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累积压力与确凿的虐待:照顾者易受伤害性及成年伴侣暴力的重要性

Cumulative stress and substantiated maltreatment: the importance of caregiver vulnerability and adult partner violence.

作者信息

Wekerle Christine, Wall Anne-Marie, Leung Eman, Trocmé Nico

机构信息

Faculty of Education, Department of Psychology, and Psychiatry Program, The University of Western Ontario, 1137 Western Road, London, Ontario, Canada N6G 1G7.

出版信息

Child Abuse Negl. 2007 Apr;31(4):427-43. doi: 10.1016/j.chiabu.2007.03.001. Epub 2007 Apr 18.

Abstract

OBJECTIVE

Our goal is to assess the effect of caregiver vulnerabilities, singly and in combination, on the substantiation of child abuse (physical, sexual) and neglect, while controlling for relevant background variables. We test the moderator role of adult partner violence in qualifying the relationship between caregiver vulnerabilities and maltreatment substantiation.

METHOD

Secondary analyses of the 1998 Canadian Incidence Study of Reported Child Maltreatment (CIS) are used to predict child protective service investigation substantiation versus non-substantiation from a range of caregiver vulnerability factors. Involvement in partner violence was examined as a moderator in the relation between caregiver vulnerabilities and maltreatment substantiation. The CIS is an epidemiological survey of first-reported cases to child protective services, using a random sample of child welfare agencies across Canada. Child welfare workers completed a research form on the child, primary caregiver, family, perpetrator, severity and type of maltreatment, as well as services and court outcomes. All maltreatment classifications were assigned according to the Canadian legal definition of child abuse and neglect. Hierarchical logistic regression analyses were used, with stepped entry of: (1) demographic factors, socioeconomic disadvantage, and caregiver's own history of maltreatment; (2) caregiver vulnerability factors; (3) involvement in partner violence; (4) the interaction between caregiver vulnerability and partner violence.

RESULTS

Caregiver substance abuse was found to be the single most potent kind of caregiver vulnerability in predicting maltreatment substantiation. When the total number of vulnerabilities was used as the predictor, prediction across all types of maltreatment increased, especially for substantiated neglect. Analyses also showed that the presence of partner violence in the home exacerbated the effect of caregiver vulnerability on substantiation.

CONCLUSIONS

The total number of caregiver vulnerabilities was the best predictor of the substantiation of child abuse and neglect. This relationship was moderated by the existence of partner violence: high caregiver vulnerability and high partner violence increased the likelihood of substantiation versus non-substantiation. These results suggest that caregiver issues should be considered in tandem with partner relationships. Among child welfare cases, caregiver vulnerability and partner violence are critical targets for child maltreatment prevention and early child protective services intervention.

摘要

目的

我们的目标是评估照料者的各种脆弱性因素单独及综合起来对证实儿童虐待(身体虐待、性虐待)和忽视行为的影响,同时控制相关背景变量。我们检验成人伴侣暴力在限定照料者脆弱性因素与虐待行为证实之间关系时所起的调节作用。

方法

利用1998年加拿大儿童虐待举报发生率研究(CIS)的二次分析,从一系列照料者脆弱性因素预测儿童保护服务调查中虐待行为被证实与未被证实的情况。将参与伴侣暴力作为照料者脆弱性因素与虐待行为证实之间关系的调节因素进行考察。CIS是一项针对首次向儿童保护服务机构举报案件的流行病学调查,采用了加拿大各地儿童福利机构的随机样本。儿童福利工作者填写了一份关于儿童、主要照料者、家庭、施虐者、虐待的严重程度和类型以及服务和法庭结果的研究表格。所有虐待分类均根据加拿大关于儿童虐待和忽视的法律定义进行判定。采用分层逻辑回归分析,逐步纳入:(1)人口统计学因素、社会经济劣势以及照料者自身的虐待史;(2)照料者脆弱性因素;(3)参与伴侣暴力的情况;(4)照料者脆弱性与伴侣暴力之间的相互作用。

结果

在预测虐待行为被证实方面,照料者药物滥用被发现是最具影响力的照料者脆弱性因素。当将脆弱性因素总数用作预测指标时,对所有类型虐待行为的预测能力增强,尤其是对已证实的忽视行为。分析还表明,家庭中存在伴侣暴力会加剧照料者脆弱性因素对虐待行为被证实的影响。

结论

照料者脆弱性因素总数是儿童虐待和忽视行为被证实的最佳预测指标。这种关系因伴侣暴力的存在而受到调节:照料者高度脆弱且伴侣暴力程度高会增加虐待行为被证实而非未被证实的可能性。这些结果表明,应将照料者问题与伴侣关系一并考虑。在儿童福利案件中,照料者脆弱性和伴侣暴力是预防儿童虐待及早期儿童保护服务干预的关键目标。

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