A Systematic Review of Childhood Maltreatment Assessments in Population-Representative Surveys Since 1990

<div><p>Background</p><p>Population-representative surveys that assess childhood maltreatment and health are a valuable resource to explore the implications of child maltreatment for population health. Systematic identification and evaluation of such surveys is needed to facilitate optimal use of their data and to inform future research.</p><p>Objectives</p><p>To inform researchers of the existence and nature of population-representative surveys relevant to understanding links between childhood maltreatment and health; to evaluate the assessment of childhood maltreatment in this body of work.</p><p>Methods</p><p>We included surveys that: 1) were representative of the non-institutionalized population of any size nation or of any geopolitical region ≥ 10 million people; 2) included a broad age range (≥ 40 years); 3) measured health; 4) assessed childhood maltreatment retrospectively; and 5) were conducted since 1990. We used Internet and database searching (including CINAHL, Embase, ERIC, Global Health, MEDLINE, PsycINFO, Scopus, Social Policy and Practice: January 1990 to March 2014), expert consultation, and other means to identify surveys and associated documentation. Translations of non-English survey content were verified by fluent readers of survey languages. We developed checklists to abstract and evaluate childhood maltreatment content.</p><p>Results</p><p>Fifty-four surveys from 39 countries met inclusion criteria. Sample sizes ranged from 1,287-51,945 and response rates from 15%-96%. Thirteen surveys assessed neglect, 15 emotional abuse; 18 exposure to family violence; 26 physical abuse; 48 sexual abuse. Fourteen surveys assessed more than three types; six of these were conducted since 2010. In nine surveys childhood maltreatment assessments were detailed (+10 items for at least one type of maltreatment). Seven surveys’ assessments had known reliability and/or validity.</p><p>Conclusions and Implications</p><p>Data from 54 surveys can be used to explore the population health relevance of child maltreatment. Assessment of childhood maltreatment is not comprehensive but there is evidence of recent improvement.</p></div

Does mandatory reporting legislation increase contact with child protection? – a legal doctrinal review and an analytical examination

Abstract Background Within Canadian provinces over the past half-century, legislation has been enacted to increase child protection organization (CPO) involvement in situations of child maltreatment (CM). This study had two objectives: 1) to document enactment dates of legislation for mandatory reporting of CM; 2) to examine reported CPO involvement among people reporting a CM history in relation to the timing of these legislative changes. Methods The history of mandatory reporting of CM was compiled using secondary sources and doctrinal legal review of provincial legislation. The 2012 Canadian Community Health Survey - Mental Health (CCHS-MH) with n = 18,561 was analyzed using birth cohorts to assess associations between the timing of legislation enactment and contact with CPO. Results All Canadian provinces currently have mandatory reporting of physical and sexual abuse; 8 out of 10 provinces have mandatory reporting for children’s exposure to intimate partner violence. Increases in reporting CM to CPOs paralleled these laws’ enactment, particularly for severe and frequent CM. Conclusions These findings show that mandatory reporting laws increase reporting contact with CPO, particularly for severe and frequent CM. Whether they have had the intended effect of improving children’s lives remains an important, unanswered question

Depression, parenting and the COVID-19 pandemic in Canada: results from three nationally representative cross-sectional surveys

Objectives Depression is associated with problems in functioning in many aspects of life, including parenting. COVID-19 has increased risk factors for depression. We investigated the prevalence of depression among parents during the pandemic and the association with dysfunctional parenting.Design Canadian nationwide cross-sectional study.Setting and participants The 2020 and 2021 Surveys on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015‒2019). Responding sample sizes for parents were 3121 for the 2020-SCMH; 1574 for the 2021-SCMH and 6076 for the CCHS.Primary outcome measures All three surveys collected information on symptoms of major depressive disorder (MDD). The SCMH measured harsh parenting.Results Based on data from the 2021-SCMH collected during wave 3 of COVID-19, 14.4% of fathers and 21.2% of mothers screened positive for MDD. These prevalence estimates were similar to those from the 2020-SCMH during wave 2, but at least two times higher than pre-COVID-19 estimates from the CCHS. Multivariate analyses revealed a linear association between MDD and harsh parenting. COVID-19-related stressors were associated with harsh parenting. Among mothers, feeling lonely or isolated because of COVID-19 was a risk factor for harsh parenting; among fathers, being a front-line worker was a risk factor. Meditation was a protective factor for mothers.Conclusions After years of stability, the prevalence of MDD increased substantially among Canadian parents during the pandemic. Ongoing monitoring is vital to determine if elevated levels of depression persist because chronic depression increases the likelihood of negative child outcomes. Programmes aimed at addressing depression and bolstering parenting skills are needed as families continue to face stressors associated with COVID-19

Childhood maltreatment as a risk factor for diabetes: findings from a population-based survey of Canadian adults

Abstract Background It is well established that childhood maltreatment (CM) is a risk factor for various mental and substance use disorders. To date, however, little research has focused on the possible long-term physical consequences of CM. Diabetes is a chronic disease, for which an association with CM has been postulated. Methods Based on data from a sample of 21,878 men and women from the 2012 Canadian Community Health Survey - Mental Health (CCHS - MH), this study examines associations between three types of CM (childhood physical abuse (CPA), childhood sexual abuse (CSA), and childhood exposure to intimate partner violence (CEIPV)) and diabetes in adulthood. Multiple logistic regression models were used to examine associations between CM and diabetes controlling for the effects of socio-demographic characteristics and risk factors for type 2 diabetes. Results When controlling socio-demographic characteristics, diabetes was significantly associated with reports of severe and frequent CPA (OR = 1.8) and severe and frequent CSA (OR = 2.2). A dose–response relationship was observed when co-occurrence of CSA and CPA was considered with the strongest association with diabetes being observed when both severe and frequent CSA and CPA were reported (OR = 2.6). Controlling for type 2 diabetes risk factors attenuated associations particularly for CPA. CEIPV was not significantly associated with having diabetes in adulthood. Conclusion CPA and CSA are risk factors for diabetes. For the most part, associations between CPA and diabetes are mediated via risk factors for type 2 diabetes. Failure to consider severity and frequency of abuse may limit our understanding of the importance of CM as a risk factor for diabetes