According to a new study in JAMA Pediatrics, 1 in 8 American children are estimated to experience a confirmed case of maltreatment before they turn 18. The cumulative prevalence was found to be highest for black and Native American children.
Maltreatment of children can encompass physical, sexual and emotional abuse. There are many associated negative outcomes - physical, mental and social - for children who have been maltreated.
For instance, maltreated children are more likely to have mental health problems than other children and are five times more likely to attempt suicide. They are also 50% more likely to have a juvenile record than other children. Rates of mortality, obesity and human immunodeficiency virus (HIV) infection are significantly higher among people who were maltreated as children.
An article in The Lancet described childhood maltreatment as "a human rights violation and a global public health problem [that] incurs huge costs for both individuals and society."
Disparity in previous reports over childhood maltreatment prevalence
But it is difficult to ascertain how many individuals are affected by maltreatment as children. Data based on retrospective self-reports have suggested that more than 40% of children are maltreated. However, officially documented cases of maltreatment in Child Protected Services (CPS) reports are much lower. In 2011, for instance, CPS data reported that 0.9% of children are confirmed victims of maltreatment.
To better determine the prevalence of childhood maltreatment, the new study analyzed the National Child Abuse and Neglect Data System Child File, which includes information on all American children with a confirmed case of maltreatment. In total, the records include 5.6 million children during the period 2004-2011.
Maltreated children are more likely to have mental health problems than other children and are five times more likely to attempt suicide.
The researchers found that, at 2011 rates, 12.5% of all American children - 13% of girls and 12% of boys - will experience a confirmed case of maltreatment by the age of 18.
The prevalence varied across racial groups:
- Black - 20.9%
- Native American - 14.5%
- Hispanic - 13%
- White - 10.7%
- Asian/Pacific Islander - 3.8%.
The study also found that children are at the highest risk for maltreatment in the first few years of life. By the age of 1, 2.1% of children will have experienced a confirmed case of maltreatment, and 5.8% will have experienced a confirmed case by the age of 5.
The researchers conclude:
"The results from this analysis - which provides cumulative rather than annual estimates - indicate that confirmed child maltreatment is common, on the scale of other major public health concerns that affect child health and well-being.
Because child maltreatment is also a risk factor for poor mental and physical health outcomes throughout the life course, the results of this study provide valuable epidemiologic information."
Earlier this year, a study published in the journal Development and Psychopathology found that although 40% of maltreated children develop post-traumatic stress disorder (PTSD) later in life, the 60% that do not develop PTSD may avoid it by talking about their painful experiences, thoughts and emotions.
People in the study who had been maltreated as children, but who had tried to avoid the painful thoughts and emotions, were significantly more likely to develop PTSD, the study found.