were a random-sample of Palestinian men and women (n=585) of 16-60 years of age. Exposure to military violence in adulthood was assessed by the Harvard Trauma Questionnaire (HTQ_I), and to childhood maltreatment by a 13-item questionnaire developed for the study. A Social Network Schedule was applied to assess the function, source, and satisfaction with social support, and the Revised SCL90-R Symptoms Checklist to assess mental health symptoms. RESULTS: Findings supported our hypothesis that exposure to childhood maltreatment was associated with low levels of social support, whereas exposure to adulthood military violence was associated with high levels of social support. Contrary to our second hypothesis, both childhood maltreatment and adulthood military violence were associated with high levels of mental health symptoms. Finally, high level and satisfactory social support moderated the association between exposure to military violence in adulthood and mental health symptoms, but not between childhood maltreatment and mental health symptoms. CONCLUSION: The findings emphasize that the nature of trauma, that is, whether familial or political, determines the availability of protective resources versus vulnerability, which should be considered when tailoring interventions to trauma victims.     

The mitigating effects of maternal social support and paternal involvement on the intergenerational transmission of violence

Childhood maltreatment is a strong risk factor for subsequent violence, including violent behaviors in young adulthood and offspring maltreatment after becoming a parent. Little is known about the specific circumstances under which supportive relationships may help disrupt this cycle of violence throughout the life course. We conducted two complementary analyses to assess whether maternal social support in early childhood, and also paternal involvement in middle childhood, could prevent the intergenerational transmission of violence, using data from the Avon Longitudinal Study of Parents and Children (n = 11,384). We found that higher levels of maternal social support in the postpartum period reduced the odds of offspring maltreatment at ages 0–8 years (OR = 0.95, 95% CI 0.93–0.96). When classifying mothers according to their abuse history, this protective association of social support was observed among mothers with no history of childhood maltreatment and among those with only childhood maltreatment (and not postpartum intimate partner violence [IPV]), but not among mothers who reported IPV since the child’s birth. We then extended our analysis of these offspring forward in time and found that paternal involvement at ages 9–10 years was associated with a reduced risk of offspring self-reported violent perpetration at ages 18–20 years (OR = 0.85, 95% CI = 0.77–0.94). This protective association was generally apparent among all subgroups of children, including those with a history of childhood maltreatment. Together these results highlight the protective influence of supportive relationships against the intergenerational transmission of violence, depending on abuse history, context, and timing, with important implications for the prevention of childhood maltreatment and mitigation of its negative effects.     

Individual, family, and neighborhood factors distinguish resilient from non-resilient maltreated children: a cumulative stressors model

OBJECTIVE: Children who are physically maltreated are at risk of a range of adverse outcomes in childhood and adulthood, but some children who are maltreated manage to function well despite their history of adversity. Which individual, family, and neighborhood characteristics distinguish resilient from non-resilient maltreated children? Do children's individual strengths promote resilience even when children are exposed to multiple family and neighborhood stressors (cumulative stressors model)? METHODS: Data were from the Environmental Risk Longitudinal Study which describes a nationally representative sample of 1,116 twin pairs and their families. Families were home-visited when the twins were 5 and 7 years old, and teachers provided information about children's behavior at school. Interviewers rated the likelihood that children had been maltreated based on mothers' reports of harm to the child and child welfare involvement with the family. RESULTS: Resilient children were those who engaged in normative levels of antisocial behavior despite having been maltreated. Boys (but not girls) who had above-average intelligence and whose parents had relatively few symptoms of antisocial personality were more likely to be resilient versus non-resilient to maltreatment. Children whose parents had substance use problems and who lived in relatively high crime neighborhoods that were low on social cohesion and informal social control were less likely to be resilient versus non-resilient to maltreatment. Consistent with a cumulative stressors model of children's adaptation, individual strengths distinguished resilient from non-resilient children under conditions of low, but not high, family and neighborhood stress. CONCLUSION: These findings suggest that for children residing in multi-problem families, personal resources may not be sufficient to promote their adaptive functioning.     

