Melbourne School of Population Health, University of Melbourne, Parkville, Victoria, Australia.
Addiction. 2012 Oct;107(10):1786-93. doi: 10.1111/j.1360-0443.2012.03917.x. Epub 2012 May 17.
This paper examined whether or not: (a) care-giver 'alcohol abuse' is associated with recurrent child maltreatment; (b) other 'risk factors' affect this relationship; and (c) which of alcohol abuse or other drug abuse plays a stronger role. It also examined (d) how children and families where alcohol-related child abuse was identified were managed by child protection services (CPS) in Victoria, Australia.
DESIGN, SETTING AND PARTICIPANTS: Using anonymized data from Victorian CPS, repeat cases were examined involving 29 455 children identified between 2001 and 2005.
Carer alcohol abuse, other drug abuse, mental ill-health, carer experience of abuse as a child, child age and gender, family type, socio-economic variables and level of child protection service intervention as recorded in the CPS electronic database were examined as risk factors for recurrence, using bivariate and multivariate techniques.
Almost one-quarter of children in CPS experienced a recurrent incident of child maltreatment in a 5-year period. Where carer alcohol abuse was identified children were significantly more likely to experience multiple incidents compared with children where this was not identified (P < 0.001), as were children where other family risk factors (including markers of socio-economic disadvantage) were identified. The majority of children whose carers were identified with alcohol abuse experienced either repeat incidents or interventions (84%), although almost three-quarters of these children were managed without resort to the most serious outcome, involving court orders.
Alcohol and drug abuse in carers are important risk-factors for recurrent child maltreatment after accounting for other known risk factors; the increased risk appears to be similar between alcohol and drug abuse.
本文旨在探讨以下问题：（a）照顾者的“酗酒”是否与儿童虐待的反复发生有关；（b）其他“风险因素”是否会影响这种关系；（c）酗酒或其他药物滥用在其中扮演了更重要的角色；（d）在澳大利亚维多利亚州，儿童保护服务机构（CPS）如何处理与酒精相关的儿童虐待案件。
设计、环境和参与者：利用维多利亚州 CPS 的匿名数据，对 2001 年至 2005 年间发现的 29455 名儿童的重复案例进行了研究。
照顾者酗酒、其他药物滥用、心理健康问题、照顾者作为儿童时遭受虐待的经历、儿童年龄和性别、家庭类型、社会经济变量以及 CPS 电子数据库中记录的儿童保护服务干预水平等被视为复发的风险因素，使用了单变量和多变量技术。
在 5 年期间，几乎四分之一的 CPS 儿童经历了儿童虐待的反复事件。与未发现照顾者酗酒的儿童相比，发现照顾者酗酒的儿童更有可能经历多次事件（P<0.001），同时也与发现其他家庭风险因素（包括社会经济劣势的标志）的儿童相比。在照顾者被确定为酗酒的儿童中，大多数（84%）都经历了重复事件或干预，但几乎四分之三的儿童没有采取最严重的措施，即涉及法院命令。
在考虑了其他已知风险因素后，照顾者的酗酒和药物滥用是儿童虐待反复发生的重要风险因素；酒精和药物滥用之间的风险增加似乎相似。
