Egami Y, Ford D E, Greenfield S F, Crum R M
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD USA.
Am J Psychiatry. 1996 Jul;153(7):921-8. doi: 10.1176/ajp.153.7.921.
In this study the authors measured the number of adults in three U.S. communities who reported abusing and neglecting children in their lifetime and assessed the relative impact of sociodemographic characteristics and lifetime diagnosis of mental disorders on both child abuse and child neglect.
A total of 9,841 respondents, identified through a household sampling procedure for the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area study, were included in the analysis. Self-reported lifetime histories of abuse and neglect of children were measured in the antisocial personality module of the NIMH Diagnostic Interview Schedule.
In the study sample, 147 adults (1.49%) stated that they had abused children, and 140 adults (1.42%) stated that they had neglected children. A total of 58.5% of those who reported abuse of children, and 69.3% of those who reported having neglected a child, had a lifetime diagnosis of a mental disorder. Increased odds of reports of both abuse and neglect were associated with having a greater number of children in the household. Low socioeconomic status was a risk factor for neglecting, but not abusing, children. In multivariate analyses, a lifetime history of alcohol disorder was associated with abuse and neglect, affective disorders with abuse, and anxiety disorders with neglecting children.
In light of the associations between mental disorders and mistreatment of children, public health policies designed to prevent child abuse and neglect might be enhanced by an increased focus on interventions targeted at individuals with mental disorders.
在本研究中,作者统计了美国三个社区中报告在其一生中虐待和忽视儿童的成年人数量,并评估了社会人口统计学特征和精神障碍的终生诊断对虐待儿童和忽视儿童行为的相对影响。
通过美国国立精神卫生研究所(NIMH)流行病学集水区研究的家庭抽样程序确定的9841名受访者被纳入分析。在NIMH诊断访谈表的反社会人格模块中测量了自我报告的虐待和忽视儿童的终生经历。
在研究样本中,147名成年人(1.49%)表示他们曾虐待儿童,140名成年人(1.42%)表示他们曾忽视儿童。报告虐待儿童的人中,58.5%以及报告忽视儿童的人中,69.3%有终生精神障碍诊断。报告虐待和忽视行为的几率增加与家庭中孩子数量较多有关。社会经济地位低是忽视儿童而非虐待儿童的一个风险因素。在多变量分析中,酒精障碍的终生史与虐待和忽视有关,情感障碍与虐待有关,焦虑障碍与忽视儿童有关。
鉴于精神障碍与虐待儿童之间的关联,旨在预防虐待和忽视儿童的公共卫生政策可能通过更加关注针对患有精神障碍的个体的干预措施而得到加强。