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Lanais K, Gnanamanickam E, Maclean M, Segal L. Investigating the impact of Out-of-Home Care on early childhood development. CHILD ABUSE & NEGLECT 2024; 154:106856. [PMID: 38850748 DOI: 10.1016/j.chiabu.2024.106856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Early childhood development is influential for life course capability. Children exposed to child maltreatment and at high risk of harm may be removed for their safety, but the effect on child development is uncertain. OBJECTIVES To assess developmental vulnerability at school commencement across five developmental domains to ascertain whether removal of children with substantiated maltreatment to foster/kinship care is likely protective, or not, of developmental vulnerabilities. METHODS The study drew on linked-data for a South Australian population birth cohort (2003 to 2014) N = 74,751. For children exposed to substantiated child maltreatment meeting study criteria (N = 2011, mean age = 5.7 years, 50.7 % boys), the effect of placement in foster/kinship care (N = 666) on developmental vulnerability was explored using generalized linear models, adjusted for child and family covariates, maltreatment severity and propensity score. RESULTS Children placed in care had a reduced risk of developmental vulnerability on the Physical Health and Wellbeing (aRR = 0.73 [0.64, 0.84]), Language and Cognitive Skills (school based) (aRR = 0.79 [0.68, 0.92]), and Communication Skills and General Knowledge (aRR = 0.81 [0.70, 0.94]) domains, compared to children who were not removed. However, these children had increased risk of vulnerability on Social Competence (aRR = 1.14 [1.01, 1.29]) and Emotional Maturity (aRR = 1.20 [1.05, 1.37]) domains. CONCLUSIONS These findings suggest placement in out-of-home care supported physical health and wellbeing, communication and cognitive but not social and emotional early childhood development. These results highlighting the need for professional therapeutic support for children in care and better attending to the physical development, communication and cognitive skills in maltreated children remaining at home.
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Affiliation(s)
- Krystal Lanais
- Health Economics and Social Policy Research Group, University of South Australia, Adelaide, Australia.
| | - Emmanuel Gnanamanickam
- Health Economics and Social Policy Research Group, University of South Australia, Adelaide, Australia
| | - Miriam Maclean
- Australian Centre for Child Protection, University of South Australia, Adelaide, Australia
| | - Leonie Segal
- Health Economics and Social Policy Research Group, University of South Australia, Adelaide, Australia
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Trott M, Bull C, Najman JM, Arnautovska U, Siskind D, Warren N, Kisely S. Hospital admissions and community health service contacts for mental illness following self-reported child maltreatment: Results from the Childhood Adversity and Lifetime Morbidity (CALM) study. CHILD ABUSE & NEGLECT 2024; 154:106912. [PMID: 38970858 DOI: 10.1016/j.chiabu.2024.106912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Child maltreatment (CM) includes neglect, and several types of abuse, including physical, emotional, and sexual. CM has been associated with a wide range of mental illnesses. Literature examining these illnesses in mid-life is scarce, and the impact of these illnesses on mental health service use is currently unknown. OBJECTIVE To examine associations between self-reported CM and subsequent hospital admissions for mental illnesses, and/or community mental health service contacts. SETTING Birth cohort study data linked to administrative health data, including hospital admissions and community mental health service contacts, up to the age of 40. METHODS Associations between hospital admissions for mental health and community mental health contacts and CM subtypes (neglect, physical abuse, emotional abuse and sexual abuse) were examined using multivariate logistic regression. RESULTS Adjusted analyses showed that all subtypes of CM were significantly (p < 0.05) associated with admissions to hospital for any type of mental illness (aOR range 1.87-3.61), non-psychotic mental disorders (aOR range 1.98-3.61), alcohol and/or substance use (aOR range 2.83-5.43), and community mental health service contacts (aOR range 2.44-3.13). Hospital admissions for psychotic mental disorders were significantly associated with physical abuse, emotional abuse, and sexual abuse (aOR range 2.14-3.93). CONCLUSIONS The results of this study confirm the current knowledge around CM and subsequent mental health illnesses up to the age of 40, and extend this knowledge to hospital and mental health service use.
