Elsevier

Child Abuse & Neglect

Volume 25, Issue 9, September 2001, Pages 1177-1200
Child Abuse & Neglect

Child maltreatment in the “Children of the nineties”: A longitudinal study of parental risk factors

https://doi.org/10.1016/S0145-2134(01)00261-7Get rights and content

Abstract

Objective: To identify and validate factors within the parental background affecting risk of child maltreatment.

Method: A nested case-control study based on the Avon Longitudinal Study of Parents and Children (“Children of the Nineties”), a cohort of children born in Avon in 1991 through 1992. Data on the childhood and psychiatric histories of the parents, along with other data on the social and family environments, have been collected through postal questionnaires from early antenatal booking onwards.

Results: Out of 14,138 participating children, 162 have been identified as having been maltreated. Using logistic regression analysis, significant risk factors within the mothers’ backgrounds were age < 20; lower educational achievement; history of sexual abuse; child guidance or psychiatry; absence of her father during childhood; and a previous history of psychiatric illness. Significant factors in the fathers’ backgrounds were age < 20; lower educational achievement; having been in care during childhood; and a history of psychiatric illness. Significant factors on univariate, but not multivariate analysis included a parental history of childhood physical abuse; divorce or separation of the mother’s parents; a maternal history of having been in care, or separated from her mother; parental alcohol or drug abuse; and a maternal history of depression.

Conclusions: This study, the first of its kind in the UK, supports the findings of others that parental age, educational achievement, and a history of psychiatric illness are of prime importance in an understanding of child maltreatment. With the exception of maternal sexual abuse, a history of abuse in childhood is not significant once adjusted for other background factors. The study suggests that psychodynamic models are inadequate to explain child maltreatment, and wider models incorporating other ecological domains are needed.

Résumé

Objectif: Identifier et valider les facteurs dans les antécédents des parents qui peuvent affecter le risque de mauvais traitements aux enfants.

Méthode: Une étude de contrôle de cas basée sur l’étude longitudinale Avon sur des parents et des enfants (“Children of the Nineties”), une cohorte d’enfants nés en Avon en 1999/1992. Les données sur l’enfance des parents et sur leur passé psychiatrique, avec d’autres données sur l’environnement social et familial,ont été recueillies grâce des questionnaires envoyés par le Poste, concernant leur vie dès avant la naissance.

Résultats: Sur 14,138 enfants, 162 ont été identifiés comme ayant été maltraités. En utilisant l’analyze par régression logistique, les facteurs de risque significatifs dans les antécédents maternels étaient les suivants: âge inférieur à 20 ans, faible niveau d’instruction, suivi en guidance infantile ou en psychiatrie, absence du père pendant l’enfance, et antécédents de maladie psychiatrique. Les facteurs significatifs dans les antécédents paternels étaient: l’âge inférieur à 20 ans, le faible niveau d’instruction, avoir été placé pendant l’enfance, et un passé de maladie psychiatrique. Les facteurs significatifs dans l’analyze à une variable mais non à plusieurs variables incluaient des antécédents de mauvais traitements physiques chez les parents, le divorce ou la séparation des parents de la mère, un placement de la mère dans l’enfance, ou une séparation d’avec sa propre mère, l’alcoolisme ou la consommation de drogue, ou la dépression maternelle.

Conclusions: Cette étude est la première de ce genre dans le Royaume-Uni. Elle confirme d’autres études qui montrent que l’âge des parents, l’éducation, un passé de maladie psychiatrique sont de première importance pour comprendre les mauvais traitements aux enfants. A l’exception d’abus sexuels chez la mère, des abus subis dans l’enfance ne sont pas significatifs une fois ajoutés à d’autres facteurs du passé. L’étude suggère que les modèles psychodynamiques ne sont pas adéquats pour expliquer les mauvais traitements aux enfants et que l’on a besoin de modèles plus larges incluant d’autres domaines écologiques.

Resumen

Objetivo: Identificar y validar los factores dentro del historial familiar que afectan el riesgo de maltrato a los niños.

Método: Un estudio de casos-control basado en el Estudio Longitudinal de Padres e Hijos Avon (Niños de los Noventa“), un grupo de niños similares nacidos en Avon en 1999/1992. Se recogieron datos sobre la niñez de los padres e historias psiquiátricas, junto con otros datos sobre el contexto social y familiar, a través de cuestionarios postales desde los registros tempranos antes del nacimiento en adelante.

Resultados: De los14,138 niños participantes, 162 han sido identificados como maltratados. Utilizando el análisis de regresión logı́stica, los factores significativos de riesgo en los antecedentes de las madres fueron edad < 20; bajo nivel académico, haber estado en cuidado sustituto durante la niñez; y una historia de enfermedad psiquiátrica. Los factores significativos en los antecedentes de los padres fueron edad < 20; nivel académico bajo, haber estado en cuidado sustituto durante la niñez; y una historia de enfermedad psiquiátrica. Los factores significativos en el análisis univariado, pero no en el multivariado, incluyen una historia parental de abuso fı́sico en la niñez; divorcio o separación de los padres de la madre; una historia materna de haber estado en cuidado sustituto, o separada de su madre; abuso parental del alcohol o las drogas; y una historia materna de depresión.

