Administrative Data Research Centre for England, University College London, United Kingdom; Centre for Population Health Research, University of South Australia, Australia.
Australian Institute of Family Studies, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia.
Child Abuse Negl. 2017 Feb;64:47-60. doi: 10.1016/j.chiabu.2016.12.002. Epub 2016 Dec 25.
Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals.
儿童虐待和其他不良童年经历会对人口健康和社会经济结果产生不利影响。了解儿童虐待的风险因素可用于识别处于危险中的儿童，也可能代表预防的机会。我们在一个前瞻性的 27 年基于人群的 2443 名澳大利亚出生队列中研究了一系列可能的儿童、父母和家庭虐待儿童的风险因素。在成年早期，我们回顾性地记录了身体虐待、性虐待、情感虐待、忽视和目睹家庭暴力的情况。潜在的风险因素是在儿童时期收集的，或者是回顾性报告的。使用双变量和多变量逻辑回归估计关联，并将其合并为累积风险评分。经济劣势、父母心理健康和物质使用不良以及社会不稳定程度较高与儿童虐待风险增加密切相关。儿童健康指标显示出混合关联，婴儿气质与虐待无关。虽然在不同类型的虐待中观察到一些差异，但风险概况通常相似。在多变量分析中，确定了九个独立的风险因素，包括一些潜在可改变的因素：经济劣势和父母物质使用问题。经历的风险因素越多，虐待风险呈指数级增加，风险最高组的虐待发生率超过 80%。基于独立风险因素的累积风险评分可识别出极有可能遭受虐待的个体，而纳入所有重要风险和保护因素的评分则可更好地识别低风险个体。