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Affiliation(s)
- Mike Trott
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia.
| | - Claudia Bull
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; ALIVE National Centre for Mental Health Research Translation, Brisbane, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston 4006, Queensland, Australia; School of Social Sciences, The University of Queensland, St Lucia 4072, Queensland, Australia
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; ALIVE National Centre for Mental Health Research Translation, Brisbane, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada
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Kızıltepe R, Yılmaz Irmak T. Intergenerational transmission of childhood maltreatment and offspring behavioral adjustment problems and competence. CHILD ABUSE & NEGLECT 2024; 153:106851. [PMID: 38761719 DOI: 10.1016/j.chiabu.2024.106851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Previous studies have consistently highlighted that exposure to childhood maltreatment adversely affects the developmental domains of subsequent generations. Little, however, is known about the relationship between maternal childhood maltreatment history and adolescent development, as well as the mediator role of offspring childhood maltreatment. OBJECTIVE The current study attempts to investigate the mediating role of offspring childhood maltreatment in the relationship between maternal childhood maltreatment history and offspring behavioral adjustment problems and competence. METHODS Participants were 1102 adolescents aged 10-15 years (Mage = 12.14, SD = 1.22) and their mothers (Mage = 39.40, SD = 5.31). Participating adolescents filled out self-report instruments assessing their childhood maltreatment by their mothers, self-esteem, academic performance, loneliness, and prosocial and aggressive behaviors between October 2018 and May 2019. In addition, we collected data from mothers on their childhood maltreatment history. RESULTS We analyzed the data through a structural equation model. The findings revealed insignificant direct effects of maternal childhood maltreatment history on offspring behavioral adjustment problems and competence. Yet, indirect effects demonstrated that offspring maltreatment by mothers mediated the relationship between maternal childhood maltreatment history and offspring behavioral adjustment problems and competence. Maternal childhood maltreatment history was significantly associated with offspring maltreatment (β = 0.30; p < .001), which in turn was linked to a higher level of behavioral adjustment problems (β = 0.40; p < .001) and a lower level of competence (β = -0.71; p < .001). CONCLUSION The research findings extend our understanding of the relationship between maternal childhood maltreatment history and offspring behavioral adjustment problems and competence, identifying the mediating role of offspring maltreatment.
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Affiliation(s)
- Rukiye Kızıltepe
- Department of Psychology, Pamukkale University, 20160, Denizli, Turkey.
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Kurata S, Nishitani S, Kawata NYS, Yao A, Fujisawa TX, Okazawa H, Tomoda A. Diffusion tensor imaging of white-matter structural features of maltreating mothers and their associations with intergenerational chain of childhood abuse. Sci Rep 2024; 14:5671. [PMID: 38453944 PMCID: PMC10920819 DOI: 10.1038/s41598-024-53666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
Child abuse causes lifelong adverse outcomes for both physical and mental health, although many are resilient. Efforts to prevent this issue from the parental side require an understanding of the neurobiological basis that leads abusive parents to perpetrate abuse and the influence of the intergenerational chain of childhood abuse. Therefore, this study was conducted to compare the brain white-matter fiber structures between 11 maltreating mothers who had been recognized as having conducted child abuse prior to the intervention and 40 age-matched control mothers using tract-based spatial statistics. There was a significantly reduced axial diffusivity (AD) and a similar trend in fractional anisotropy (FA) in the right corticospinal tract in maltreating mothers compared to control mothers. Therefore, maltreating mothers may have excessive control over the forcefulness of voluntary movements. These features also decreased as the number of childhood abuse experiences increased, suggesting that an intergenerational chain of child abuse may also be involved. Other aspects observed were that the higher the current depressive symptoms, the lower the AD and FA values; however, they were not related to parental practice or empathy. These results corroborate the neurobiological features that perpetrate behaviors in abusive mothers.