Conclusiones: Este estudio, el primero de su clase en el Reino Unido, apoya los hallazgos de otros en relación a que la edad parental, el nivel educativo alcanzado, y una historia de enfermedad psiquiátrica son de primera importancia para entender el maltrato a los niños. A excepción del abuso sexual materno, una historia de abuso en la niñez no es significativa una vez adaptado por otros factores del historial. El estudio sugiere que los modelos psicodinámicos son inadecuados para explicar el maltrato en la niñez y se necesitan modelos más amplios que incorporen otras dimensiones ecológicas.

Introduction

It is well recognized that certain factors in the child and her or his environments are associated with an increased risk of that child being maltreated. Previous work has identified some of these risks, including an intergenerational cycle of abuse, various parental factors, and social factors. Because the consequences of maltreatment and of any intervention can have profound effects on the child and family, it is essential that all work with child maltreatment be based on contemporary and well-researched evidence. Identification and validation of risk and protective factors within a comprehensive framework is important to a full understanding of the nature and patterns of maltreatment, to appropriate work with maltreated children, and to effective preventive work (Korbin, 1991).

Early work on the etiology of child abuse focused on two main strands Erchak 1981, Pelton 1985. In the first, the psychodynamic model, abuse is seen as a disorder of the individual (abuser or child), or more significantly of the relationship between abuser and abused. This model has led to an understanding of the personalities, backgrounds, and demographic characteristics of individuals that put a child at risk (e.g., Spinetta & Rigler, 1972). In contrast, the sociological model has emphasized external socio-economic factors affecting risk (e.g., Baldwin & Spencer, 1993). This model has enabled important social class differences to be identified along with such factors as unemployment, the stresses of poor housing, and lack of access to amenities.

A major breakthrough in the scientific understanding of child maltreatment, however, seems to have come through the adoption of ecological models of abuse Belsky 1980, Belsky 1993, Garbarino 1985, Kotch et al 1995, Kotch et al 1997. The basis of such models is that child maltreatment is multiply determined by forces at work in the individual, the family, and the community and culture, and that these determinants are nested within one another. Four levels of analysis are recognized: First, ontogenic development, or how a particular parent grows up to behave in an abusive or neglectful manner; second the microsystem—the context of the child’s immediate family and household; third, the exosystem—the larger social systems within which the family is embedded; and finally, the macrosystem, or overriding cultural beliefs and values in any particular society. The theoretical framework of the model suggests a hierarchical approach to analysis, beginning with the parents and the pathways through which factors in their childhood lead to personality traits and ultimately altered perceptions and behavior with regard to parenting. Subsequent levels work inwards from wider socio-cultural norms, through the social exosystem to the family, the child, and parent-child interactions.

This research project aims to build on previous research in the field, utilizing multivariate analysis to explore risk factors within a comprehensive ecological framework. The research is based on a large cohort study in which data on the environment and health of the children have been collected at regular intervals from early antenatal booking and throughout childhood. The overall aim is to analyze the multiple factors affecting risk of maltreatment in young children and ultimately identify those factors that may protect “high-risk” children from maltreatment. The initial stage of the research has been a study of background parental factors identified predominantly through antenatal questionnaires. These have been analyzed with respect to the single outcome of children placed on the child protection register.

Section snippets

Methods

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large study following a cohort of children born to mothers resident in Avon while pregnant (Golding, 2000). The ALSPAC study area—the three Bristol-based health districts of Avon—has a population of approximately one million and includes the city of Bristol (population 500,000), a mixture of inner city deprivation (7% of Avon children live in poor urban areas), rural areas (15%), leafy suburbs, and moderate sized towns. Children

Results

A total of 438 Avon-born children with birth dates between April 1, 1991 through December 31, 1992 were referred for investigation of possible child abuse or neglect in the eight years from January 1, 1991 through December 31, 1998, and 202 placed on the child protection register. Three hundred twenty-nine of the investigated children (75.1%) and 162 (80.2%) of the registered children were included in the ALSPAC cohort. The overall incidence of registration was 115:10,000 children over the 8

Parental age and education

Both in the UK and in the United States, much of the work on risk factors has concentrated on identifying situations of high risk from an understanding of maternal factors. One of the most consistent, though not universal, findings has been that the mothers of abused children tend to be younger than other mothers. Quoted proportions of young mothers vary between 10% and 40% for mothers aged less than 20 years at the birth of their child Kinard and Klerman 1980, Leventhal et al 1984, Lynch and

Conclusions

Through a multivariate analysis of data in the parents’ backgrounds, personalities, and psychiatric histories, we have been able to explore an initial level of risk factors for child maltreatment within an ecological framework. Two of the strongest variables in this analysis are parental age and education. Young parental age is an important association with child maltreatment, although it is clear that the majority of young parents do not maltreat their children. Thus, the important research

Acknowledgements

The authors are extremely grateful to all the mothers who took part, and to the midwives for their cooperation and help in recruitment. The whole ALSPAC study team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers, and managers who continue to make the study possible.

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