Institute of Psychiatry, King's College London, London, UK.
J Child Psychol Psychiatry. 2011 Feb;52(2):184-94. doi: 10.1111/j.1469-7610.2010.02304.x. Epub 2010 Aug 23.
Chronic maltreatment has been associated with the poorest developmental outcomes, but its effects may depend on the age when the maltreatment began, or be confounded by co-occurring psychosocial risk factors.
We used data from the National Survey of Child and Adolescent Well-Being (NSCAW) to identify four groups of children who varied in the timing, extent, and continuity of their maltreatment from birth to 9 years. Internalizing and externalizing problems, prosocial behavior, and IQ were assessed 21 months, on average, following the most recent maltreatment report.
Children maltreated in multiple developmental periods had more externalizing and internalizing problems and lower IQ scores than children maltreated in only one developmental period. Chronically maltreated children had significantly more family risk factors than children maltreated in one developmental period and these accounted for maltreatment chronicity effects on externalizing and internalizing problems, but not IQ. The timing of maltreatment did not have a unique effect on cognitive or behavioral outcomes, although it did moderate the effect of maltreatment chronicity on prosocial behavior.
There is a need for early intervention to prevent maltreatment from emerging and to provide more mental health and substance use services to caregivers involved with child welfare services.
慢性虐待与最糟糕的发展结果有关,但它的影响可能取决于虐待开始的年龄,或者与同时存在的心理社会风险因素混淆。
我们使用了全国儿童和青少年福利调查(NSCAW)的数据,从出生到 9 岁,确定了在时间、程度和连续性方面存在差异的四类受虐待儿童。在最近一次受虐待报告后平均 21 个月,评估了内化和外化问题、亲社会行为和智商。
在多个发展阶段受虐待的儿童比仅在一个发展阶段受虐待的儿童有更多的外化和内化问题以及较低的智商分数。慢性受虐待的儿童比在一个发展阶段受虐待的儿童有更多的家庭风险因素,这些因素解释了虐待的慢性对外化和内化问题的影响,但对智商没有影响。虐待的时间没有对认知或行为结果产生独特的影响,尽管它确实缓和了虐待的慢性对亲社会行为的影响。
需要早期干预来防止虐待的出现,并为参与儿童福利服务的照顾者提供更多的心理健康和药物使用服务。