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Affiliation(s)
- Sawa Kurata
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shota Nishitani
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Natasha Y S Kawata
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Akiko Yao
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Takashi X Fujisawa
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Kanazawa University, Kanazawa, Japan
- Hamamatsu University School of Medicine, Hamamatsu, Japan
- Chiba University, Chiba, Japan
- University of Fukui, Osaka, Japan
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Osaka, Japan.
- Kanazawa University, Kanazawa, Japan.
- Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Chiba University, Chiba, Japan.
- University of Fukui, Osaka, Japan.
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
- Life Science Innovation Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
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O'Dea B, Roe Y, Gao Y, Kruske S, Nelson C, Hickey S, Carson A, Watego K, Currie J, Blackman R, Reynolds M, Wilson K, Costello J, Kildea S. Breaking the cycle: Effect of a multi-agency maternity service redesign on reducing the over-representation of Aboriginal and Torres Strait Islander newborns in out-of-home care: A prospective, non-randomised, intervention study in urban Australia. CHILD ABUSE & NEGLECT 2024; 149:106664. [PMID: 38354600 DOI: 10.1016/j.chiabu.2024.106664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Strategies to reduce over-representation of Indigenous children in out-of-home care must start in pregnancy given Indigenous babies are 6 % of infants (<1 year), yet 43 % of infants in out-of-home care. OBJECTIVE To determine if an Indigenous-led, multi-agency, partnership redesign of maternity services decreases the likelihood of babies being removed at birth. PARTICIPANTS AND SETTING Women carrying an Indigenous baby/babies who gave birth at the Mater Mothers' Public Hospital, Brisbane (2013-2019). METHODS A prospective, non-randomised, intervention trial evaluated a multi-agency service redesign. Women pregnant with an Indigenous baby birthing at a tertiary hospital were offered standard care or Birthing in Our Community (BiOC) service. We compared likelihood of babies being removed by Child Protection Services (CPS) at birth by model of care. Inverse probability of treatment propensity score weighting controlled baseline confounders and calculated treatment effect. Standardized differences were calculated to assess balance of risk factors for each copy of multiple imputation. Australian New Zealand Clinical Trial Registry, ACTRN12618001365257. RESULTS In 2013-2019, 1988 women gave birth to 2044 Indigenous babies, with 40 women having babies removed at birth (9 BiOC, 31 standard care). Adjusted odds of baby removal were significantly lower for mothers in BiOC compared to standard care (AOR 0.37, 95 % CI 0.16, 0.84). In total, 2.0 % of Indigenous babies were removed by CPS; eight times higher than non-Indigenous babies at the same hospital (0.25 %). CONCLUSIONS BiOC reduced removals of newborn Indigenous babies likely disrupting generational cycles of CPS contact, trauma, and maltreatment, and contributing to short and long-term health and wellbeing benefits for mothers and babies.
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Affiliation(s)
- Birri O'Dea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Adrian Carson
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Rd, Woolloongabba, Queensland 4103, Australia
| | - Renee Blackman
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Rd, Woolloongabba, Queensland 4103, Australia
| | - Maree Reynolds
- Mater Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Kay Wilson
- Mater Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Jo Costello
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia.
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Racine N, Barriault S, Motz M, Leslie M, Poole N, Premji S, Andrews NCZ, Penaloza D, Pepler D. A comparative effectiveness study of the breaking the cycle and Maxxine Wright intervention programs for substance-involved mothers and their children: study protocol. BMC Psychol 2024; 12:16. [PMID: 38183089 PMCID: PMC10768363 DOI: 10.1186/s40359-023-01484-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Children of substance-involved mothers are at especially high risk for exposure to adverse childhood experiences (ACEs) and poor mental health and development. Early interventions that support mothers, children, and the mother-child relationship have the greatest potential to reduce exposure to early adversity and the mental health problems associated with these exposures. Currently, there is a lack of evidence from the real-world setting demonstrating effectiveness and return on investment for intervention programs that focus on the mother-child relationship in children of substance-involved mothers. METHODS One hundred substance-involved pregnant and/or parenting women with children between the ages of 0-6 years old will be recruited through the Breaking the Cycle and Maxxine Wright intervention programs, in Toronto, Ontario, Canada and Surrey, British Columbia, Canada, respectively. Children's socioemotional development and exposure to risk and protective factors, mothers' mental health and history of ACEs, and mother-child relationship quality will be assessed in both intervention programs. Assessments will occur at three time points: pre-intervention, 12-, and 24-months after engagement in the intervention program. DISCUSSION There is a pressing need to identify interventions that promote the mental health of infants and young children exposed to early adversity. Bringing together an inter-disciplinary research team and community partners, this study aligns with national strategies to establish strong evidence for infant mental health interventions that reduce child exposure to ACEs and support the mother-child relationship. This study was registered with clinicaltrials.gov (NCT05768815) on March 14, 2023.
