Child maltreatment is mediating long-term consequences of household dysfunction in a population representative sample

Background: Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in gene...

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Bibliographic Details
Published in:European psychiatry 2019-05, Vol.58, p.10-18
Main Authors: Clemens, Vera, Berthold, Oliver, Witt, Andreas, Sachser, Cedric, Brähler, Elmar, Plener, Paul L., Strauß, Bernhard, Fegert, Jörg M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult Survivors of Child Abuse - psychology
Adult Survivors of Child Abuse - statistics & numerical data
Adverse childhood experiences (ACE)
Anxiety - epidemiology
Child
Child Abuse - psychology
Child Abuse - statistics & numerical data
Child maltreatment
Cross-Sectional Studies
Depression - epidemiology
Domestic Violence - psychology
Domestic Violence - statistics & numerical data
Family Characteristics
Female
Germany
Health Status
Humans
Intimate partner violence (IPV)
Male
Mentally ill parents
Parental separation
Parental substance abuse
Substance-Related Disorders - epidemiology
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Summary:Background: Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs. Methods: A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey. Results: The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95–5.55), just as household substance abuse (ORs 5.32–6.98), violence against the mother (ORs 4.43–10.26), incarceration of a household member (ORs 6.11–14.93) and parental separation (OR 3.37–4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood. Conclusions: ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.
ISSN:0924-9338
1778-3585
DOI:10.1016/j.eurpsy.2019.01.018