Adolescents at risk for mistreating their children: Part I: prenatal identification

Objective: To determine if the Family Stress Checklist helps prenatal care providers identify adolescents who are at risk for mistreating their children. Methods: We studied 262 participants in a comprehensive, adolescent-oriented maternity program. During the prenatal period, the Family Stress Chec...

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Bibliographic Details
Published in:Child abuse & neglect 2001-06, Vol.25 (6), p.737-751
Main Authors: Stevens–Simon, Catherine, Nelligan, Donna, Kelly, Lisa
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Mothers
Adolescent parenting
Adolescent parents
Adolescent pregnancy
Antenatal programmes
Biological and medical sciences
Child Abuse
Child abuse & neglect
Child Abuse - statistics & numerical data
Child maltreatment
Child Neglect
Colorado - epidemiology
Emergency Medical Services
Emergency Service, Hospital - statistics & numerical data
Female
Health Services Misuse - statistics & numerical data
Hospitals, University
Humans
Incidence
Infant
Maternal Health Services - statistics & numerical data
Medical Records
Medical sciences
Mothers - psychology
Parenting - psychology
Parents & parenting
Pregnancy
Pregnancy in Adolescence - psychology
Pregnancy in Adolescence - statistics & numerical data
Pregnant adolescent girls
Prenatal Care
Psychology. Psychoanalysis. Psychiatry
Psychometrics. Diagnostic aid systems
Psychopathology. Psychiatry
Risk Assessment
Risk Assessment - classification
Stress, Psychological - classification
Stress, Psychological - complications
Surveys and Questionnaires
Techniques and methods
Teenage pregnancy
USA
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Summary:Objective: To determine if the Family Stress Checklist helps prenatal care providers identify adolescents who are at risk for mistreating their children. Methods: We studied 262 participants in a comprehensive, adolescent-oriented maternity program. During the prenatal period, the Family Stress Checklist was used to quantify abuse potential, with scores >25 defining high risk. Information about the social context of the pregnancy and the pattern of health care utilization was obtained with a self-administered questionnaire, and by reviewing the medical records. Major disruption of primary care giving by the adolescent mother was classified hierarchically as abuse, neglect, and abandonment. Results: Family Stress Checklist scores ranged from 0 to 65 ( mean + SD = 20.1 + 1.4); 113 (43%) of the 262 teenagers were classified as high risk. High and low risk adolescent mothers made an equivalent number of health maintenance and Emergency Department visits, but the high risk group initiated significantly more acute care visits (6.0 + 4.1 compared to 3.9 + 3.3; p < .0001). After controlling for pre-existing sociodemographic differences, high risk 1-year-olds were 8.41 (95% CI:1.77–40.01) times and high risk 2-year-olds 5.19 (95% CI:1.99–13.60) times more likely to have been mistreated than their low risk counterparts. Conclusions: Prenatal care providers can use the Family Stress Checklist to systematically identify a subgroup of adolescent mother whose excessive use of the acute medical care services and propensity for mistreating their children suggests the need for additional support services. Objectif: Déterminer si le Family Stress Checklist sert aux intervenants en services prénataux à identifier les adolescentes qui seraient portées à maltraiter leurs enfants. Méthode: Les auteurs ont étudié 262 adolescentes qui faisaient partie d’un programme de préparation à la maternité. Durant la période prénatale, on a administré le Family Stress Checklist afin de déterminer la probabilité de mauvais traitements; un score de ≥ 25 fut considéré le seuil de risque élevé. Au moyen d’un questionnaire auto-administré, on a recueilli des renseignements sur le contexte social de la grossesse et la qualité des services de santé fournis et on a consulté les dossiers médicaux. On a classé trois types d’interruption des soins maternels, en ordre descendant: les mauvais traitements, la négligence et l’abandon. Résultats: Les scores tirés du Family Stress Checklist variaient de 0 à
ISSN:0145-2134
1873-7757
DOI:10.1016/S0145-2134(01)00236-8