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Affiliation(s)
- Nicole Racine
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L, Canada.
| | - Sophie Barriault
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
| | - Mary Motz
- Mothercraft Breaking the Cycle, 393 King Street East, Toronto, ON, M5A 1L3, Canada
| | - Margaret Leslie
- Mothercraft Breaking the Cycle, 393 King Street East, Toronto, ON, M5A 1L3, Canada
| | - Nancy Poole
- Centre of Excellence for Women's Health, Vancouver, BC, V6H 3N1, Canada
| | - Shainur Premji
- Centre for Health Economics, University of York, York, UK
| | - Naomi C Z Andrews
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Denise Penaloza
- Maxxine Wright Community Health Centre, 13733 92 avenue, Surrey, BC, V3V 1H9, Canada
| | - Debra Pepler
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Segal L, Hiscock H. Child abuse and premature mortality: disrupting the harm cascade. Med J Aust 2023; 219:301-302. [PMID: 37622210 DOI: 10.5694/mja2.52092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
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Segal L, Amos J. The serious health consequences of abuse and neglect in early life. BMJ 2023; 381:930. [PMID: 37137517 DOI: 10.1136/bmj.p930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Leonie Segal
- University of South Australia, Adelaide, Australia
| | - Jackie Amos
- University of South Australia, Adelaide, Australia
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Segal L, Dawe S, Nguyen H, Dennison S, Gnanamanickam ES, Bell M, Spittal M, Kinner S, Preen DB. Child protection system involvement in children of incarcerated mothers: A linked data study. CHILD ABUSE & NEGLECT 2023; 139:106126. [PMID: 36889149 DOI: 10.1016/j.chiabu.2023.106126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Women prisoners are a growing portion of the prison population. Health and social outcomes of their children have been studied and found to be poor, but little is known about child protection outcomes. OBJECTIVES Ascertain child protection system contact of children exposed to maternal incarceration. PARTICIPANTS AND SETTING All children born between 1985 and 2011 exposed to the incarceration of their mothers in a Western Australian correctional facility and a matched comparison group. METHODS A matched cohort study using linked administrative data on 2637 mothers entering prison between 1985 and 2015 and their 6680 children. We estimated hazard ratios (HRs) and incidence rate ratios (IRRs) of child protection service (CPS) contact post maternal incarceration (four concern levels), comparing rates for children exposed to maternal incarceration with a matched non-exposed group, adjusting for maternal and child factors. FINDINGS Exposure to maternal incarceration increased risk of CPS contact. Unadjusted HRs exposed vs unexposed children were 7.06 (95%CI = 6.49-7.69) for substantiated child maltreatment and 12.89 (95%CI = 11.42-14.55) for out-of-home care (OOHC). Unadjusted IRRs were 6.04 (95%CI = 5.57-6.55) for number of substantiations and 12.47 (95%CI = 10.65-14.59) for number of removals to OOHC. HRs and IRRs were only slightly attenuated in adjusted models. CONCLUSIONS Maternal incarceration is a warning flag for a child at high risk of serious child protection concerns. Family-friendly rehabilitative women's prisons, incorporating support for more nurturing mother-child relationships could provide a placed-based public health opportunity for disrupting distressing life trajectories and intergenerational pathways of disadvantage of these vulnerable children and their mothers. This population should be a priority for trauma-informed family support services.