Urbanicity matters in self-reported child maltreatment prevalence: Findings from a nationally representative study

Despite indications that there are differences in rates of child maltreatment (CM) cases in the child protection system between urban and rural areas, there are no published studies examining the differences in self-reported CM prevalence and its correlates by urbanicity. The present study aimed to: (1) identify the distribution of self-reported childhood experiences of maltreatment by urbanicity, (2) assess whether differences by urbanicity persist after adjusting for known risk factors, and (3) explore whether the associations between these risk factors and CM are modified by urban-rural designation. Using nationally representative data from waves I and III of the National Longitudinal Study of Adolescent to Adult Health, the prevalence of six maltreatment outcomes was estimated for rural, minor urban, and major urban areas (N = 14,322). Multivariable logistic models were estimated identifying if risk associated with urbanicity persisted after adjusting for other risk factors. Interactions between urbanicity and main effects were explored. Prevalence estimates of any CM, poly-victimization, supervision neglect, and physical abuse were significantly higher in major urban areas. Those from major urban areas were more likely to report any maltreatment and supervision neglect even after adjusting for child and family risk factors. The association between race/ethnicity, welfare receipt, low parental educational attainment, and disability status and CM were modified by urbanicity. Significant differences in the prevalence and correlates of CM exist between urban and rural areas. Future research and policy should use self-reported prevalence, in conjunction with official reports, to inform child maltreatment prevention and intervention.     

Associations of neighborhood disorganization and maternal spanking with children’s aggression: A fixed-effects regression analysis

This study employed fixed effects regression that controls for selection bias, omitted variables bias, and all time-invariant aspects of parent and child characteristics to examine the simultaneous associations between neighborhood disorganization, maternal spanking, and aggressive behavior in early childhood using data from the Fragile Families and Child Wellbeing Study (FFCWS). Analysis was based on 2,472 children and their mothers who participated in Wave 3 (2001–2003; child age 3) and Wave 4 (2003–2006; child age 5) of the FFCWS. Results indicated that higher rates of neighborhood crime and violence predicted higher levels of child aggression. Maternal spanking in the past year, whether frequent or infrequent, was also associated with increases in aggressive behavior. This study contributes statistically rigorous evidence that exposure to violence in the neighborhood as well as the family context are predictors of child aggression. We conclude with a discussion for the need for multilevel prevention and intervention approaches that target both community and parenting factors.     

Risk terrain modeling predicts child maltreatment

As indicated by research on the long-term effects of adverse childhood experiences (ACEs), maltreatment has far-reaching consequences for affected children. Effective prevention measures have been elusive, partly due to difficulty in identifying vulnerable children before they are harmed. This study employs Risk Terrain Modeling (RTM), an analysis of the cumulative effect of environmental factors thought to be conducive for child maltreatment, to create a highly accurate prediction model for future substantiated child maltreatment cases in the City of Fort Worth, Texas. The model is superior to commonly used hotspot predictions and more beneficial in aiding prevention efforts in a number of ways: 1) it identifies the highest risk areas for future instances of child maltreatment with improved precision and accuracy; 2) it aids the prioritization of risk-mitigating efforts by informing about the relative importance of the most significant contributing risk factors; 3) since predictions are modeled as a function of easily obtainable data, practitioners do not have to undergo the difficult process of obtaining official child maltreatment data to apply it; 4) the inclusion of a multitude of environmental risk factors creates a more robust model with higher predictive validity; and, 5) the model does not rely on a retrospective examination of past instances of child maltreatment, but adapts predictions to changing environmental conditions. The present study introduces and examines the predictive power of this new tool to aid prevention efforts seeking to improve the safety, health, and wellbeing of vulnerable children.     

Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care

OBJECTIVE: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services. METHODS: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient ambulatory services at a community-based Indian Health Service Hospital in Albuquerque, New Mexico. Dependent measures included mood, substance abuse, and anxiety disorders as well as posttraumatic stress disorder (PTSD) as measured by the Composite International Diagnostic Interview. CAN was assessed using the Childhood Trauma Questionnaire. RESULTS: Approximately three-quarters of respondents (76.5%; 95% CI = 70.4, 81.7) reported some type of childhood abuse or neglect; over 40% reported exposure to severe maltreatment. Severity of child maltreatment was associated in a dose response manner with lifetime diagnosis of mental disorders. After adjusting for social and demographic correlates, severe child maltreatment was strongly associated with lifetime PTSD (prevalence ratio [PR] 3.9; 95% CI = 1.9, 8.0); and was moderately associated with lifetime substance use disorders (PR = 2.3; 95% CI = 1.6, 3.3); mood disorders (PR = 2.1; 95% CI 1.4, 3.2); and with two or more disorders (PR = 2.3; 95% CI = 1.6, 3.4). CONCLUSION: CAN was common in our sample of American Indian women in primary care and was positively associated with lifetime psychiatric disorders outcomes. Screening for CAN and psychiatric disorders would enhance the treatment of patients seeking primary care services. Primary prevention of child maltreatment might reduce the high prevalence of mental disorders among American Indian women.     

