Chaffin M, Kelleher K, Hollenberg J
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72202, USA.
Child Abuse Negl. 1996 Mar;20(3):191-203. doi: 10.1016/s0145-2134(95)00144-1.
Studies of psychiatric and social risk factors for child maltreatment have been limited by retrospective methodologies and reliance on officially reported or identified samples. Using data from both Waves I and II of the National Institute for Mental Health's Epidemiologic Catchment Area survey, 7,103 parents from a probabilistic community sample who did not self-report physical abuse or neglect of their children at Wave I were followed to determine the risk factors associated with the onset of self-reported physical abuse or neglect identified at Wave II. Social factors considered included age, socioeconomic status, social support, education, household size, and gender. In addition, several psychiatric disorders, including substance abuse disorders and depression were examined. Risk models were developed using hierarchical logistic regression. Physical abuse and neglect were found to have distinct sets of risk factors, with minimal overlap between the groups. Social and demographic variables were found to be limited predictors of maltreatment, while substance abuse disorders were strongly associated with the onset of both abuse and neglect (relative risks = 2.90 and 3.24 respectively). Depression was found to be a strong risk factor for physical abuse (relative risk = 3.45). Implications of the findings are discussed in terms of major causal models of maltreatment.
针对儿童虐待的精神和社会风险因素的研究一直受到回顾性方法以及对官方报告或已识别样本的依赖的限制。利用美国国立精神卫生研究所流行病学集水区调查第一波和第二波的数据，对来自概率社区样本的7103名家长进行了跟踪，这些家长在第一波调查中并未自我报告对其子女的身体虐待或忽视行为，目的是确定与在第二波调查中自我报告的身体虐待或忽视行为的发生相关的风险因素。所考虑的社会因素包括年龄、社会经济地位、社会支持、教育程度、家庭规模和性别。此外，还对包括物质滥用障碍和抑郁症在内的几种精神疾病进行了研究。使用分层逻辑回归建立了风险模型。结果发现，身体虐待和忽视行为具有不同的风险因素集，两组之间的重叠极少。社会和人口统计学变量被发现是虐待行为的有限预测因素，而物质滥用障碍与虐待和忽视行为的发生都密切相关（相对风险分别为2.90和3.24）。抑郁症被发现是身体虐待的一个重要风险因素（相对风险 = 3.45）。研究结果的意义将根据虐待行为的主要因果模型进行讨论。
