Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect

Author:

Strathearn Lane12,Giannotti Michele3,Mills Ryan45,Kisely Steve678,Najman Jake4,Abajobir Amanuel49

Affiliation:

1. Department of Pediatrics, Carver College of Medicine, The University of Iowa, Iowa City, Iowa;

2. Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City, Iowa;

3. Department of Psychology and Cognitive Science, University of Trento, Trento, Italy;

4. School of Public Health, The University of Queensland, Herston, Queensland, Australia;

5. Department of Paediatrics, Logan Hospital, Meadowbrook, Queensland, Australia;

6. School of Medicine, The University of Queensland and Princess Alexandra Hospital, Woolloongabba, Queensland, Australia;

7. Departments of Psychiatry and

8. Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; and

9. Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya

Abstract

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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