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描述虐待行为:儿童保护服务报告与研究定义是否一致?

Describing maltreatment: do child protective service reports and research definitions agree?

作者信息

Runyan Desmond K, Cox Christine E, Dubowitz Howard, Newton Rae R, Upadhyaya Mukund, Kotch Jonathan B, Leeb Rebecca T, Everson Mark D, Knight Elizabeth D

机构信息

Department of Social Medicine, Campus Box 7240, The University of North Carolina School of Medicine, Chapel Hill, NC 27599-7240, USA.

出版信息

Child Abuse Negl. 2005 May;29(5):461-77. doi: 10.1016/j.chiabu.2004.06.015.

Abstract

OBJECTIVE

The National Research Council identified inadequate research definitions for abuse and neglect as barriers to research in child maltreatment. We examine the concordance between child protective services (CPS) classifications of maltreatment type with the determinations of type from two research coding systems. We contrast the two coding systems and the CPS classification, in their ability to predict subsequent difficulties in the psychological functioning of maltreated children at age 8.

METHOD

The sample included 545 children who were enrolled in Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) with a report of child maltreatment, had data collected at approximately 4 and 8 years of age, and had a lifetime review of CPS records to age 8. CPS Maltreatment reports were coded using LONGSCAN's modification of the Maltreatment Classification System (MMCS) and the Second National Incidence Study maltreatment coding system (NIS-2). The first analyses used reports as the unit of analysis to examine agreement between CPS and research determinations of allegation type. Validation analyses examined outcomes for each type of maltreatment experienced after age 4 under each coding system using the Child Behavior Checklist (CBCL), Trauma Symptom Checklist-Alternative form, and the Vineland Screener as the measures of outcome. Control variables were the CBCL and Battelle Developmental Screener, measured at age 4.

RESULTS

There were a total of 1980 reports of maltreatment for 545 study children although only 1593 CPS reports specified at least one type of maltreatment. There were differences between the type of maltreatment recorded in child protective service records and the conclusions reached by either research classification system. CPS classifications were most discordant with the research systems for emotional abuse and neglect. Nearly 10% of physical and sexual abuse reports, as determined by the MMCS, were classified as neglect by the child protective service agencies. The NIS-2 system and the MMCS had very high Kappa statistics for agreement for physical and sexual abuse. The validity of the research definitions for physical and sexual abuse was demonstrated in models predicting children's functioning at age 8. Prediction of child functioning was significantly but modestly improved in several domains compared to the CPS classifications.

CONCLUSION

Both research classification systems moderately improved on the prediction of the adverse effects of maltreatment compared to the characterization of a maltreatment exposure as recorded by CPS.

摘要

目的

美国国家研究委员会指出,虐待和忽视的研究定义不充分是儿童虐待研究的障碍。我们考察了儿童保护服务机构(CPS)对虐待类型的分类与两种研究编码系统对虐待类型的判定之间的一致性。我们对比了这两种编码系统以及CPS分类在预测受虐待儿童8岁时心理功能后续困难方面的能力。

方法

样本包括545名参与虐待与忽视儿童纵向研究(LONGSCAN)的儿童,他们有儿童虐待报告,在大约4岁和8岁时收集了数据,并且对其8岁前的CPS记录进行了终生回顾。CPS虐待报告使用LONGSCAN对虐待分类系统(MMCS)的修改版以及第二次全国发生率研究虐待编码系统(NIS - 2)进行编码。首次分析以报告为分析单位,以考察CPS与研究对指控类型判定之间的一致性。验证性分析使用儿童行为检查表(CBCL)、创伤症状检查表替代版以及文兰筛查工具作为结果测量指标,考察了在每个编码系统下4岁后经历的每种虐待类型的结果。控制变量为4岁时测量的CBCL和巴特尔发育筛查工具。

结果

545名研究儿童共有1980份虐待报告,不过只有1593份CPS报告明确了至少一种虐待类型。儿童保护服务记录中记录的虐待类型与任何一种研究分类系统得出的结论之间存在差异。CPS分类与情感虐待和忽视的研究系统差异最大。MMCS判定的身体虐待和性虐待报告中,近10%被儿童保护服务机构归类为忽视。NIS - 2系统和MMCS在身体虐待和性虐待的一致性方面有非常高的卡帕统计值。身体虐待和性虐待研究定义的有效性在预测儿童8岁时功能的模型中得到了证明。与CPS分类相比,在几个领域中对儿童功能的预测有显著但适度的改善。

结论

与CPS记录的虐待暴露特征相比,两种研究分类系统在预测虐待的不良影响方面都有适度改善。

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