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Affiliation(s)
- Leonie Segal
- Health Economcis and Social Policy Group, University of South Australia, Adelaide, SA, Australia.
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, Qld, Australia
| | - Ha Nguyen
- Health Economcis and Social Policy Group, University of South Australia, Adelaide, SA, Australia
| | - Susan Dennison
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Qld, Australia
| | - Emmanuel S Gnanamanickam
- Health Economcis and Social Policy Group, University of South Australia, Adelaide, SA, Australia
| | - Megan Bell
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Matthew Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia
| | - Stuart Kinner
- Justice Health Unit, The University of Melbourne, Melbourne, Vic, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
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Gnanamanickam ES, Brown DS, Armfield JM, Segal L. Excess hospital costs incurred by individuals with child abuse and neglect history in South Australia: A birth-cohort study. Prev Med 2023; 166:107378. [PMID: 36493867 DOI: 10.1016/j.ypmed.2022.107378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 11/20/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Child abuse and neglect is a serious public health issue across the globe, with documented impacts on health, but the impact on hospital costs, at the population level, is unknown. We aimed to estimate the additional public hospital costs for emergency department visits and admitted patient hospitalizations, for persons with reported child protection concerns, from birth to 31 years and modelled to age 65. Using linked hospital data from 2003 to 2017 for a population birth-cohort of all individuals born in South Australia from 1986 to 2017, we estimated costs of public hospital care. Mean cost and cost differences (adjusted and unadjusted) in 2018 Australian dollars (AU$) were calculated for persons with child protection contact vs none, per person and at the population level. Persons with child protection contact had higher annualized mean hospital costs than those with no contact, with cost differentials increasing with age. Unadjusted differential cost per person was AU$338 (95% CI AU$204-AU$473) from birth to 12 years; increasing to AU$2242 (AU$2074-AU$2411) at ages 25 to 31 years, equating to an additional AU$124 (US$100) million for public hospital services from birth to 31 years, an 18% cost penalty (33% from 13 to 31 years). Modelled to age 65 years, excess costs were estimated at AU$415 (US$337, adjusted: AU$365 and US$296) million, a 27% cost impost. There is a considerable hospital cost penalty associated with persons with reported child protection concerns, especially from adolescence into adulthood, highlighting an opportunity for cost savings by preventive investment in effective early-in-life interventions.
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Affiliation(s)
| | - Derek S Brown
- Institute for Public Health, Washington University in St. Louis, St. Louis, USA
| | - Jason M Armfield
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Leonie Segal
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
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Traumatic head injury due to child maltreatment: epidemiology, cost analysis, and impact of prevention. Childs Nerv Syst 2022; 38:2281-2287. [PMID: 35680684 DOI: 10.1007/s00381-022-05560-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Traumatic head injury due to child maltreatment (THI-CM), also known as abusive head trauma (AHT), is a significant public health problem due to the wide array of consequences affecting multiple domains of a child's health and development. Several studies have evaluated its cost on healthcare systems, families, and societies. Many jurisdictions have implemented caregiver education programs to prevent THI-CM. OBJECTIVES This paper aims to provide a brief overview of the epidemiology and cost analysis of THI-CM and discuss its prevention and the intergenerational transmission of child maltreatment. METHODS Although not systematic, a literature search of original articles published from 2000 to 2022 in English and French was undertaken using the following databases: PubMed, EMBASE (Ovid), and PsycINFO (OVID). The search combined terms related to traumatic head injury and child maltreatment, with terms related to its cost and prevention. Studies of children aged 0-5 years old were included. The authors completed a screen of the titles and abstracts to determine relevance with respect to this article. RESULTS Globally, although THI-CM accounts for a small proportion of cases of child maltreatment, there is a high incidence of death and neurological sequelae compared to other causes of head trauma.The incidence of THI-CM is likely underestimated due to the lack of standardized definitions, differences in reporting, and challenges in identifying less severe cases. Cost analysis studies reveal the significant short- and long-term costs associated with THI-CM. Caregiver education programs have been studied and implemented in many centers and have shown varying but promising results. CONCLUSION A multi-pronged approach to prevention efforts should be considered to support families and help to prevent THI-CM and maltreatment throughout childhood.
