Department of Pediatrics, Carver College of Medicine, The University of Iowa, Iowa City, Iowa;
Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa.
Pediatrics. 2020 Oct;146(4). doi: 10.1542/peds.2020-0438. Epub 2020 Sep 17.
Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.
儿童虐待的潜在长期不良影响已被广泛报道，但对于不同类型虐待的独特长期影响知之甚少。我们撰写这篇专题文章的目的是整合昆士兰大学 Mater 研究孕期（一项跨越 20 年的纵向产前队列研究）的研究结果。我们比较和对比了特定类型的虐待与长期认知、心理、成瘾、性健康和身体健康结果之间的关联，这些结果在 14 岁和/或 21 岁时评估了多达 5200 名后代。总体而言，心理虐待（情感虐待和/或忽视）与几乎所有评估领域的大多数不良结果相关。性虐待与性早熟和青少年怀孕、注意力问题、创伤后应激障碍症状和抑郁有关，尽管性虐待的关联并不特异。身体虐待与外化行为问题、犯罪和药物滥用有关。忽视，而不是情感虐待，与多个性伴侣、大麻滥用和/或依赖以及出现幻视有关。情感虐待，而不是忽视，与精神病、注射毒品使用、以后生活中受到骚扰、流产和报告哮喘症状的几率增加有关。在青少年和成年期，虐待和忽视都与认知能力明显延迟和教育失败有关。总之，儿童虐待，特别是情感虐待和忽视，与广泛的长期不良健康和发育结果有关。未来需要重新关注预防和早期干预策略，特别是与心理虐待有关的策略，以应对这些挑战。
