Regionally representative survey data published in Journal of Interpersonal Violence indicated that parental mental illness, addiction and domestic violence were strongly associated with childhood physical abuse.
WHO cautions against universal screening to detect children who are maltreated, but an alternative strategy may be to implement a stepwise approach where families are first screened for salient risk factors that are strongly linked to abuse, according to Esme Fuller-Thomson, PhD, professor and Sandra Rotman Endowed Chair, Factor-Inwentash Faculty of Social Work & Faculty of Medicine, University of Toronto, and colleagues.
“Children in families that are identified as being ‘high risk’ can then be further screened for physical abuse,” they wrote. “This targeted approach would likely result in a reduction of false positives and provide a more efficient use of the limited child welfare resources.”
Fuller-Thomson and colleagues examined three potential correlates of childhood physical abuse: childhood exposure to parental domestic violence, parental addictions, and parental mental illness using data from the 2010 (n = 9,241 men; n = 13,627 women) and 2012 (n = 11,656 men; n = 18,145 women) Brief Risk Factor Surveillance Survey (BRFSS).
“By determining the association between childhood physical abuse and these factors, we hope to establish whether a cluster or cumulative model is better at identifying those with a history of childhood physical abuse,” they wrote.
They combined the data using a cumulative model and a cluster model to determine which was better at detecting adults with a history of childhood abuse. The cluster model involved looking at the link between childhood physical abuse and particular combinations of the three risk factors, while the cumulative model involved examining only the number of the three risk factors present, according to the study.
Adults with parental addiction, parental mental illness and parental domestic violence were about 10 times more likely to have a history of childhood physical abuse than those without these risk indicators in 2010 (78.3% vs. 7.5% for males; 66.9% vs. 5.9% for females), according to the results. Even without parental mental illness or addiction, parental domestic violence was linked to a 38% prevalence of physical abuse among men and women.
Using the cluster model and the cumulative risk model, logistic regression analyses showed that compared with adults with no risk factors, women with all three risk factors present were 32.7 times more likely to have childhood physical abuse and men were 44.7 times more likely.
The researchers observed similar findings for the 2012 analyses.
Although the cluster model provided a slightly better fit than the cumulative model for men and for women in the 2010 survey, clinicians may find the cumulative model easier to adopt, according to the authors.
“There is an urgent need for a more nuanced screening protocol for childhood physical abuse because early detection has important implications for preventing future incidents of abuse and their cascade of negative sequelae. In this light, the proposed hybrid model warrants further investigation,” Fuller-Thomson and colleagues wrote. – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.