Annual Research Review: Umbrella synthesis of meta‐analyses on child maltreatment antecedents and interventions: differential susceptibility perspective on risk and resilience

Abstract

Child maltreatment in the family context is a prevalent and pervasive phenomenon in many modern societies. The global perpetration of child abuse and neglect stands in stark contrast to its almost universal condemnation as exemplified in the United Nation’s Convention on the Rights of the Child. Much work has been devoted to the task of prevention, yet a grand synthesis of the literature is missing. Focusing on two core elements of prevention, that is, antecedents for maltreatment and the effectiveness of (preventative) interventions, we performed an umbrella review of meta‐analyses published between January 1, 2014, and December 17, 2018. Meta‐analyses were systematically collected, assessed, and integrated following a uniform approach to allow their comparison across domains. From this analysis of thousands of studies including almost 1.5 million participants, the following risk factors were derived: parental experience of maltreatment in his or her own childhood (d = .47), low socioeconomic status of the family (d = .34), dependent and aggressive parental personality (d = .45), intimate partner violence (d = .41), and higher baseline autonomic nervous system activity (d = .24). The effect size for autonomic stress reactivity was not significant (d = −.10). The umbrella review of interventions to prevent or reduce child maltreatment showed modest intervention effectiveness (d = .23 for interventions targeting child abuse potential or families with self‐reported maltreatment and d = .27 for officially reported child maltreatment cases). Despite numerous studies on child maltreatment, some large gaps in our knowledge of antecedents exist. Neurobiological antecedents should receive more research investment. Differential susceptibility theory may shed more light on questions aimed at breaking the intergenerational transmission of maltreatment and on the modest (preventive) intervention effects. In combination with family‐based interaction‐focused interventions, large‐scale socioeconomic experiments such as cash transfer trials and experiments with vouchers to move to a lower‐poverty area might be tested to prevent or reduce child maltreatment. Prevalence, antecedents, and preventive interventions of prenatal maltreatment deserve continuing scientific, clinical, and policy attention.

Study of the Differential Consequences of Neglect and Poverty on Adaptive and Maladaptive Behavior in Children

“…This study could be a small step beyond the assertion of Van IJzendoorn et al [3] that a low socio-economic level is a risk factor for the possible presence of neglect. Following the suggestions made by Schumaker [62] and Chapple and Vaske [63], it sheds some light on the controversy inasmuch that it is important to distinguish between poverty and neglect as predictors of adaptation problems.…”

“…Jonson-Reid et al [56], for example, in their systematic review of longitudinal research into experiences of child maltreatment and economic outcomes in adulthood found (despite an extremely limited evidence base) that neglect had a consistent relationship with several long-term economic outcomes such as reduced income, unemployment, lower levels of professional skills, and fewer assets. As Van IJzendoorn et al [3] recently asserted in a meta-analysis of 28 studies into neglect, socio-economic status is a predictor of elevated risk for child maltreatment.…”

“…The failure of a caregiver to provide the food, clothing, shelter, medical care, or supervision required to ensure that a child's health, safety, and wellbeing are not harmed has been defined as physical neglect [1,2], a subtype of child maltreatment with a global prevalence, according to the meta-analysis recently carried out by Van IJzendoorn, Bakermans-Kranenburg, Coughlan, and Reiiman [3], of 163/1000. Neglect has serious consequences for children's development and for their physical and mental health [1,[4][5][6][7].…”

“…Poverty correlates highly with neglect. Its harmful consequences, widely identified in many literature reviews, can be observed from the earliest stages of children's lives [3,27,[34][35][36][37][38][39][40]. Children who live in poor families manifest more behavioral and emotional problems [41].…”

“…In this regard, both Schumaker [62] and Chapple and Vaske [63] argue that it is necessary to discriminate the consequences of poverty on development during childhood and adolescence from those attributable to child abandonment, because poverty alone cannot explain the results of their studies; and yet, as noted by Van IJzendoorn and others [3], researchers have tended to focus almost exclusively on poverty as a risk factor for abandonment or abuse. It is therefore necessary to conduct studies to distinguish the consequences of poverty from those of neglect itself, because very little research has been carried out in this area to date.…”