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Wiertsema M, Vrijen C, van der Ploeg R, Kretschmer T. Intergenerational Transmission of Peer Aggression. J Youth Adolesc 2022; 51:1901-1913. [PMID: 35657572 PMCID: PMC9363369 DOI: 10.1007/s10964-022-01638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022]
Abstract
It is plausible that peer aggression—like general forms of aggression—is transmitted from one generation to the next. As such, parental behavior in childhood and adolescence may be associated with offspring aggressive behavior against peers. This study used 1970 British Cohort Study data to test intergenerational transmission of peer aggression. The baseline sample consisted of 13,135 participants. At the first assessment that was used in this study, participants were on average 4.95 years old (SD = 0.79; 48.20% female). At the last assessment, participants were on average 33.88 years old (SD = 0.36; 52.1% female). Models were computed for early and middle childhood, and adolescence. Significant associations between parents’ and offspring peer aggression were found in most models – especially when correlating aggression in similar developmental periods for parents and children. Other transmission mechanisms such as genetic transmission may be relevant and should be taken into account in future studies.
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Affiliation(s)
- Maria Wiertsema
- Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands.
| | - Charlotte Vrijen
- Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
| | - Rozemarijn van der Ploeg
- Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
| | - Tina Kretschmer
- Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
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Li J, Li Z, Lei X, Yang J, Yu X, Liu H. Longitudinal Association Between Child Psychological Abuse and Neglect and Academic Achievement in Chinese Primary School Children: A Moderated Mediation Model. Front Psychol 2022; 13:870371. [PMID: 35548529 PMCID: PMC9081801 DOI: 10.3389/fpsyg.2022.870371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
To investigate the relationships among child psychological abuse and neglect (CPAN), children’s learning engagement, family socioeconomic status (family SES), and children’s academic achievement, 271 children (Mage = 9.41 ± 0.81 years old) and their parents participated in this study with a longitudinal design. Results revealed that learning engagement at T1 mediated the relationship between CPAN at T1 and academic achievement at T2 when gender, age, grade, and academic achievement at T1 were under control. Family SES at T1 moderated the relationship between children’s learning engagement at T1 and academic achievement at T2. The association between learning engagement and academic achievement was stronger among children from lower family SES. Our findings highlighted the negative impact of CPAN and the critical role of learning engagement in children’s academic achievement, especially for those from low SES families.
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Affiliation(s)
- Jiajing Li
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Ziying Li
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Xiuya Lei
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Jingyuan Yang
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Xiao Yu
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Haoning Liu
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
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14
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Nakanishi M, Yamasaki S, Niimura J, Endo K, Nakajima N, Stanyon D, Baba K, Oikawa N, Hosozawa M, Ando S, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan. BMJ Open 2022; 12:e058862. [PMID: 35301214 PMCID: PMC8932275 DOI: 10.1136/bmjopen-2021-058862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Perceived capacity denotes a subjective sense of having resources to cope with strains and hardships, and hence maternal perceived capacity may be protective against risk factors for child maltreatment. This study investigated the longitudinal association between maternal perceived capacity in life and child maltreatment. DESIGN This population-based longitudinal study used self-reported questionnaires from the Tokyo Teen Cohort study (TTC), a large community-based cohort study conducted in Japan between 2014 and 2019. SETTING Mother-child pairs were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. METHODS A total of 2515 mothers participated. Mothers' perceived capacity in life was evaluated using the self-reported TTC wave 2 survey when their children were 12 years old. Mothers rated the extent to which they had capacity in terms of time, finance, physical well-being, mental well-being and life in general. Physical punishment, which is linked to more severe childhood maltreatment, was assessed using a question about the use of physical punishment at the wave 3 survey when children were 14 years old. RESULTS After controlling for baseline covariates (including maternal social support, age, marital status, annual household income, educational attainment, child's age, gender, sibling and birth order, and behavioural difficulties), higher perceived capacity in finance (OR 0.95, 95% CI 0.90 to 0.99, p=0.026) and mental well-being (OR 0.93, 95% CI 0.88 to 0.98, p=0.005) were associated with less frequent use of physical punishment with 14-year-old children. CONCLUSIONS Maternal perceived capacity in finance and mental well-being may decrease the risk of frequent use of physical punishment at the 2-year follow-up. Child maltreatment prevention strategies should aim to empower mothers and promote their perceived capacity in financial management and mental health.
