Childhood maltreatment and adolescent mental health and behaviour

Abstract

Child maltreatment is defined by the WHO as constituting all those forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity. This study focused on maltreatment in children and adolescents. The aim of this study was to determine whether categories of maltreatment, either individually or in combination, was associated with increased health risk behaviours and mental health problems in a community sample of secondary school students. Nine state schools participated in the study. A 33 item self-report questionnaire was distributed to fifth-form students. The response rate was 76%. The commonest category of maltreatment experienced was emotional abuse and the least common was sexual abuse. 27.4% of respondents reported that they had experienced one category of maltreatment whilst 16.6%, 11.1% and 6.5% reported experiencing two, three and four categories of maltreatment respectively. All categories of maltreatment except for emotional abuse were found to be associated with increased rates of adolescent smoking. Consumption of alcohol was only associated with sexual abuse, whilst illicit drug use was associated with physical abuse, neglect and multi-type maltreatment. Adolescents who reported maltreatment were more likely to be involved in school fights, but only some categories of maltreatment were associated with breaking school rules and reporting poor school performance. This study found a strong association between maltreatment and mental health outcomes. Depression was associated with all categories of maltreatment except for sexual abuse. Emotional abuse, neglect and multi-type maltreatment were associated with increased levels of anxiety symptoms and with low self-esteem. The

presence of emotional abuse and neglect predicted adverse mental health outcomes. Identification of risk factors showed that family characteristics are important predictors for every category of maltreatment. The findings reported in this study provide the evidence as background to developing the preventive and therapeutics services required in the management of child and adolescent maltreatment.