Fluke J D, Yuan Y Y, Edwards M
Children's Division, The American Humane Association, Englewood, CO 80112-5117, USA.
Child Abuse Negl. 1999 Jul;23(7):633-50. doi: 10.1016/s0145-2134(99)00039-3.
The research describes and compares patterns of maltreatment recurrence across multiple states using large samples, confirms the patterns of recurrence found in the literature, and explores unreported patterns of recurrence.
A recurrence data set for calendar years 1994 and 1995 was constructed from the multi-state case level data from the National Child Abuse and Neglect Data System. These data were available for 10 states and included a range from 2,419 to 99,288 substantiated or indicated report-child pairs per state. A common set of data constructs lent consistency to data construction and analysis, while preserving differences in policy. Event History Analysis (survival) techniques were used.
Single site studies were confirmed across the 10 states. These include the pattern where neglect is most likely to recur, followed by physical abuse and then sexual abuse. Similarly, younger children are more likely to recur. A finding of the analysis is that the likelihood of recurrence increases in a systematic and consistent fashion based upon the sequential ordering of recurrent maltreatment events. Also, the likelihood of recurrence is associated with the provision of postinvestigative services.
Highly consistent patterns of recurrence were observed across states. Children experiencing multiple recurrences compared to no recurrence or one recurrence may represent a special at risk population requiring additional research. Adequate baselines and an understanding of recurrence is needed when considering recurrence as an outcome indicator or in developing risk assessment tools. Important recurrence patterns may be difficult to detect reliably with relatively small samples.
本研究使用大样本描述并比较多个州虐待复发的模式，证实文献中发现的复发模式，并探索未报告的复发模式。
利用国家虐待和忽视儿童数据系统的多州个案层面数据，构建了1994年和1995年的复发数据集。这些数据涵盖10个州，每个州有2419至99288对经证实或有迹象表明的报告儿童对。一组通用的数据结构使数据构建和分析具有一致性，同时保留了政策差异。采用了事件史分析（生存）技术。
在这10个州中证实了单项研究结果。这些结果包括忽视最有可能复发，其次是身体虐待，然后是性虐待。同样，年龄较小的儿童更有可能复发。分析发现，复发的可能性会根据复发虐待事件的顺序系统且一致地增加。此外，复发的可能性与调查后服务的提供有关。
各州观察到高度一致的复发模式。与未复发或仅复发一次相比，经历多次复发的儿童可能代表一个需要额外研究的特殊高危人群。在将复发作为结果指标或开发风险评估工具时，需要足够的基线数据并了解复发情况。使用相对较小的样本可能难以可靠地检测到重要的复发模式。