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Affiliation(s)
- Miharu Nakanishi
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Junko Niimura
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Kaori Endo
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Naomi Nakajima
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Daniel Stanyon
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | - Kaori Baba
- Graduate School of Nursing, St Luke's International University, Tokyo, Japan
| | - Nao Oikawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Shinjuku-ku, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (The Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
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Purtell J, Mendes P, Saunders BJ. Where Is the Village? Care Leaver Early Parenting, Social Isolation and Surveillance Bias. ACTA ACUST UNITED AC 2021; 4:349-371. [PMID: 34377945 PMCID: PMC8338202 DOI: 10.1007/s42448-021-00084-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 12/24/2022]
Abstract
Young people transitioning from out-of-home care (termed care leavers) are known to be a relatively vulnerable group. One example is their over-representation in early pregnancy and parenting. This paper presents findings from a study of care leaver early parenting in the Australian state of Victoria. Sixteen service provider staff working with care leavers who had become young parents were asked, via focus groups and interviews, for their perspectives on the factors that influence the high prevalence of early parenting amongst care leavers, and the key support services that are available and necessary to assist both care leavers and their children. Service providers raised multiple issues common to the existing leaving care literature concerning the lack of support provided to young people being exited from state care as potentially leading to both early parenting and parenting challenges. Service providers also expressed concern about what many studies of care leaver early parenting have termed 'surveillance bias'. There was a clear consensus that young people transitioning from care face unique challenges and social isolation due to their difficult experiences pre-care, in-care and post-care. Those experiences place them at risk of disadvantages that impede their ability to demonstrate the practical, physical and financial means to safely raise children. At the same time, they are under greater scrutiny than other parents by being known to child protection already. Service providers argued in favour of greater support for young care leaver parents to prevent their children's engagement with child protection systems.
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Affiliation(s)
- Jade Purtell
- Department of Social Work, Monash University, Melbourne, Australia
| | - Philip Mendes
- Department of Social Work, Monash University, Melbourne, Australia
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Straatmann VS, Jackisch J, Brännström L, Almquist YB. Intergenerational transmission of out-of-home care and the role of mental health problems: Findings from Stockholm birth cohort multigenerational study. Soc Sci Med 2021; 284:114223. [PMID: 34325325 DOI: 10.1016/j.socscimed.2021.114223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/15/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
Out-of-home care (OHC) experiences are associated with poor long-term outcomes throughout life. However, the continuity of OHC over generations is not fully explored, and the influence of mental health problems (MHP) and socioeconomic conditions on such transmission is still unclear. We therefore assessed the extent to which MHP affect the intergenerational transmissions of OHC as well as whether there are differential patterns depending on the socioeconomic conditions of the family of origin. We used a prospective data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen) on 11,333 cohort members (Generation 1; G1), their parents (Generation 0; G0), and 24,905 children (Generation 2; G2). Multivariate regressions and path models were used to examine the associations between OHC and MHP across generations; stratified analysis by occupational class in G0 was performed to explore potentially differential patterns. Our findings support the existence of an intergenerational transmission of OHC, particularly in the working class group (OR 4.70); MHP was only transmitted across generations in this group (OR 1.51). While the results indicated a stronger role of MHP among the middle/upper class (OR 5.59) compared to working class (OR 3.52) in part of the pathway (MHP G1→OHC G2), this patter was not consistent throughout the whole pathway (e.g. OHC G1→MHP G1). We conclude that there is a tendency for OHC and MHP experiences to continue across generations, particularly among families with more disadvantageous socioeconomic conditions. MHP seem to play an important role in the transmission of OHC irrespective of socioeconomic conditions.