Effects of academic performance on the relationship between child maltreatment and deviant behavior: A national study in Taiwan

BackgroundChild maltreatment has been found to significantly increase the risk of deviant behavior. Academic performance has been shown to have an indirect effect on the relationship between child maltreatment and deviant behavior. However, not all adolescents who have been maltreated engage in deviant behavior, so the relationship between child maltreatment and deviant behavior has remained unclear.ObjectiveThe aim of this research was to examine the potential mediating and/or moderating effects of academic performance on the relationship between child maltreatment and deviant behavior.Participants and settingThe data in this study were from a nationwide study examining the consequences of childhood maltreatment in Taiwan. The database consisted of data from 2321 adolescents.MethodsA secondary data analysis was conducted. Self-report data were obtained on childhood maltreatment experiences, academic performance, and deviant behaviors. Path analyses and a generalized linear model were used to examine the effects of academic performance on the relationship between child maltreatment and deviant behavior.ResultsMost participants were male (61.4%), with a mean age of 15.9 years. The mean scores of self-rated academic performance and deviant behavior were 2.86 and 8.2, respectively. A total of 83% participants reported having experienced childhood maltreatment. In this study, academic performance was found to have a moderating rather than a mediating effect on the relationship between child maltreatment and deviant behavior. Among adolescents who had been maltreated during childhood, those who self-rated poorer academic performance were more likely to have a higher deviant behavior score than those who self-rated better academic performance.ConclusionsGood academic performance can be a buffer that reduces the risk of deviant behavior among individuals with a history of childhood maltreatment. Healthcare professionals and educators can tailor early prevention and intervention educational programs targeted toward adolescents with experience of childhood abuse or poor academic performance to prevent the incidence of deviant behavior and thus break the cycle of violence.     

Intergenerational transmission of child maltreatment: Predictors of child emotional maltreatment among 11 to 17 years old children residing in communities of Karachi,Pakistan

ObjectiveFamilies where parents had childhood history of victimization may likely to abuse their children; hence contributing as an important predictor of child emotional maltreatment (CEM). This study aimed to determine the relationship of intergenerational abuse with CEM among 11–17 years old children residing in peri-urban and urban communities of Karachi, Pakistan.MethodStructured interviews were conducted with 800 children and parents-pair using validated questionnaire “International Child Abuse Screening Tool for Child (ICAST-C)” comprised of 4 domains. Domain of child emotional maltreatment was considered as outcome (CEM-score). The relationship between Parental history of childhood victimization and CEM-Score was measured using linear regression.ResultsThe average CEM-score was came to be 19+5.2 among children whom parental history of childhood victimization was present (P < 0.001). The estimated mean CEM-score increased by 5.59 units (95% CI= {2.61, 8.51}) among children whom parents had a history of childhood victimization (Intergenerational abuse) with severe physical familial abuse.ConclusionThe current study provided evidence on intergenerational transmission of maltreatment suggesting early prevention to break the cycle of child maltreatment through generations. Preventive measures can be taken, once a parental history of childhood victimization has been identified, by providing appropriate services to those families who belong to lower socioeconomic status, where mothers are young, presence of siblings’ rivalry/ bullying and/or violence among family members. However, these factors do not explain a complete causality of the intergenerational transmission therefore additional factors, for instance parenting styles must be taken into consideration.     

National call to action: Working toward the elimination of child maltreatment. The economics

No reliable estimates exist of the overall costs to society of child maltreatment that will withstand serious examination. Arguably some of the most important human costs of maltreatment are unquantifiable. Moreover, in many cases it is difficult if not impossible to separate the economics of child abuse and neglect from the economics of a host of other problems facing families. Still, even conservative estimates of government spending on behalf of abused and neglected children and their families illustrate that child maltreatment costs society a great deal, with much of that expense going for deep-end intervention rather than family support and prevention. Government expenditures directed at this social problem have grown rapidly since the rediscovery of child abuse in the 1960s and now exceed spending for a number of essential supports for children and families. Moreover, the new era of continuing commitment to child protection in the context of a revised social contract with the nation's poor raises serious questions about the economics of child maltreatment in the future.