The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health

Abstract

Children with substantiated child maltreatment (CM) experience adverse health outcomes. However, it is unclear whether substantiation vs. an investigation not resulting in substantiation has a greater impact on subsequent adolescent health. Propensity scores were used to examine the effect of investigated reports on the subsequent health of 503 adolescent females. CM was categorized into three levels: 1) investigated and substantiated, 2) investigated but unsubstantiated, and 3) no investigation. Models using inverse propensity score weights estimated the effect of an investigation on subsequent teen motherhood, HIV-risk behaviors, drug use, and depressive symptoms. Females with any investigation, regardless of substantiation status, were more likely to become teen mothers, engage in HIV-risk behaviors, and use drugs compared to females with no investigated report. Substantiated CM was associated with depressive symptoms. Findings underscore the importance of maintaining case records, regardless of substantiation, to better serve adolescents at risk for deleterious outcomes. Prospective methods and propensity scores bolster causal inference and highlight how interventions implemented following investigation are an important prevention opportunity.

Childhood Physical Neglect Is Associated With Exaggerated Systemic and Intracellular Inflammatory Responses to Repeated Psychosocial Stress in Adulthood

“…However, the CTQ is a widely used instrument and examinations of the effects of child maltreatment experiences outside of the scope of expensive, longterm prospective studies are bound to suffer from assessment challenges as many cases of child maltreatment go unreported even in official records. Somewhat encouragingly, retrospective self-reports may include more false negative than false positive reports, suggesting that associations reported here may be conservative (46). Relatedly, participants in this study were generally healthy and reported overall low to moderate levels of child maltreatment experiences which may explain the absence of hypothesized associations between sexual and physical abuse history and acute inflammatory stress reactivity.…”

Grit-related profiles predict polysubstance use in youth with a history of childhood maltreatment

“…Finally, it is important to acknowledge that 20% of current sample included children with unsubstantiated investigations of CM, which some suggest may confer a different level of risk compared to those with substantiated reports. However, prior work has shown a degree of equivalency between those with and without substantiated CM reports in terms of the risk of adverse/maladaptive long-term outcomes (Kohl, Jonson-Reid, & Drake, 2009;Kugler et al, 2019;Leiter, Myers, & Zingraff, 1994), suggesting a level of similarity in the experiences of those whose cases are investigated but not substantiated and those that are substantiated.…”

“…Although the sample included children with substantiated and unsubstantiated reports of CM, there is long-standing evidence that the physical and psychological consequences of CM do not differ for substantiated and unsubstantiated reports (Kohl, Jonson-Reid, & Drake, 2009;Kugler et al, 2019;Leiter, Myers, & Zingraff, 1994).…”

Differential associations of threat and deprivation with emotion understanding in maltreated children in foster care

“…Nevertheless, the information substantiated in child protection records may be that one most easily proved by social workers, rather than a full account of the children's lived experience. For example, previous research has shown that substantiated and unsubstantiated cases for maltreatment in child protection services do not differentiate with regard to later health outcomes or risk for later reports of maltreatment (Kohl, Jonson‐Reid, & Drake, 2009; Kugler et al, 2019). Therefore, some information relevant for understanding the children's maltreatment experiences may have been missing.…”