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Affiliation(s)
- Viviane S Straatmann
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Josephine Jackisch
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Lars Brännström
- Department of Social Work, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Ylva B Almquist
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden.
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Segal L, Doidge J, Armfield JM, Gnanamanickam ES, Preen DB, Brown DS, Nguyen H. Association of Child Maltreatment With Risk of Death During Childhood in South Australia. JAMA Netw Open 2021; 4:e2113221. [PMID: 34110393 PMCID: PMC8193432 DOI: 10.1001/jamanetworkopen.2021.13221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Child maltreatment is a prominent public health concern affecting 20% to 50% of children worldwide. Consequences for mental and physical health have been reported, but population-level estimates of risk of death during childhood that are adjusted for confounders have not been published to date. OBJECTIVE To estimate the association of documented child protection concerns regarding maltreatment with risk of death from infancy to 16 years of age. DESIGN, SETTING, AND PARTICIPANTS This case-control study was nested in a population birth cohort of 608 547 persons born in South Australia, Australia. Case children were those who died between 1 month and 16 years of age (with the death registered by May 31, 2019). Control children were randomly selected individuals from the same population who were alive at the age at which the case child died, matched 5:1 for age, sex, and Aboriginal status. Data were analyzed from January 2019 to March 2021. EXPOSURE Children were assigned to 1 of 4 child protection concern categories (child protection system notification[s] only, investigation[s] [not substantiated], substantiated maltreatment, and ever placed in out-of-home care) based on administrative data from the South Australia Department for Child Protection or were classified as unexposed. MAIN OUTCOMES AND MEASURES Mortality rate ratios for death before 16 years of age, by child protection concern category, were estimated using conditional logistic regression, adjusted for birth outcomes, maternal attributes, and area-based socioeconomic status. Patterns of cause of death were compared for children with vs without child protection concerns. RESULTS Of 606 665 children included in the study, 1635 were case children (57.9% male [when sex was known]; mean [SD] age, 3.59 [4.56] years) and 8175 were control children (57.7% male; mean [SD] age, 3.59 [4.56] years [age censored at the time of death of the matched control child]). Compared with children with no child protection system contact, adjusted mortality rate ratios among children who died before 16 years of age were 2.69 (95% CI, 2.05-3.54) for children with child protection system notification(s) only; 3.16 (95% CI, 2.25-4.43) for children with investigation(s) (not substantiated); 2.93 (95% CI, 1.95-4.40) with substantiated maltreatment; and 3.79 (95% CI, 2.46-5.85) for children ever placed in out-of-home care. External causes represented 136 of 314 deaths (43.3%) among children with a documented child protection concern and 288 of 1306 deaths (22.1%) among other children. Deaths from assault or self-harm were most overrepresented, accounting for 11.1% of deaths in children with child protection concerns but just 0.8% of deaths among other children. CONCLUSIONS AND RELEVANCE In this case-control study, children with documented child protection concerns, who were known to child protection agencies and were typically seen by clinicians and other service providers, had a higher risk of death compared with children with no child protection service contact. These findings suggest the need for a more comprehensive service response for children with protection concerns.
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Affiliation(s)
- Leonie Segal
- Health Economics and Social Policy Group, Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - James Doidge
- Intensive Care National Audit & Research Centre, London, United Kingdom
| | - Jason M. Armfield
- Health Economics and Social Policy Group, Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Emmanuel S. Gnanamanickam
- Health Economics and Social Policy Group, Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - David B. Preen
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Derek S. Brown
- Brown School, Institute for Public Health, Washington University in St Louis, St Louis, Missouri
| | - Ha Nguyen
- Health Economics and Social Policy Group, Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
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18
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Gilbert R, Lacey R. Intergenerational transmission of child maltreatment. LANCET PUBLIC HEALTH 2021; 6:e435-e436. [PMID: 33939967 DOI: 10.1016/s2468-2667(21)00076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ruth Gilbert
- University College London Institute of Child Health, University College London, London WC1E 6BT, UK.
| | - Rebecca Lacey
- Institute of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
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