Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis

Abstract

BackgroundBuilding an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare.MethodsThe sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model.ResultsAbout half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference).ConclusionsGreater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be proactive in prevention or intervention for adults with perpetration risk.Electronic supplementary materialThe online version of this article (10.1186/s12199-018-0703-6) contains supplementary material, which is available to authorized users.

Child maltreatment is mediating long-term consequences of household dysfunction in a population representative sample

“…Felitti et al showed a high correlation between different [34]. A study from Ohashi and colleagues showed in a Japanese sample that the risk for child maltreatment increases with the number of ACEs related to household dysfunction [35]. In an Australian study, where a sample of 7223 mothers and their offspring was assessed, odds for maltreatment ranged between 2.0 and 3.5 in case of IPV in dependence of maltreatment subtype and gender of the child [27].…”

“…In a later analyses based on the same data, Felitti et al showed increased ratios for child maltreatment in case of household substance abuse (odds ranging between 2.1–3.0 in dependence of the subtype of maltreatment), mental illness (odds 2.1–4.2), domestic violence (odds 2.5–5.9), incarcerated household member (odds 2.3–2.7) and parental separation (odds 2.0–2.6) [34]. A study from Ohashi and colleagues showed in a Japanese sample that the risk for child maltreatment increases with the number of ACEs related to household dysfunction [35]. In an Australian study, where a sample of 7223 mothers and their offspring was assessed, odds for maltreatment ranged between 2.0 and 3.5 in case of IPV in dependence of maltreatment subtype and gender of the child [27].…”

Troubled childhoods cast long shadows: Childhood adversity and premature all-cause mortality in a Swedish cohort

“…A common explanation for the association between involvement with CWS and premature mortality is that the problems in the family of origin deprive a child from reaching their full developmental potential. Greater exposure to household dysfunction is related to registration with child welfare and to having been the victim of maltreatment (Ohashi et al, 2018). Nonetheless, relatively few studies have examined the differential relationships between household dysfunction and CWS involvement explicitly.…”

Childhood adversity subtypes and violence victimization and perpetration among early adolescents in Shanghai, China

“…The ACE subtypes were usually generated by discrete groups with similar patterns of ACE exposure [ 9 ]. Evidence suggests that in many young people, ACEs with significant interrelations between the different types or groups [ 10 , 11 ] usually occur simultaneously in multiple rather than simple forms and have cumulative effects [ 9 , 12 ]. In the surveys undertaken in eight eastern European countries to evaluate ACEs among young adults, the results showed that over half of the respondents reported at least one ACE, and experience of one ACE increased the probability of having other ACEs [ 13 ].…”